In breast reduction surgery, a doctor removes skin and breast tissue from large breasts and reshapes them into a smaller, lighter and firmer pair.
Less Pain After Breast Augmentation
Breast augmentation involves making a pocket beneath the big muscle (Pectoralis major) of the chest. This requires separating the muscle from the chest wall and actually cutting it along its inferior border. This leads to immense post operative pain. Some doctors try to decrease this pain by placing a “pain pump” in the wound before the patient wakes up. This involves a tube that comes through the skin and is attached to a pump that constantly instills a small amount of anesthetic for the first 24 hours. The problem is these pumps don’t always work (they either clog or aren’t in the right place), plus they have to be taken out. Other doctors rinse the pocket with an anesthetic before the patient wakes up. This is a short term solution and isn’t reliable. You can also give the patient large doses of narcotics in the recovery room, but this leads to nausea, vomiting and a longer time in recovery before you can go home. We thought there must be a better way.
We wanted our patients to have the least possible pain in recovery and for that pain relief to last as long as possible. We knew that liposuction patients have very little pain after surgery. One of the reasons is the tumescent solution that is infused into the fat has an anesthetic and it stays in the tissues for an extended period. We also knew that an anesthetic injected into, rather than rinsed over, the muscle lasts longer. In addition, there are different kinds of anesthetic. Some last longer than others. We decided to try injecting the pocket area with tumescent solution before the pocket is made AND directly injecting any muscle that had to be cut during the procedure with a long acting anesthetic (Marcaine). We were amazed at the results.
The recovery room nurses came to us asking what we were doing differently. They noted our patients were completely comfortable in the recovery room and were able to be discharged sooner than patients that did not receive our treatment. Our patients also reported they had no discomfort until the next day and that this was easily controlled with oral medication.
We went back and compared our last 100 patients using our new pain control method to the previous 100 that had not received the treatment. The results confirmed our initial impressions. The women that received the extra measures went home sooner, used less post operative pain medicine, had less nausea, and most importantly were more comfortable.
We are in the process of writing our technique and submitting it for publication so that other doctors can help their patients too.
Cosmetic Surgery Associates