A Popular Cosmetic Procedure
Breast augmentation is a highly sought-after procedure. More than 300,000 augmentations are done each year in the United States, making it one of the top-ranking cosmetic surgeries. Despite recent interest in above-the-muscle augmentations—which I wholeheartedly disagree with—by far, the majority of augmentations are done by placing the implant beneath the pectoralis muscle. This allows the muscle to act as structural support, giving the breast a longer-lasting, more natural appearance.
Going above the muscle to decrease surgical discomfort is shortsighted. The ligaments that anchor the breast and skin to the muscle (Cooper’s ligaments) are disrupted, leaving only the skin to support the weight of the implant. Over time, this will lead to more sagging than if the implant were placed beneath the muscle.
Understanding Post-Operative Pain
One issue with going beneath the muscle is post-operative pain. This occurs because the pectoralis muscle must be elevated off the underlying chest wall and transected (cut) along its inferior border near the inframammary crease. A pain pump can be placed to decrease pain, but they can be a bother. Another way to decrease pain is to gently handle the tissue—only touching the chest wall as necessary—and cutting the muscle with a cautery.
Reducing Pain Through Surgical Technique
In addition, I have found—and shown—that using long-acting anesthetic injected into the cut muscle and the lateral chest wall, as well as tumescent fluid infiltration, can markedly decrease post-operative pain. We studied patients who had augmentations done by us with and without the use of injected long-term pain medicine and found a marked decrease in pain using our technique.
You can read our paper here. We published our findings to help other surgeons decrease pain in their patients by showing that it is superior to just “rinsing” the pocket with an anesthetic.
Schedule a Consultation with Dr. Jabs
I look forward to seeing you in the office and discussing how I can help you reach your goals.
If you’re considering breast augmentation or want to learn more about my approach to minimizing discomfort and achieving natural results, schedule a consultation with Dr. Jabs at Cosmetic Surgery Associates. Call our office or request an appointment online today to get started on your personal transformation.
Article by Dr. Arthur Jabs, board-certified plastic surgeon in the Washington, D.C. metro area, specializing in deep plane facelift and natural facial rejuvenation.
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