Q: Dr. Eppley, I have reads that some doctors offer pain-free breast augmentations. How does that work and why isn’t that done for every braest augmentation surgery. Who would not want it?
A: The idea of a pain-free breast augmentation is more of a marketing concept that a reality. It is simply an impossibility to lift up the chest muscle (pectoralis muscle) and put an implant underneath it that is without pain anymore than it is to tear a muscle without any discomfort. What this so-called ‘pain-free’ procedures are is that they incorporate a new long-lasting local anesthetic. This new type of local numbing medicine, known as Exparel or Depofoam Bupivicaine, has been specifically studied in breast augmentations (as well as other plastic surgery procedures) and has shown showed good results with no complications. This local anesthetic when injected into the muscle during the breast augmentation does reduce pain after the procedure that has a lasting effect upt o three days afster surgery. While pain may be reduced, no study has ever shown that any method of breast augmentation can result in a ‘pain-free breast augmentation’. It may reduce the pain one may feel after surgery but will not eliminate it completely.
Exparel is a longer-acting form of an already long-acting local numbing medicine. (Bupivicaine or Marcaine) It is formulated in a liposome carrier that allows for slower absorption and lasting effects up to 3 days after surgery. This is a critical period for most cosmetic procedures as this is when the most severe discomfort occurs. This also reduces the need for oral narcotics and reduces the likelihood of nausea and vomiting and constipation, all common side effects of pain medication in women.
The one problem with Exparel injections is the cost. It adds at least $200 for the injections in a single patient, a significant expense when a patient is already paying $4,000 to $6,000 for their breast augmentation.
Dr. Barry Eppley