Patients who are on chronic pain meds are difficult to treat with local/IV sedation. We treat these patients best with general anesthesia. Also, it is likely that routine pain meds will not be adequate, therefore I strongly encourage the usage Exparel at the time of surgery. It provides three days of very good pain relief with no side effects and patients LOVE it.

Published on Jul 11, 2012

Our policy is that patients under the care of an addiction or pain specialist handles the post op pain meds. Others may do it differently, but I don't think it's a good idea for the breast surgeon managing your pain. My suggestion would be to have your addiction doc increase your suboxone or split doses for 2-3 days post op--muscle relaxant might be marginally helpful.

Published on Jul 11, 2012

Proper technique should result only in mild to moderate discomfort after breast augmentation surgery. Our patients take some mild narcotic medication for a day or two. In your particular case, your pain management should be pre-arranged by your surgeon and your addiction doctor. We have treated a number of recovering patients without any relapse, not unusual pain med requirements. Good luck on your procedure.

Published on Jul 11, 2012

You should have no problem with the aug, but I think your post-op pain management should be with your normal pain doctor and your plastic surgery getting together to discuss this.

Published on Jul 11, 2012

Thank you for your question. This is a situation where, in my practice, I would certainly have a team approach to post-operative pain relief. I would consult your addiction specialist, as well as a pain specialist to collaborate on what would be the most efficacious approach to post-op pain management. Additionally, I find that muscle relaxers are certainly an excellent adjunct pain reliever in breast surgery, because most of the pain typically originates from muscle spasms in this type of surgery (when placing the implants under the muscle). I hope this information is helpful!

Published on Jul 11, 2012

This is better addressed with your addiction physician, and is usually tailored and individual for each patient.

Published on Jul 11, 2012

Post-op pain control and management of suboxone after surgery should be done by your addiction specialist more so than your plastic surgeon. The best step is getting both physicians on board with your medical history so that your addiction doctor can plan with your plastic surgeon. Other additional steps would be to have someone accountable for your pain medication and muscle relaxers in and around the time of surgery, so that they are distributed correctly. Long acting local anesthetics like Exparel could be considered to help give a long lasting local block that will help to limit your discomfort. In general, breast augmentation, when done correctly, should be a straightforward and short recovery. Anti-inflammatory medications are very important and should be started as soon as possible after the procedure.

Published on Jul 11, 2012