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The "Painless Breast Augmentation:" Separating Fact from Fiction


There seems to be a lot of attention recently about pain-free cosmetic procedures and especially breast augmentation. Most of this surrounds a new promising long-term local numbing medicine that has far reaching implications. This local numbing medicine has been specifically studied with breast augmentation and showed good results with little to no complications.* This is potentially exciting to aesthetic patients who often fear discomfort associated with various cosmetic procedures. Often this is the only reason they don’t proceed with their desires.  However, there has been no study showing that any method of breast augmentation or use of special medicines has led to consistent “painless breast augmentations.”

Rabecca breast augmentationDepofoam Bupivicaine is a longer-acting form of an already long-acting local numbing medicine. It has been formulated in a way that allows for slower absorption which can result in decreased pain and use of oral pain medication for the first 1-3 days.   This critical time period for most cosmetic procedures is when discomfort is at its highest. The idea of locally numbing a surgical incision long term is not new. It is known that if patients can reduce the amount of pain medicines after surgery, they may also face a reduction in the complications associated with them. Side effects from narcotics usually consistent of constipation, nausea, itching, and headaches . In recent years, doctors have tried “pain pumps” that contain lidocaine (a shorter acting local numbing medicine) to pump the solution into the surgical wound. The problem with this approach is that it can add significant cost to an already costly procedure since most cosmetic procedures are not covered by insurance. Further, the pump contains a catheter that goes through the skin. This allows for a potential source for infections as skin bacteria can have a direct route into the incision. These pain pumps also add time to the surgical procedure, and while it may only represent an extra few minutes, the quicker the procedure the less likely the patient will have complications.

Depofoam Bupivicaine may alleviate the above problems with the exception of one…cost. Currently the newly developed product, is expensive at $150 per treatment. This is a significant expense when a patient is already budgeting $3,000-$5,000 for her breast augmentation.  However, when being used for “breast reconstruction” (i.e. post mastectomy for cancer, etc.) insurance may cover the cost of the product.

Depofoam Bupivicaine is very promising, and hopefully over time it will become more cost effective for our cosmetic surgery patients. It is important to note that as physicians we should never promise a “pain-free” procedure, and this is no exception. The results from the study do show “improvement in pain control” and "decreasing the amount of narcotics taken” but the study did not indicate that patients were pain-free. Further evidence may show that Depofoam is a great treatment for surgical pain, but additional study is needed.  We will keep researching the latest advances in cosmetic surgery and bring them to you at Southern Surgical Arts.

About the Chattanooga cosmetic surgery center – Southern Surgical Arts
With two offices, Board-Certified Cosmetic Surgeons Carey Nease, MD and Chad Deal, MD serve the Chattanooga, North Georgia and North Alabama regions with cosmetic surgery offerings including Face & Neck Lifts, Laser Assisted Face Lifts, Eye & Brow Lifts, Rhinoplasty & Nose Reshaping, Breast Augmentation, Breast Lifts & Reductions, SmartLipo, Liposculpture & Laser Body Sculpting, Tummy Tucks, Brazilian Butt Lifts and Mommy Makeovers. Visit to schedule a free cosmetic surgery consultation.

-The Efficacy and Safety of Depofoam Bupivacaine in Patients Undergoing Bilateral, Cosmetic, Submusclar Augmentation Mammaplasty. Smoot, Bergese, Williams and Hedden.
-A Two-Year Observational Study Assessing the Safety of DepoFoam Bupivacaine After Augmentation Mammaplasty. Minkowitz, Onel, Patronella and Smoot.


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