Persistent pain and sensory changes following cosmetic breast augmentation

Abstract

Background Persistent postsurgical pain has been reported following cosmetic breast augmentation, but little is known about the underlying mechanisms. Aims To describe the prevalence, character, and impact of sensory changes and chronic pain following cosmetic breast augmentation and to assess possible causes of pain. Methods In September 2009, a detailed questionnaire was mailed to all 142 patients who underwent cosmetic breast augmentation at Viborg Private Hospital from 2004 to 2009. Results Ninety-five patients (66.9%) returned the questionnaire; mean age was 34.2 years (SD 9.3). All patients were operated by the same surgeon. Mean time since operation was 31.8 months. Forty-two patients (44.2%) reported having pain as a consequence of the operation, 9.5% had moderate to severe pain, and 6.3% regretted the cosmetic surgery due to pain. Patients with pain were less satisfied with the surgery than those without pain. Seventy-two patients (75.8%) had sensory changes over the breast. There was an increased risk for developing pain in those with hypoesthesia (OR 4.6 (1.7–12.8)) and hyperesthesia (OR 2.6 (1.1–6.2)). Sixty-two percent had touch-evoked pain and 38% used pain descriptors that met the neuropathic pain diagnostic questionnaire (DN4) cut-off criteria for neuropathic pain. Conclusion Sensory changes and persistent pain are common following cosmetic breast augmentation and may have a negative impact on daily activities and satisfaction after surgery. Findings suggest that neuropathic pain should be considered in these patients. Preoperative information about the risk of developing sensory changes and chronic pain after breast augmentation is important.