The Use of Exparel for Breast Augmentation

Most patients who are seeking breast augmentation have concerns about the management of postoperative pain after their augmentation.  We use Exparel which is a long-acting local anesthetic (liposomal Marcaine) that is injected around the breast at the time of surgery.  This allows for pain relief for up to 5 days after surgery leading to less use of narcotics by patients. Narcotic usage is a major concern for patients due to risks of abuse, associated side effects i.e. nausea and vomiting, and overall effects on cognition and motor activity.  

Reducing the need for postoperative narcotics is a welcome addition to the treatment regimen for most patients seeking breast augmentation. As seen in the accompanying video, Exparel is injected around the breast at the time of the surgery with the patient under general anesthesia.  We are targeting the intercostal nerves of the T3 – T5 dermatomes and the underlying pectoralis muscle. The patient will then have anesthesia of the breast tissue as well as the pectoralis muscle under which the implant is placed in the majority of cases.