Chronic pain in women after breast augmentation: Prevalence, predictive factors and quality of life

Chronic pain is a common complaint after surgery (Macrae, 2001; Kehlet et al., 2006). Because little is known about chronic pain after cosmetic surgery we investigated the prevalence of chronic pain after breast augmentation, tried to identify possible characteristics of patients developing chronic pain, measured cosmetic satisfaction after surgery and determined quality of life. We performed a retrospective, mono-center study and used a questionnaire which included questions about presence of pain, biometric characteristics, a cosmetic satisfaction VAS, the McGill Pain Questionnaire and the RAND-36 Health Survey and we contacted 494 female patients who underwent breast augmentation from 2002 to 2005. We defined chronic post-surgery pain, according to the International Association for the Study of Pain, as “persisting continuous or intermittent pain for more than 3months after surgery and different from the preoperative pain” (IASP, 1986). The unpaired Student's T-test and ANOVA were used for intergroup comparisons. We received 317 questionnaires (64%) of which 265 were complete and suitable for analysis (54%) with a mean follow-up of 27months (SD±10months). We found a point prevalence of 25% for chronic pain and a cumulative prevalence of 31%. Three smaller studies showed similar results: 38% (Wallace et al., 1996), 13% (Romundstad et al., 2006) and 18% (Hölmich et al., 2007) of patients reported chronic breast pain after prosthetic breast augmentation. Patients with chronic pain were younger (p=0.008) and smaller (p=0.016). Reported cosmetic satisfaction was less in patients with chronic pain (p<0.001). Of the patients with chronic pain 9% reported a VAS for pain of ≥50mm. Reported quality of life was inferior in patients with chronic pain vs. patients without pain (p<0.05) regarding physical and social functioning, physical limitations and mental health. See Table 1 for full results. This large scale investigation shows that chronic pain is a common complaint after breast augmentation. Predictive factors for chronic pain are young age and smaller body height. Cosmetic satisfaction and quality of life are less in patients with chronic pain after breast augmentation compared to patients without chronic pain.