Putting it all together: managing pain in autologous and implant-based breast reconstruction.

BACKGROUND: Appropriate pain management in breast reconstruction improves outcomes and patient satisfaction. The purpose of this study is to review the current methodology and paradigms in pain management following breast reconstruction.
METHODS: A review of the scientific literature was performed. The protocols used at our institution were further examined and contrasted in the context of this published literature.
RESULTS: Pain following breast reconstruction is multifactorial and patient specific. Pain can originate from the mastectomy alone, from the donor site, or from tissue expansion. Counseling a patient is of upmost importance. The armamentarium to address pain includes narcotic analgesics, nonnarcotic analgesics, local anesthesia, and other nontraditional regimens. Each of these methods has an evidence-based efficacy and patient selection factors for application.
CONCLUSIONS: The data contained herein provide a review of perioperative pain management following autologous and implant-based breast reconstruction.