What is the most painful plastic surgery to recover from?

What’s standing between you and full bust, a flat stomach, or a straight nose — or all of the above? If you’re like many people, the answer is the fear of pain. A study on attitudes about plastic surgery that appeared in the World Journal of Plastic Surgery showed that pain from surgical procedures is one reason prospective surgery patients shy away from going under the knife. But doctors say these surgical procedures hurt a lot less than you’d expect. “A good example of this is breast augmentation,” says Gregory A. Buford, MD, a board certified plastic surgeon in Englewood, CO. “I can't tell you how many patients say that their recovery was far easier than they thought it would be.”

Still, since invasive procedures involve going beneath the skin—and having stuff slipped in, sucked out, or trimmed down—there is usually some degree of discomfort afterward. general and local anesthesia ensure you don’t feel pain during the actual operation, the post-procedure pain is a big deterrent. We asked Dr. Buford and Jason Bloom, MD, a board certified facial plastic surgeon in Ardmore, PA, to reveal exactly how much each cosmetic surgery procedure hurts, how much pain to expect, and for how long you can anticipate being sore during the recovery period.

Breast Augmentation

Pain Rating: 3 to 5/10 Unlike a breast lift, breast implants are inserted into the body either over or under the chest muscle. Dr. Buford, and many other cosmetic surgeons, tend to place them underneath the muscle for a more natural look—and this technique hurts more. “The main discomfort that patients feel is related to stretching of the pectoralis major muscle and the resulting spasm,” says Dr. Buford. “To reduce pain from the procedure, I perform an Intercostal Nerve Block (an injection) right before the patient wakes up from surgery, which lasts six to eight hours. Once this wears off, the pain fibers are reset and most patients report being able to discontinue prescription pain medication as early as 24 to 48 hours after surgery.” And while you’ll probably feel well enough to go back to work after a few days, some mild soreness may linger for a few weeks as your body adjusts to the new implants.

Liposuction

Pain Rating: 3 to 6/10 “Like any surgery, liposuction can hurt because it involves tissue injury. But that being said, liposuction is not really a painful procedure,” says Dr. Buford. However, having lipo on multiple body parts at one time will leave you more sore than having surgery on just one area (which is why the pain rating here could potentially reach a six). Dr. Buford uses a less aggressive type of lipo called Vaserlipo®, which utilizes ultrasound to liquefy the fat in stubborn areas such as the back, stomach, hips, and thighs. “The result is better—and so is the recovery,” he says. You’ll likely feel some soreness for about a week after the procedure (similar to after working out), and then be ready to resume normal activity.

Tummy Tuck

Pain rating: 4 to 6/10 Tummy tucks can be a doozy because they affect skin, muscle, and fat. “To help reduce post-operative discomfort, I inject a combination solution of BOTOX® Cosmetic, Exparel (a long-lasting pain medication), and Marcaine (a shorter-lasting pain medication) into the internal abdominal wall before closing,” says Dr. Buford. “Most of my tummy tuck patients are off strong pain medications within a week and return to normal activities within four to six weeks following their surgery. “

Eyelid Surgery

Pain rating: 1 to 2/10 Since a blepharoplasty involves tightening up the muscles and skin above the eyes, it will leave you with some swelling and bruising for about a week. “But patients are always surprised at how little pain they feel,” says Dr. Buford. “Many of my patients never take prescription pain medication following their surgery and instead just use Extra Strength Tylenol.” If you go for a lower lid surgery too, that can increase the pain rating up to a three or four. Often those involve fat grafting to fill in lost volume under the eyes, according to Dr. Bloom. In other words, the doctor will suck fat out of your stomach or thigh and place about a teaspoon of that fat under each eye.

Rhinoplasty

Pain rating: 2 to 3/10 Don’t let the nose splint and black eyes scare you: nose jobs typically aren’t very painful. The associated discomfort usually stems from congestion. “The nose feels blocked and clogged for about a week,” says Dr. Bloom. Some patients opt to take pain meds, especially to help them sleep, but many report not needing them. “After about five to eight days, patients come back in, I take the splint off, and I suction out the blood and mucus that has collected,” says Dr. Bloom. By that point in the recovery period, you may still look a little banged up, but you’ll feel perfectly normal.

Facelift

Pain rating: 3 to 5/10 A facelift involves bringing the facial muscles together to tone and tighten drooping skin, “so you can expect to feel tightness in your lower face and neck for a number of weeks,” says Dr. Bloom. But since it’s more of an uncomfortable, constricted feeling as opposed to actual pain from the procedure, pain meds are only typically needed for three to four days in the recovery period.

Many people who think about getting plastic surgery are afraid of pain. According to the survey, that we conducted on our social media channels, fear of pain was a certain number one answer to the question “What restrains you from getting plastic surgery?”, followed by the fear of general anaesthesia, fear of bad results and fear of financial burden. Fear is a very natural reaction to something unknown and uncertain. Neuroscientists say that expectancy of pain, as well as beliefs about pain, often induces fear and fear results in elusive behaviour, that pushes back from possibly painful experiences. In this article we will list the most painful plastic surgeries, so you will have an overall idea about the pain you might potentially feel during and after the surgery. Spoiler ahead! The pain is much less than you expect. 

We will start with the considerably least painful surgery and will finish at the most painful procedure. Please be advised, that pain tolerance for every person is different and this order will not be applicable for everyone. 

5. V-line surgery 

Pain level: 3/10

V-line surgery is a very popular plastic surgery in South Korea. It aims to reshape the “U” shaped jaw to “V” shaped, which is by East Asian beauty standards considered aesthetically more attractive. V-line surgery is quite an invasive procedure. It involves ostectomy – bone shaving, which seems painful even when only thought about. Surgery is performed under general anaesthesia, so during the procedure, it is impossible to feel ANY pain. The pain after the procedure is managed by prescribed pain-killer medications. Most patients feel pain and discomfort in jaw joints, but it is bearable. Some patients complain about dry and sore throat for the first week after the surgery. In the case of v-line surgery, the pain level is considerably low – forasmuch as painful might the recovery process might look like. However, more serious than pain is discomfort during the first 2 weeks after the surgery. Depending on the patient, due to limited mobility of the jaw, 1-2 weeks they can intake only liquid or soft foods. Also, after bone shaving, the swelling is weighted as more severe than other facial plastic surgeries. The patient might also feel numbness in the lower jaw and lips.

4. Inverted “T” shaped breast lift or breast reduction

Pain level: 3.5/10

Breast lift with inverted “T” shaped incision is the most effective surgery for severely sagging breasts. This incision is also applicable for macromastia correction – breast reduction surgery. The incision is made along the nipple, vertically from the nipple to under the breasts and horizontally under the breasts. During the surgery, the patient is under general anaesthesia, so they feel no pain at all. Most patients experience moderate or low-level pain in the incision areas for 1-3 days after the surgery, but it easily subsides after taking regular non-narcotic painkillers. The level of pain might be increased in case of more complex surgery, such as mastopexy or reduction mammoplasty that involves implants and fat graft augmentation. Similarly, to v-line surgery, in this case, also discomfort is a much more serious issue than pain. For the first weeks after the surgery, the patient must sleep on their back, might also feel numbness, and are depending on the individual needs are required to wear a special garment for a couple of weeks or months. 

3. Liposuction

Pain level 4/10

Liposuction is a surgery that literally removes a patient’s fat from certain areas. There are various ways to perform liposuction, such as water-jet liposuction or tumescent liposuction. The latter one is considered more painful, but also more effective. Surgery is performed under general anaesthesia or sedation – depending on the surgery area and the amount of the fat to be removed. During the surgery, the patient feels nothing. As liposuction is a rather invasive surgery, the patient might be required to be hospitalized for one day. Many patients describe post-liposuction pain as having a giant bruise in treated areas, they might also experience nausea. Pain can be subsided with regular non-narcotic painkillers. If needed, the patient can also get a pain and nausea control device from the hospital. Aside from the pain patients might feel a certain discomfort when moving, due to pain and numbness in surgery areas, regular sleep might be disturbed. Liposuction involves considerable trauma to small blood vessels under the skin, so the swelling and bruising are usually greater than after other surgeries. A patient is also required to wear special compression garments to ensure the best effect.

2. Implant Breast Augmentation

Pain level 4-4.5/10

Implant breast augmentation is a surgery that enlarges the breasts by implant augmentation. Implants might be silicone or saline, though nowadays, silicone implants are much more popular. The implant is inserted into the breast via under the breast incision, periareolar (around the nipple) incision or auxiliary incision (armpit). During the surgery patients is under general anaesthesia so again, they feel no pain. The level of post-operation pain and the speed of the recovery process is also dependent on the incision areas. Under the breast incision is considered the least painful. The patient might start to feel moderate pain in the incision areas and the implant pocket, after the anaesthesia completely wears off. Implant augmentation may also be combined with an autologous fat graft, that involves liposuction, which can make the recovery process slightly more painful. The hospital provides with pain and nausea control device if needed. The first day might be a little challenging, but regular painkillers help to ease the pain. Similarly, to breast reduction surgery, the patient should sleep on the back for the first weeks or months after the surgery, special breast holding garments are also required.

1. Tummy Tuck (Abdominoplasty)

Pain level: 5/10

Tummy Tuck (Abdominoplasty) is a surgery that removes excess skin and fat and then puts it together, making a completely new shape of the belly. The incision is made over the belly button and over the mons pubis. Excessive skin and fat are removed, tightened together, sutured, and fixed. The incision area is greater than in other surgeries and also, the recovery process involves skin and muscle regeneration, which makes it considerably long and demanding. During the surgery, the patient is under general anaesthesia, so there is no pain. However, after the surgery, they might experience moderate pain in incision areas. The overall pain in the abdomen is often described as a “stretch out feeling” while trying to sit up. Therefore, the patient might be advised to sleep in a semi-incline position, refrain from driving and exercising for some time after the surgery. For the first month after the surgery wearing special, pressuring garments are required. 

Conclusion

All surgeries are not painful during the procedure, but a certain level of pain might be experienced during the first days or weeks after the surgery.  In all cases, the pain is manageable by regular non-narcotic pain killers. As you can see, fear of pain shouldn’t be a reason to restrain from getting the plastic surgery you dreamed of, as the pain is completely bearable.

There are a few conditions to make the recovery process even less painful, from which the most important is the technique and experience of the doctor who performs the surgery. A well experienced and skilled doctor will know how to make incisions and perform the operation with minimal vessel and tissue damage. Post-operative care is also very important, so to ensure your quickest recovery and minimal pain, therefore we advise you to listen well and follow the doctor’s guidance.