A plastic surgeon’s clinical trial found that Botox can reduce post-operative pain in breast cancer patients who receive silicone implant breast reconstruction after a mastectomy.
Dr. Allen Gabriel, a plastic surgeon in Vancouver, Washington, presented his findings for this off-label use of Botox at the recent International Society of Aesthetic Plastic Surgery Congress. His clinical trial of 30 patients demonstrated that botulinum toxin A addresses the sources of severe pain associated with a breast implant after mastectomy.
Silicone breast implantation often involves the positioning of a temporary expander implant between layers of the chest muscle, which is filled with water to create a pocket where a permanent implant will reside. The muscle often contracts and spasms in response to the expansion, causing the patient pain, according to Dr. Gabriel.
Dr. Gabriel and his collaborator Dr. G. Patrick Maxwell theorized that since Botox injections would temporarily paralyze the muscle, fewer spasms would occur and result in less pain.
“The use of [botulinum] is changing the reputation of expanders as a painful part of breast reconstruction,” Dr. Gabriel said. “Before we started using [botulinum], patients leaned toward autologous reconstruction because of anxiety about expander pain. Now, patients are more inclined to choose expanders.”
In the clinical trial 30 patients, who were all getting a mastectomy with silicone implant breast reconstruction, were divided into two groups. One group received Botox injections in the chest muscle and the other received saline solution injections as a placebo.
The group who got Botox injections were far more comfortable after surgery than those who received placebo, said Dr. Gabriel. He measured patient responses three times during and after the procedure. He also found that during days 7 to 45 of the recovery period, those in the Botox group used significantly fewer doses of narcotics and muscle relaxants.
