Reduction in Postoperative Pain and Complications in Breast Augmentations Following the Implementation of a Bloodless Atraumatic Technique (BAT)

Introduction: In Italy, breast augmentation is the second most common cosmetic surgical procedure. This procedure is experiencing a surge of interest and undoubtedly represents a significant proportion of aesthetic surgery practice, with over 55 000 procedures performed annually. However, the procedure is associated with significant discomfort and pain in the immediate postoperative period and may result in adverse effects. In this study, we review the experience of our single accredited outpatient surgery center in transitioning from the use of classical breast augmentation technique to the use of Bloodless Atraumatic Technique (BAT) breast surgery. Methods: A retrospective analysis was performed of all breast augmentation cases performed by multiple surgeons in the practice over a 12-year period (January 2012 to July 2024). The postoperative follow-up period was used to observe the length of recovery, the incidence and severity of side effects, and the level of pain and discomfort experienced by patients. In addition, the incidence of complications including hematoma, infection, seroma, hypertrophic scar, need for reoperation, and pulmonary embolism/deep vein thrombosis (PE/DVT) was documented. Results: Four of the most notable findings were a significant reduction in pain and discomfort and a significant reduction in bruising, swelling, and hematoma in the BAT group (715 patients). In this group, no pain was reported in 19% of cases, while 76.1% of patients experienced only mild pain, 4.9% reported moderate pain and 0% reported intense or severe pain. In contrast, the Traditional Breast Augmentation (TBA) group (195 patients) showed a higher prevalence of severe pain (15.6%), intense pain (71.6%), and moderate pain (6.3%), with no cases of mild or no pain. Discussion: The level of pain and discomfort experienced by patients undergoing BAT breast augmentation was significantly lower than that reported by patients in the Traditional Breast Augmentation group. These results demonstrate that BAT is an effective method of reducing postoperative pain and discomfort, even in patients who have undergone subpectoral silicone breast implantation for cosmetic breast augmentation. Conclusions: The implementation of the BAT has been observed to significantly reduce the level of postoperative discomfort and pain in our clinical practice. The use of BAT has been shown to facilitate objective improvements in the recovery process, incidence of complications, need for revision, and overall patient experience. However, these outcomes are not necessarily predictable and require a significant commitment from the surgical team, particularly the surgeon.