Botox reduces pain and spasms during breast reconstruction after mastectomy

Botox, known for reducing wrinkles, also can be used to reduce pain and spasms during breast reconstruction after mastectomy, according to results of a recent University of Arkansas for Medical Sciences (UAMS) study.

The study, presented recently at the Plastic Surgical Forum of the American Society of Plastic Surgeons in Philadelphia, found that women injected with Botox after the surgical removal of their breasts had less pain and shorter hospital stays during reconstruction with tissue expanders.

Tissue expanders are temporary implants placed beneath the chest muscle and slowly inflated over several weeks to stretch the tissue in preparation for permanent implants.

"The reconstruction process can be painful for some women, and we are happy to find a way to ease that pain," said Julio Hochberg, M.D., professor of surgery in the division of plastic surgery in the UAMS College of Medicine, study co-author.

Hochberg and co-author V. Suzanne Klimberg, M.D., professor of surgery and pathology and chief of the division of breast surgical oncology in the UAMS College of Medicine, conducted the study between July 2001 and February 2004. Klimberg is also director of the Breast Cancer Program at UAMS' Arkansas Cancer Research Center.

The study included 56 patients who underwent mastectomy with tissue expanders followed by implant placement -- 30 with Botox and 26 without. The two groups were comparable in age, tumor size and expander size.

Hochberg found that patients who received Botox injections used 89 percent less morphine in the first 24 hours after surgery, had their hospital stays reduced by one day and used less morphine overall than the group without Botox.

The study has drawn inquiries from surgeons and medical publications across the country. In addition to being chosen to present at the forum in Philadelphia, the study was one of only five of the 300 presented there that was chosen for promotion by the forum. It was published in the October issue of the monthly Annals of Surgery, a highly referenced surgery journal, after a months-long peer review process.

Other UAMS co-authors of the study are Rakshanda Layeeque, M.D., Ronda Henry-Tillman, M.D., associate professor of surgery; Kent Westbrook, M.D., professor of surgery and chief of the division of surgical oncology; James C. Yuen, M.D., associate professor of surgery; and Kelly M. Kunkel, R.N.

UAMS is the state's only comprehensive academic health center, with five colleges, a graduate school, a medical center, five centers of excellence and a statewide network of regional centers. UAMS has about 2,170 students and 650 residents and is the state's largest public employer with almost 9,000 employees. UAMS and its affiliates have an economic impact in Arkansas of about $3.8 billion a year.

UAMS centers of excellence are the Arkansas Cancer Research Center, Harvey and Bernice Jones Eye Institute, Donald W. Reynolds Center on Aging, Myeloma Institute for Research and Therapy and Jackson T. Stephens Spine and Neurosciences Institute.

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