Pain Control in Augmentation Mammaplasty: The Use of Indwelling Catheters in 813 Consecutive Patients
Publication Date: 6-22-2010

Abstract: Plastic & Reconstructive Surgery, Vol 125(6), Pages 1814-1815, June 2010

Viewpoint: Botox Treatment for Vaginismus
Publication Date: 12-1-2009

Abstract: Botox Treatment for Vaginismus discusses a relatively new concept of treating spastic vaginal muscles with Botox. Uncontrolled involuntary spasm occurs because of an extreme fear of intercourse due to the thought that it will be very painful. The results of our first 20 patients are discussed. Our patients continue to experience a success rate of over 90 percent.

Plastic & Reconstructive Surgery, Vol 124, Pages 455e-456e, December 2009

Contralateral Pain Reduction in Augmentation Mammaplasty Using Pain Control Catheters and Controls
Publication Date: 3-1-2009

Abstract: In this letter to the editor, Dr. Pacik discusses the value of self administration of long-acting local anesthesia following breast enlargement surgery. He quotes his previous study showing a reduction in pain on one side when the opposite breast is instilled with local anesthesia. he also notes the safety and efficacy of indwelling catheter control of pain in 644 consecutive patients when patients are able to instill local anesthesia following augmentation mammaplasty.

Plastic & Reconstructive Surgery, Vol 123, Page 1130, March 2009

Pain Control in Augmentation Mammaplasty Using Indwelling Catheters in 687 Consecutive Patients: Data Analysis
Publication Date: 11-1-2008

Abstract: In this article, Dr. Pacik describes the continued use of pain control catheters to help control post-operative pain in aungmetation mammaplasty patients. Data analysis revealed multiple areas of pain such as the sternum (breast bone), sides of the chest, below the collar bones (clavicle) and back pain in addition to the expected breast pain. It was found that older women had less pain, and that frightened patients had more pain, and used narcotics for a longer period of time. Otherwise there were no statistical differences as related to the size of the breast implants, intra-operative expansion, handedness, duration of surgery and different techniques of dissection to create the implant pocket.

Continued safety of this device for pain control was noted. One patient developed an unusal infection which resulted in loss of one of the implants. This was later successfully replaced. No patient had a problem with overdose.

It was also determined that instilling a long acting anesthetic into the augmentation mammaplasty breast pocket was as effective in controlling post-op pain as narcotics. Ibuprofen and muscle relaxants, though helpful, were less effective.

15 percent of our patients used the catheters for 2 days, the rest had the catheters removed during their first postop visit.

Bolus instillation of a long acting anesthetic into the dissected implant pocket following augmentation mammaplasty allows the patient to have control over her post-op pain, and can be used in conjunction with other analgesics. Patients have been very grateful for this added form of pain control, and are able to have less fear going into the surgery knowing that we will do everything possible to help keep them comfortable after their surgery.

Aesthetic Surgery Journal, Vol 28, No 6, November/December 2008

Pain Control in Augmentation Mammaplasty: Safety and Efficacy of Indwelling Catheters in 644 Consecutive Patients
Publication Date: 5-1-2008

Abstract: In our ongoing study of pain control using indwelling catheters so that patients can instill local anesthesia into the implant pocket, 644 consecutive patients were studied showing the safety and efficacy of this method of pain control after breast enlargement surgery. This method of pain control helps reduce the need for narcotics and gives patients an additional means of pain control.

Aesthetic Surgery Journal, Vol 28, No 3, May/June 2008

Fat Free -- If you've tried diet and exercise, and you still have those dreaded "unslightly bulges," consider liposuction.
Publication Date: 5-1-2007

Abstract: Dr. Peter T. Pacik was interviewed by Martha Bauman several times for this easy-to-read, well-done article about liposuction which appeared in the New Hampshire Magazine (May 2007. In easy-to-understand language, this article delivers an update on liposuction which is now one of the most commonly performed cosmetic procedures.

Augmentation Mammaplasty: Postoperative Cephalosporin Induced Hepatitis
Publication Date: 3-2-2007

Abstract: Even though most surgeons use a single dose of I.V. antibiotic prior to starting augmentation mammaplasty, prophylactic antibiotics are not without problems.

In this article written by Dr. Peter T. Pacik, he explores 2 patients who developed post-opoerative hepatitis after using prophylactic antibiotics for augmentation mammaplaty thought to be due to pre-operative sensitization to the cephalosporin group of antibiotics. Kefzol I.V. is probably the most frequently used prophylactic antibiotic prior to breast enlargement surgery and was the antibiotic used in the 2 patients who developed post-operative hepatitis. Kefzol, a member of the cephalosporin group of antibiotics, is broad spectrum, and therefore commonly used by many physicians for specific infections or when the cause of a fever or other problems is unknown.

There continues to be debate about the value of prophylactic antibiotics. Infection after augmentation mammaplasty is uncommon, and prophylactic antibiotics do not necessarily protect the patient against post-operative infection.

Plastic & Reconstructive Surgery, Vol 119, No 3, Page 1136, March 2007

Breast Augmentation Revisited
Publication Date: 2-1-2007

Abstract: Dr. Peter T. Pacik explores how experience inspired new techniques for improved outcome in Breast Augmentations.

Cosmetic Surgery Times January/February 2007 initiated a new column called "First Person Surgical". This column presents techniques, in the surgeon's own voice, that only hard-won years in the surgical field can teach. Dr. Pacik was honored to have his article appear in this first-time column for the Cosmetic Surgery Times.

Letters & Viewpoints: Augmentation Mammaplasty: Asymmetrical Lowering of the Breast Fold
Publication Date: 6-1-2006

Abstract: A new technique for lowering the breast fold was developed to help round and enhance cleavage of the inner lower portion of the breast. This has proven to be especially helpful for women with wide cleavage, a high breast fold (constriction of the lower portion of the breast), lateral flare of the breasts and when oversized implants are planned to help prevent "bottoming out." This new technique has been used in over 200 augmentation mammaplasty patients and has been shown to be both effective and safe.

Plastic & Reconstructive Surgery, Vol 117, No 7, June 2006

The Ambulatory Surgery Facilities (ASF) Source: "Twenty-One Years As An Accredited Facility"
Publication Date: 1-23-2006

Abstract: This article was published in The Ambulatory Surgery Facilities (ASF) Source Magazine in the Winter 2006 issue. Dr. Pacik and his accredited Surgi-Center was featured for having the longest uninterrupted term of 21 years by the American Association for Accreditation of Ambulatory surgery Facilities, Inc. (AAAASF).

Outpatient Surgery Magazine: "New Ways to Keep Cosmetic Surgery Patients Comfortable"
Publication Date: 9-1-2005

Abstract: This article was published in Outpatient Surgery Magazine in the September 2005 issue. Dr. Peter T. Pacik was interviewed by Dianne Taylor, Contributing Editor, on his views of post-operative pain managment.

Augmentation Mammaplasty: Enhancing Inferomedial Cleavage
Publication Date: 7-1-2005

Abstract: This study deals with one of the more complex issues in augmentation mammaplasty, that of lowering the breast fold. A new design for lowering the breast fold is helpful in correcting a high breast fold, improving cleavage in patients with lateral flare, and allowing increased safety when larger implants are planned.

Aesthetic Surgery Journal, Vol 25, No 4, July/August 2005

Discussion: The Efficacy of Continuous Local Anesthetic Infiltration in Breast Surgery: Reduction Mammaplasty and Reconstruction
Publication Date: 6-1-2005

Abstract: The use of indwelling catheters was used to control postop pain in this series of breast reduction patients. Dr. Pacik was invited to discuss this paper.

Plastic & Reconstructive Surgery, Vol 115, No 7, June 2005

Augmentation Mammaplasty and Von Willebrand's Disease
Publication Date: 4-15-2005

Abstract: It is important for patients to share any bleeding tendencies with their surgeons prior to surgery. This is a case report of a nurse who was able to have her surgery done safely with the proper support.

Plastic & Reconstructive Surgery, Vol 115, No 5, April 2005

Follow-Up Pain Control in Augmentation Mammaplasty: The Use of Indwelling Catheters in 350 Consecutive Patients
Publication Date: 2-1-2005

Abstract: At this point in our ongoing study, we now had a considerable amount of data on 350 consecutive patients to show the benefits of pain control using indwelling catheters. This is the largest study published using indwelling catheters for pain control in augmentation mammaplasty.

Plastic & Reconstructive Surgery, Vol 115, No 2, February 2005

Pain Management in Augmentation Mammaplasty: A Randomized Comparative Study to Compare the Use of a Continuous Infusion Versus Self-Administration Intermittent Bolus of a Local Anesthetic
Publication Date: 11-1-2004

Abstract: It was found that intermittent bolus instillation of local anesthesia was similar in effectiveness and patient preference to pain pumps which give a continuous flow of local anesthesia.

Aesthetic Surgery Journal, Vol 24, No 6, November/December 2004

Discussion: Efficacy of the Pain Pump Catheter in Immediate Autologous Breast Reconstruction
Publication Date: 9-15-2004

Abstract: Dr. Pacik was invited to discuss this paper on the use of indwelling catheters for pain control following breast reconstruction.

Plastic & Reconstructive Surgery, Vol 114, No 4, September 15, 2004

Discussion: Pain Control in Augmentation Mammaplasty: The Use of Indwelling Catheters in 200 Consecutive Patients
Publication Date: 5-1-2003

Abstract: Thomas M. Biggs, MD, was invited to discuss Dr. Pacik's paper on the use of indwelling catheters in 200 consecutive patients.

Plastic & Reconstructive Surgery, Vol 111, No 6, May 2003

Pain Control In Augmentation Mammaplasty: The Use of Indwelling Catheters in 200 Consecutive Patients
Publication Date: 5-1-2003

Abstract: This was our first publication on pain control in augmentation mamaplasty using indwelling catheters for intermittent bolus instillations of a long acting anesthetic. 200 consecutive patients were studied which showed the efficacy and safety of this method of pain control. This was a landmark paper which has been quoted as a reference many times and represents a new way of thinking about pain control at the surgical site, rather than relying on narcotics.

Plastic & Reconstructive Surgery, Vol 111, No 6, May 2003

Liposuction: Fat vs Total Aspirate -- A Time for More Precise Terminology
Publication Date: 10-1-2001

Abstract: In this article, Dr. Pacik explains why it is important to measure the amount of fat removed, rather than the total aspirate which combines fat with the injected fluids.

Plastic & Reconstructive Surgery, Vol 108, No 5, October 2001