Pectoral Block in Breast Reduction for Pain Control

Inclusion Criteria: * Undergoing breast reduction surgery * Women older than age 18 and under age 75 * Stable breast size for at least 1 year * Member has persistent symptoms in at least two of the anatomical body areas below, directly attributed to macromastia and affecting daily activities for at least 1 year: Headaches; Pain in neck; Pain in shoulders; Pain in upper back; Painful kyphosis documented by X-rays; Pain/discomfort/ulceration from bra straps cutting into shoulders; Skin breakdown (severe soft tissue infection, tissue necrosis, ulceration hemorrhage) from overlying breast tissue; Upper extremity parasthesia * Patient has evidence of severe breast hypertrophy that is documented by frontal and side profile photographs * Pain symptoms persist as documented by the physician despite at least a 3-month trial of therapeutic measures such as: Analgesic/non-steroidal anti-inflammatory drugs (NSAIDs) interventions and/or muscle relaxants Dermatologic therapy of ulcers, necrosis and refractory infection Physical therapy/exercises/posturing maneuvers Supportive devices (e.g., proper bra support, wide bra straps) Chiropractic care or osteopathic manipulative treatment Medically supervised weight loss program Orthopedic or spine surgeon evaluation of spinal pain * Breast Reduction is likely to cause a reduction in patient symptoms * Women 50 years of age or older are required to have a mammogram that was negative for cancer performed within the two years prior to the date of the planned reduction mammoplasty * Greater than 40 kg in weight Exclusion Criteria: * History of chronic pain controlled with prescribed narcotics * English as non-primary language * No access to email or internet * Positive pre-surgery pregnancy test * Women not of ages 18-75 * Less than 40 kg in weight