Reply to Bozkurt et al.: Not Just Pain Relief-Fascial Plane Block Combination as a Primary Anesthetic Technique in Breast Implant Removal.

Interfascial plane blocks are increasingly used in breast surgery for analgesia and, in selected cases, as an alternative to general anesthesia. Bozkurt et al. reported improved analgesic outcomes with the addition of pecto-intercostal fascial plane block (PIFB) to serratus anterior plane block (SAPB) in breast reduction surgery. We present a 50-year-old woman who underwent implant explantation after 27 years due to capsular contracture, pain, deformity, and rupture. Owing to a previous negative anesthetic experience, she declined general anesthesia. Bilateral SAPB and PIFB were performed under light sedation, producing complete sensory block from the sternum to the mid-axillary line. Surgery was completed with propofol infusion, stable hemodynamics, and only minor discomfort requiring local infiltration. Postoperatively, pain scores remained below NRS 3 for 11 h with no additional analgesics. This case suggests that the SAPB and PIFB combination may serve not only for analgesia but also as a primary anesthetic technique in selected breast procedures.Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .