Inclusion Criteria:  Female Age 18-80 Bilateral reduction mammaplasty American Society of Anesthesiologists (ASA) physical status classification 1, 2, or 3 Must choose to receive preoperative nerve block as part of pain management strategy  Exclusion Criteria:  Allergy to dexamethasone or bupivacaine History of postoperative nausea and vomiting following anesthesia History of chronic pain conditions History of narcotic abuse or dependency History of chronic renal disease History of chronic liver disease