Ask a doctor

I Am Allergic to Codeine. Any Suggestions for Pain Control After Mommy Makeover?

Doctor Answers 61

Non-Narcotic Medication following Mommy Makeover

Most of my patients do fine with non-narcotic medications and Exparel and / or a pain pump. The surgical technique used, anesthesia administered, and intra-operative pain control all will make a significant difference in your comfort during recovery from a mommy makeover. It is also my preference that mommy makeover patients stay overnight with roind the clock medical care the night of surgery. Not every surgeon feels this way, but I beleive patients and their families feel more comfortable and have more peace of mind in tis scenario.  If you are very concerned about discomfort, you could have your mommy makeover performed in stages rather than all at once. Discuss your concerns with your plastic surgeon, and speak to other patients about their experience to determine what makes most sense for you.


Raleigh-Durham Plastic Surgeon
4.5 out of 5 stars 50 reviews

Have a question? Ask a doctor

Ultram & Double Strength Tylenol are Great Options

Pain control is extremely important following cosmetic surgery. Patients frequently report allergies to various pain medications and as a result, pain management may require adjustment in the postoperative period.
Most patients who say they are allergic to codeine don’t have a true allergy. They usually have severe nausea, which codeine is notorious for causing.
We typically use a synthetic codeine derivative called Hydrocodone, which has a decreased incidence of nausea compared to codeine.
Examples of prescription Hydrocodone commonly used include Vicodan and Lortab. When these don’t work or patients are allergic to them as well, we use Ultram. We replace narcotic pain relievers with double strength Tylenol as soon as possible following surgery to avoid the potential for drug problems.
Pain tolerance varies from patient to patient and with appropriate care can usually be managed without difficulty. When allergies to pain medications occur, multiple alternatives exist to deal with this problem.

Allergic to Codeine Pain Medications

The allergy to codeine in pain medicines is so common that I rarely use these pain medications in my practice.  Artificial codeine, hydrocodone, is more commonly prescribed and used in products like Vicodin and Lortab and these medications are surprisingly effective on many individuals who cannot tolerate codeine but can tolerate hydrocodone.

Even when I have prescribed the hydrocodone medications, I encourage my patients to as quickly as possible to convert to anti-inflammatory medications like Advil, Nuprin and Motrin which are Ibuprofen products and Alleve which is a different anti-inflammatory product.  These medications actually effect the pain problem itself instead of hiding the symptoms in one's brain and have less side effects.

Never forget the use of ice and cold packs to reduce the amount of pain on almost all areas of the body following surgery.

John K. Long, MD
Houston Plastic Surgeon
5.0 out of 5 stars 4 reviews

Codeine allergy

Other drugs can be used to control postoperative pain like antinflamatories, generally opiates pain killers are not used postoperative, but they can be substituted by other ones.

Regards

Kemil Issa, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 3 reviews

Many options for pain control

 Whenever a patient tells me they have an allergy to a medicine the first thing I asked them is what happens when you take the medicine. Most the time when it comes to narcotics the patients experience an upset stomach or nausea. This would not be a true allergy but what  we were referred to as a intolerance. Although the breast portion of a mommy makeover usually does not have much discomfort, the abdomen can be a very different story. In an effort to alleviate postoperative pain or at the very least to minimize it I usually recommend to my patients either the use of Experal, a long acting injectable or an On-Q pain pump. Additionally I will usually have the patience take some form of a nonsteroidal such as Motrin or Toradol. Some patients experience postoperative muscle spasms and this can be addressed with a low dose of Valium. Finally the mainstay of any postoperative pain management program will be a narcotic. Even for patients who say they are codiene allergic medicine such as  hydrocodone or oxycodone can usually be used with success. But keep in mind all of these medications must be taken on a full stomach otherwise nausea is assured.  Also keep in mind that everybody has a different pain tolerance and their experience does not nessisarily mean it will be the same as yours. I hope this information has been helpful and good luck .

John Mancoll, MD
Virginia Beach Plastic Surgeon
4.5 out of 5 stars 9 reviews

Mommy makeover

The combination of a tummy tuck and breast aug  will help you regain your figure.  These procedures are done separately all of the time but can be combined very easily.  Allergies to medicines are significant but can be made less problematic with newer medications like Exparel which I use in the OR routinely to provide long lasting pain relief.  This can be injected in each site of surgery to help provide pain relief for 2 to 3 days for some patients.

A tummy tuck can be done as a solitary procedure. Many times the results are enhanced by adding liposuction to the hip and love handle area. A tummy tuck is also done in combination with a breast augmentation in a mommy makeover.

In breast augmentation I have chosen to spend time reviewing photographs with patients to fully understand their expectation of size and shape. Many times this simply raises more questions. I will make measurements and use the implant guides to allow the patient to understand exactly the sizes that are reasonable for their body type and measurements.

Please find an experienced Board Certified Plastic Surgeon and member of the Aesthetic Society using the Smart Beauty Guide. These Plastic Surgeons can guide you on all aspects of facial surgery, breast augmentation and body procedures including tummy tucks or mommy makeovers!

Options beyond codeine

You have alot of options beyond codeine. During sugery, your surgeon can give you some local anesthesia, use exparel or pain pumps. After surgery when you are at home recovering, there are many options of oral pain medications that do not include codeine. Speak with your plastic surgeon and discuss your options before surgery and talk to him or her about expectations after surgery as well.

Kiran Polavarapu, MD
Fort Worth Plastic Surgeon
5.0 out of 5 stars 17 reviews

Staying comfortable after a mommy makeover

There are lots of options for keeping you comfortable after a mommy makeover.  I usually use a variety of things so that you get all the benefit and little in the way of side-effects.  Some options include different combinations of:  tylenol, gabepentin, opioids (tramadol, oxycodone, morphine, demerol, dilaudid), NSAID's and can all be use effectively so that you are comfortable following surgery.
I wouldn't worry about the allergy, you have lots of options.

Dr Rodger Shortt
Oakville

Rodger Shortt, FRCSC
Toronto Plastic Surgeon
5.0 out of 5 stars 19 reviews

Allergic to codeine, considering Mommy makeover

I recommend that patients allergic to codeine consider the use of a pain pump or injected Exparel( a slowly released local anesthetic).  In addition to this, patients allergic to codeine are often able to take other narcotics such as oral Demerol or hydrocodone, or non-narcotics such as Toradol

John Zavell, MD, FACS
Toledo Plastic Surgeon
4.5 out of 5 stars 15 reviews

Pain after Mommy Makeover

The discomfort after mommy makeover procedures is often less than expected if the surgeon follows a few simple guidelines. Treatment with non-opioid pain medications at the start of the procedure as well as the use of local anesthetic can prevent activation of some pain mediated pathways. This limits the amount of anesthesia and pain medication required as well as decreases the discomfort and recovery after your procedure.

Exparel has become a wonderful addition to procedures in appropriate patients and can provide some degree of pain relief for up to 72 hours if used at the time of the procedure.

There are many non-opioid alternatives to codeine and your plastic surgeon can evaluate your particular allergy and make recommendations.

As with any procedure there will be some discomfort after a mommy makeover, however, with appropriate steps this can be dramatically improved.

Ryan Diederich, MD
Saint Louis Plastic Surgeon
5.0 out of 5 stars 4 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.