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

Doctor Answers 64

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 59 reviews

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

Post-Op Pain Management After Mommy Makeover

Many people who have nausea or vomiting when taking codeine products, do not have an allergy which would be manifested by swelling, itching, rash.  If nausea is the problem, some preventive measures can be useful: try crushing the pill into a fine powder, mix with a small amount of applesauce to kill the taste, drink half a cup of chamomile, mint, or ginger tea to settle the stomach, take the medicine/applesauce and wash it down with the rest of the tea. This will speed the absorption of the medicine and reduce the risk of nausea.
Other medications can work; sometimes variations on the brand or type of codeine can make a difference.
Your surgeon may have some favorites to suggest for you.
I have been using the local anesthetic infusion pain pump for thousands of patients with great success in reducing pain and need for narcotics.
There are some new long-acting injectable local anesthetics (Exparel) that can also be of help.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.5 out of 5 stars 14 reviews

Allergy to codeine

Many patients with narcotic allergies can still take other narcotics without difficulty.  It depends on whether you had a true allergic reaction vs a normal side effect of nausea and vomiting.  Sometimes nonnarcotic medications such as toradol may be used but some believe it increases the possibility of bleeding.   Discuss with your surgeon and/or anesthesiologist to see their recommendations.  Good luck.  Donald R. Nunn MD  Atlanta Plastic Surgeon 

Donald Nunn, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 11 reviews

Pain Medication for Boca Raton Mommy Makeover

Here are our practice in Boca Raton, mommy makeover patients find that Percocet or Vicodin are excellent for discomfort. Neither have the drawbacks of codeine (nausea, etc) and both can be used for patients who are actually allergic to codeine.

Some patients find that discomfort is lessened by the following:
1.  Getting enough rest. Rest is the primary treatment for surgical discomfort! 

2.  Absolutely avoid lifting anything over 15 lb. This includes taking young children in and out of the tub, the carseat and the highchair, as well as bags of groceries. Don't run the vac or do other strenuous household tasks and definitely avoid exercise until you're cleared to return to the gym. 

3. Keeping things moving! Constipation is common after any surgery, especially abdominal surgery. Eat plenty of fruit and veggies and drink lots of water to avoid becoming constipated, which can increase abdominal discomfort. 

4. Contact your surgeon if the discomfort is not controlled by pain meds. 

To your health & beauty,
Jonathan Berman, MD, FACS
Double Board Certified Boca Raton Plastic Surgeon

Jonathan Berman, MD
Boca Raton Plastic Surgeon
4.5 out of 5 stars 9 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.


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 11 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 20 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.