Ask a doctor

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

Doctor Answers (53)

Alternatives to codeine for pain relief

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
All narcotic pain relievers have some resemblance in their chemical structure, and an allergy to one can mean being allergic to others.

Many times when patients tell me they are allergic to codeine  it is not a true allergy, but rather a sensitivity, meaning they get nauseated or have some other side effect, rather than a rash, hives or other true allergic reaction. It is best to define this first, and then look at some of the alternatives, both narcotic and non-narcotic.

Although we have relied on the use of narcotic pain relievers for pain  since the Civil War, they have some negatives and some patients just don't tolerate them. Or, in the case of recovering addicts, they never want to touch them again. Does this prevent us from being able to do surgery because of inability to deal with the pain? Not at all.

There are non-narcotic alternatives available which may be sufficient with proper mental preparation and  good planning. 

Discuss this with your doctor at length and I am sure a good program me can be planned to give you peace of mind going into surgery


Vancouver Plastic Surgeon
5.0 out of 5 stars 12 reviews

Non-Narcotic Medication following Mommy Makeover

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
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.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.5 out of 5 stars 45 reviews

Consider using a pain pump for post operative pain control

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Alternatives to codeine include oral Demerol and synthetic forms of morphine.  I usually place a pain pump and this greatly decreases post operative pain and discomfort.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 10 reviews

Ultram & Double Strength Tylenol are Great Options

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

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

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

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

Pain relief after tummy tuck

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
There are many codeine alternatives that are suitable for a tummy tuck procedure.  Once you speak to your surgeon, I am sure you can be prescribed an alternative medicine. 

Best, 

Dr. Karamanoukian 

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 54 reviews

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

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
I am using a long acting local anesthesia that is applied at the end of the operative procedure and will keep the patient pain free for 3 days. Also, during the operation under general anesthesia the tumescent process prior to excision and dissection limits swelling and therefore keeps the pain low. This combination of techniques could then be augmented with a non narcotic oral pain medication.

Codeine Allergy

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
It is important to discuss your allergy with your treating plastic surgeon. There are several alternatives to codeine available. Also, be sure to describe what your reaction was to your plastic surgeon, as oftentimes patients mistake side effects (such as nausea) for an allergy.

I'm sure he or she will find an adequate alternative - good luck!

Pain management following Mommy Makeover

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Many people have adverse reaction to pain relief medications containing narcotics such as codeine (Tylenol #3), hydrocodone (Vicodan) and oxycodone (Percocet). Rarely is it a true allergy but rather a sensitivity causing symptoms such as itching, nausea or grogginess. Alternatives like extra strength Tylenol may not be strong enough and anti-inflammatory meds like Advil, Motrin, Aleve or Ultram can have the undesirable side effect of excessive bruising or even hematoma formation. I am a strong proponent of the marcaine pain pump (On-Q) for all my abdominoplasty patients and have also used it in combination with breast surgery procedures. The medication is automatically delivered through very thin catheters under the skin anesthetizing the muscles where most discomfort is felt. After 3 days the pump becomes depleted, but it can be refill by the doctor if necessary, or removed by the patient if not.

Best,

Scott A. Brenman, M.D., F.A.C.S.
Plastic & Reconstructive Surgery

Scott A. Brenman, MD, FACS
Philadelphia Plastic Surgeon
4.5 out of 5 stars 14 reviews

There are codeine alternatives that can help you feel comfortable after surgery.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
A true allergic reaction to codeine requires an alternative for pain management—but luckily there are several excellent alternatives to choose from. Be sure to discuss your concerns with your surgeon, and you can also do some research on your own to find out the different classes of drugs that are safe for people allergic to codeine. If you have a negative reaction to codeine (such as severe nausea) rather than an allergic response, bring this question up to your surgeon to see what he or she recommends as an alternative. In either case, a strong NSAID may work to help keep your discomfort manageable after surgery without the need for opiates.

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.