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.
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.
I Am Allergic to Codeine. Any Suggestions for Pain Control After Mommy Makeover?
Allergies to codeine is relatively common. Most patients do well with medications containing oxycodone or hydrocodone when they have allergies to codeine. All of these medications tend to make patients somewhat nausious and so we typically also prescribe an antiemetic like phenergan or zofran. In addition, when taking any opioid, be sure to also take a stool softener and/or laxative to avoid the associated constipation.
Pain Control after Surgery
Non narcotic pain control can be accomplished with local anesthesia such as Ropivacaine or Exparel. Ultram can be another effective oral pain medication.
How to have a comfortable recovery after a mommy makeover
I would recommend that you have a pain pump placed by your surgeon during your tummy tuck, if that is part of the plan. In addition, I routinely prescribe Percocet, which has a derivative of codeine, but is different enough that you shouldn't necessarily be allergic to it.
Talk with your surgeon about pain management prior to surgery.
A mommy makeover is a big procedure that involves working on
multiple areas of the body during the same surgery, so you can imagine you will
be sore in lots of areas and definitely will need something for the
discomfort! In my practice we typically
prescribe Norco (or Hydrocodone) for early post-operative pain as well as a
muscle relaxer if a submuscular implant is placed, and most patients do well
with that.Hydrocodone is a synthetic
derivative of codeine that has a lot less side effects than does codeine and is
usually much better tolerated.Frequently people say they are allergic to codeine because of the side
effects they have experienced (nausea, vomiting, itching, constipation) so it
would be important to know how your allergy was diagnosed and your
symptoms.If you had a true allergy to
the codeine with hives, swelling, and difficulty breathing, anaphylaxis, then
it would be best to steer away from any codeine derivative.Ultram (Tramadol) is a non-narcotic pain
medicine that can usually be taken safely even with true codeine allergies and
it can help alleviate some of the discomfort after a surgical procedure. Extra
strength Tylenol also is an alternative as the pain begins to lessen.This has none one the side effects of
codeine, no chemical relationship to codeine, and when properly dosed can
provide relief safely.For the first 2
weeks, following surgery you need to continue to avoid any NSAID’s (Aspirin,
Motrin, Aleve, Ibuprofen) as they will increase the risk of bleeding with any
surgical procedures.Once you are 2
weeks out form surgery NSAID’s would be a safe alternative if you still need
relief. I would suggest talking extensively with your plastic surgeon before
surgery so that you can make a plan that will keep you comfortable and safe
throughout the operative experience.Good luck with your surgery.
There are other options
Today there are other options other than codeine to help manage post operative discomfort- in my practice we rarely even prescribe it any more. Talk to your doctor about other optinons
I hope this helps
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.
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