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

Doctor Answers 71

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
5.0 out of 5 stars 70 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

Codeine is a Lousy Drug. There are Superior Alternatives.

Codeine causes a lot of nausea.  I have not used it for twenty years. There are many great narcotic and non-narcotic alternatives which have fewer side effects. 

Most of my patients find recovery from combination procedures quite manageable. Many have related it to be similar to a c-section or hysterectomy. Sometimes they find it easier.

I have seen a profound improvement in the last few years related to 3 game-changers:

1. Exparel gives a 3 day effect of local anesthesia which gets patients off to a great start.

2. Elimination of drains decreases pain and hassle and gets patients moving faster.

3. Anesthesia improvements using our proprietary combinations has markedly decreased the pain and nausea.

Codeine allergy and mommy makeover pain control

Thank you for your question.

There are alternatives to codeine for pain relief after a mommy makeover.  Usually codeine is not used as there are stronger medications such as Vicodin or Percocet that are more effective in relieving pain.  

It will be important for your surgeon to ascertain what type of allergy you have to codeine.  Many people feel they cannot tolerate pain medications such as codeine due to nausea.  If this is the case in your situation, it will be important to prescribe anti nausea medication to help you with this.

Best wishes for your surgery.


Shim Ching, MD

Shim Ching, MD
Honolulu Plastic Surgeon
4.5 out of 5 stars 22 reviews

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.  

John Burns, MD
Dallas Plastic Surgeon
4.5 out of 5 stars 18 reviews

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

Good morning!

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

Robert Steely, MD
Houston Plastic Surgeon
5.0 out of 5 stars 31 reviews

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