Ask a doctor

Exparel or Pain Pump? Does Anyone Feel There is a Difference?

I have an option tomorrow for either the onQ pain pump or the Exparel injections. Im having a Full TT w/ MR and lipo of the flaks and mons.

Doctor Answers (9)

Exparel vs Pain Pump


I rarely get excited about new products, but when I find one that changes my patients’ recovery in such a positive way, it’s hard not to be enthusiastic. Exparel is priced to be competitive with pain pumps, so I’m not sure that its cost makes it worthwhile for smaller procedures, such as breast augmentation, but for tummy tucks or Mommy Makeovers, I feel it’s one of the best innovation to come along in years.

Exparel is an injectable numbing medication that lasts for up to 72 hours and is designed to replace the need for pain pumps.  I can inject Exparel exactly where I need pain control – in areas of high nerve concentration, for example. The patient will feel dramatically less pain for 3 days following the injection, which is usually when surgical pain starts to decrease significantly on its own.

Exparel is not a narcotic, and it does not have systemic effects. It simply blocks pain in the area where it is injected. I have now used Exparel on many of my abdominoplasty patients and it has far exceeded my expectations. Pain control in the first 3 days following surgery is dramatically better than I have seen in the past, allowing my patients to get off pain pills sooner, move around much easier and recuperate with a lot less discomfort. Additionally, patients no longer need to hassle with pain pumps.

Scottsdale Plastic Surgeon
5.0 out of 5 stars 17 reviews

Exparel is a Game Changer

I recommend you choose Exparel.

In 2003, I conducted a clinical study and published the first plastic surgery article on pain pumps. I was a big advocate for the product, so I was eager to run trials on Exparel when it came on the scene.

Exparel has really transformed Tummy Tuck recovery. My patients say they don't have any pain at the incision, just soreness at the muscle. It uses the same local anesthetic as the pain pump, but it is in a slow release form. The means it is administered one time to control pain for 3-5 days without the patient having to tell the pain pump in response to discomfort. I believe the benefits of Exparel® include improved, consistent pain relief, faster recovery, reduced risk of pain killer addiction, and fewer complications for an all-around safer recovery without a clumsy pain pump.

Henry Mentz, MD
Houston Facial Plastic Surgeon
4.5 out of 5 stars 14 reviews

Exparel vs. Pain Pump.


In my experience, Exparel has transformed the postoperative recovery for my patients.   The pain pump worked well in some folks and didn't work well in others. Based on my experience with both, I'd tell you to opt for the Exparel.

Best wishes,

Dr. Basu

Houston, TX

C. Bob Basu, MD, FACS
Houston Plastic Surgeon
4.5 out of 5 stars 123 reviews

You might also like...

Exparel for Tummy Tucks


Exparel is an ideal drug for tummy tucks.  It is injected into the muscle and fascia of the repair and provides 3-4 days of pain relief.  The pain pump only places the medication in the vicinity of the repair and works by absorption into the tissues.  The direct placement of the medication into the muscle is a huge advantage and provides for much more pain relief.

David Finkle, MD
Omaha Plastic Surgeon
5.0 out of 5 stars 46 reviews

Exparel is a game changer


I used to use pain pumps. Then I tried Exparel. Exparel is injected by the surgeon where the pain is. The pain pump drips a similar medication in the area and hopefully the area that hurts absorbs the pain medication. In the ER docs inject lidocaine to numb a spot. They don't just pour it over the injury and hope it absorbs. Exparel is very expensive which is most likely why most surgeons don't offer it. Pain pumps are also expensive but not nearly as much. The cost is worth it to me given the results I have witnessed. The difference in my practice has been night and day in terms of the recovery. I have observed it, my nurses have noticed, and my techs have noticed it. Think about it.... Just my 2 cents......

Evan Sorokin, MD
Cherry Hill Plastic Surgeon
4.5 out of 5 stars 40 reviews

Exparel vs On-Q pain pump


The main difference between these two options is that with Exparel you don't have the catheters and external reservoir. Both approaches use a numbing agent infused into the surgical site to block the pain after surgery, but Exparel is a slow-release formulation so the only injection is the one done during the surgery.

Richard Baxter, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 25 reviews

Exparel, pain pumps, or neither


We favor the injections, as we just don't like the 'tubes' sticking out of our patients. We don't use drains either. And no, we have rarely used Exparel as well. Lidocaine we use in liposuction during tummy tuck can cause a faster release of the active ingredient (bupivicaine) in Exparel which could be a risk. Ask your surgeon for a clear discussion before you 'choose'.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 29 reviews

onQ pain pump or the Exparel injections.


They both are engineered to deliver on a time release basis local anesthesia to the surgical field. I don't think anyone knows if one is better than the other. A disadvantage of the pain pump is that you have this device to carry around with you that is not so for the injections.

Thanks for your question, best wishes. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.5 out of 5 stars 31 reviews

Exparel or Pain Pump? Does Anyone Feel There is a Difference?


I think it depends on the size of reservoir in the pain pump. Exparel works for up to 72 hours. The pain pumps we use give relief for over 100 hours.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 13 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.