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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 14

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

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.

Robert Cohen, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 30 reviews

No pain-No drain Mommy Makeovers with Exparel

There is a large difference.  The pain pump involves a small catheter hooked to a large awkward ball filled with numbing medicine.  In the past, people have tried to figure out how to hide these, sometimes unsuccessfully.  And more importantly, sometimes it did not work well.  Exparel is placed during your surgery and lasts up to 72 hours.  We performed a mommy makeover without using any drains and used exparel for local pain control.  The patient did very well and said she could not feel pain in both her breast and abdomen.  

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.5 out of 5 stars 94 reviews

Exparel really can make a difference. Not so much Pain Pumps.

For my tummy tuck patients and for patients undergoing other procedures where I don't anticipate much discomfort but the patient's concern about postoperative pain and need to recover as quickly as possible is a driving force, Exparel has been a real game changer for us/them.

I was so disappointed with the time, expense, and lack of improvement with pain pumps that I stopped using them.

Best of luck.

Brian K. Brzowski, MD
Ogden Plastic Surgeon
5.0 out of 5 stars 47 reviews

Exparel Makes a Difference

I use exparel for nerve blocks in all of my abdominoplasty procedures.
Instead of just injecting the exparel into the skin or muscle, I actually perform a *true* nerve block of the intercostal nerves that supply the abdominal wall with sensation. My patients have been thrilled, and you can see for yourself with the link below.
I perform what is called a TAP block, where I directly observe the needle going into the internal oblique muscle where the nerves are found. My patients still have discomfort after a tummy tuck, but it is just that: discomfort. My patients do not require much in the way of oral pain medications and the return to activities is much quicker than before I was using exparel. It is worth it all the way!

Exparel is Superior to a Pain Pump

Ibuprofen is usually not allowed as it increases your changes of excessive bruising and bleeding.
Exparel is extremely safe when used as directed. As it is injected through a small guage needle mostly under direct vision the complications are rare and less than the tummy tuck itself. See the below link for more information. In my experience it is more effective than a pain pump (plus you don't have tubes hanging out of you that have to be removed).

In summary,  Exparel is a very long-acting local anesthetic that has just been released. It lasts approximately 3 or more days following injection. This is the same length of time that a pain pump lasts and will therefore take the place of a pain pump. This means patients can enjoy the same effect of a pain pump, but without any catheters and no pain pump to carry around.
Exparel will be available for those concerned about minimizing discomfort after surgeries such as tummy tuck and breast augmentation.
Exparel costs the same as a pain pump and produces the same result but with less hassle.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 72 reviews

Exparel or pain pump? Does anyone feel there is a difference?

Hello! Thank you for your question! Exparel is an excellent form of delivery of a local anesthetic, Marcaine. It is delivered within a liposomes form, which is slowly released over a 72 hour period. The injectable form lasts approximately 6 hours. It has significantly reduced postoperative pain as well as the need for postoperative narcotics following surgical procedures. Sometimes a small additional fee is required for it's use, but it's benefits have been great.  The pain pumps are excellent as well as they continuously drip the anesthetic within the pocket. 

Typically, Exparel is either injected into the surrounding soft tissue/underlying muscle layer or just simply released into the pocket itself. If injected between the ribs, there certainly is a theoretical, and higher, risk of puncturing of the lung. the former methods are more common. Hope that this helps! Best wishes!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 14 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 Plastic Surgeon
4.5 out of 5 stars 19 reviews

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 62 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......

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