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

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.

I have used
both exparel and pain pumps previously in my practice for my tummy tuck
surgeries. When I started practice I was
using the pain pumps, about two years ago I starting using the exparel and I
never went back to the pain pumps.

The exparel in
my patients has created an enhanced experience for my patients for several
reasons. One I typically do not use any
drains with my tummy tuck so with the use of the exparel I don’t have any
standard drainage tubes or the tubes connected to the pain pumps for the
patients to deal with after surgery. The
second reason is that with exparel is injected at the time of surgery, so there
is no concern of the pain pump tubing be removed prematurely, kinking or having
any type of problems. Thirdly and most
importantly the exparel can be injected directly to the areas where you plastic
surgeon wants it. It can be injected
along the muscles that are tightened, any areas that liposuction was performed
and along your incision.

In my
experience patients have had a much easier recovery after their tummy tuck with
the exparel then with the pain pumps. It
makes such a difference for patients that every one of my tummy tuck patient
receives the exparel.

Please discuss
the two options with your board certified plastic surgeon.

I tried pain pumps for tummy tuck pain control - they do  not work enough. First of all drain is placed to heal the tummy tuck better - it would suck the pain pump medication even if the catheters are placed under fascia. Exparel works for 72 hours (3 days!) nothing comes close

Thanks for your question -We have started offering patients Exparel for tummy tucks and other procedures.  We find it offers exceptional pain relief without the downsides of narcotics or muscle relaxants.While pain pumps are similar in function, our patients get slightly longer pain relief with Exparel and don't have the inconvenience of having the pain pump hanging around their waist and avoid the catheters that have to be placed under the skin with pain pumps.I hope this helps!

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!

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.

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!

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.

Thank you for the question. These days plastic surgeons have many options when it comes to pain control after tummy tuck surgery. The use of narcotic medication, muscle relaxants, non-narcotics, pain control pumps, and long-lasting local anesthetics have made the postoperative experience much better than in the past. In my opinion, there is no demonstrable difference between the use of local anesthesia provided through a pain pump versus long lasting injectable anesthetics. There are certainly no objective studies that demonstrate the superiority of one over the other. Best wishes.

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.