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Which Do You Think is Better for Pain After a Tummy Tuck?

I'm on methadone and am going to have a tummy tuck. For the post op pain management, I wanted to know which would better help with the pain, tramadol or the on q pain pump for 5 days?

Doctor Answers 9

Tummy tuck pain control


I have had a few patients on long term pain management who have undergone a tummy tuck.  It will be important in your case to have your plastic surgeon and your pain/addiction doctor discuss the best course of action.  Often, numbing medication is injected during the procedure (marcaine) and Percocet, Nucynta, and Sprix can be used as post op pain management.  I would discuss Exparel with your plastic surgeon as it may provide 24+ hour pain relief early on.

All the best,

Dr. Remus Repta

Scottsdale Plastic Surgeon
5.0 out of 5 stars 111 reviews

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Exparel vs Pain Pump for Tummy Tuck

The short answer is the On-Q pain pump works better. The long answer is that Exparel is a better choice.
Essentially Exparel is a very long-acting local anesthetic that works great. 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 plus decreases spasm of muscles after a tummy tuck.
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. I use if in virtually all of my tummy tuck patients.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 59 reviews

Multiple strategies for pain relief after abdominoplasty.

With a methadone history your postop pain management will be more complicated. I'm not a big fan of pain pumps but Marcaine injected into the fascia at the time of closing seems to help. Toradol is an excellent drug but can be given orally for only a brief time.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 13 reviews

Pain Control after Tummy Tuck

With your medical history, you are best served by having Exparel injections done into the muscle during surgery for the first few days. Afterwards your after surgery pain management should be done by your pain management physician.

Best way to manage pain after a tummy tuck?

I used the On-Q Pain pump for about 12 years or so before going to Exparel. I have been using Exparel for about 1 1/2 years now and there is no comparison. It is not uncommon for patients to require as little as only tylenol after surgery or a couple of narcotic pain pills the first day or two (and I mean a couple of pain pills!). Although the On - Q pump works, the degree of pain relief, in my opinion, as well as that of my recovery room nurses (becasue we have discussed this) is far, far better with Exparel.

Mark D. Epstein, MD
Stony Brook Plastic Surgeon
5.0 out of 5 stars 164 reviews

Exparel to minimize pain med needs after tummy tuck

First, it is really best to have your pain management doctor involved. However, a good way to minimize your pain and therefore the need for medications is Exparel, a long-acting numbing agent that would be injected during surgery and lasts for up to 3 days. An On-Q works the same way except that it has an external reservoir and slowly infuses a numbing medication through small catheters.

Richard Baxter, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 30 reviews

Which Do You Think is Better for Pain After a Tummy Tuck?

Have your pain management doctor involved. Multi-modality pain control is better than just one type of medication. Tramadol does not work for everyone but a combination of tylenol & an NSAID is a good way to start. The On Q pain pump or Exparel during surgery are also good and can be used in addition to the pills. 

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
5.0 out of 5 stars 26 reviews

Pain pump

Tramadol could also aid in pain control, but the pain pump is a great help in numbing the abdominal wall!


good luck 

David Shifrin, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 70 reviews

Which Do You Think is Better for Pain After a Tummy Tuck?

There are two methods of providing extended local anesthetic--pain pump which gives about three days worth of marcaine, and can be refilled, and Exparel, which is injected during surgery and can give up to 3 days of pain relief, but can't be supplemented after that. It will be important for both you and your surgeon to be in touch with your pain doc. 

All the best. 

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.