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What is your opinion on pain medication post-op for Tummy Tuck or Butt-Lift?

In reading many different reviews I found some doctors use very strong pain meds after surgery like Morfine , Percocet where some would give Tylenol 3 along with antibiotics. What are the opinions on this? Does it help with the recovery to not have strong pain meds? Is that just because the pain is SOOO massive ? I am trying to understand please bare with me?

Doctor Answers (7)

Pain control after tummy tuck.

+3
All of our tummy tuck, buttock lift, and even full circumferential lower body lifts are done as outpatient operations in our nationally-accredited (AAAASF) office surgical facility. Since every one of our patients goes home (or to a local hotel, if they are from out-of-town), pain control is a big deal, not only for the patient, but also for the spouse, significant other, family member, or friend that is responsible for their after care the night of surgery.

I see virtually every one of my patients the very next morning after surgery, so they have to be up, moving around, and comfortable enough to get in a car and be driven to my office for their recheck appointments, and the vast majority (97% by our latest data review) have NO nausea or vomiting, and pain that is well-controlled by our medication protocol.

In addition to our TIVA (Total IV Anesthesia) general anesthetic, which avoids the use of inhalation anesthetics and nitrous oxide (7-28% nausea and vomiting rate), we utilize a continuous-infusion ultra-short-acting narcotic that avoids IV boluses, which causes periods of narcosis interspersed with periods of physiologic pain. Even when a patient is asleep, her nerve endings and receiving and sending pain signals, and highs and lows are much more stressful than continuously-controlled pain medication infusion. Our post-op nausea rate with TIVA is about 3% (all operations, even long ones).

In addition, BEFORE surgery, the patient receives an oral anti-inflammatory medication (Celebrex), and an oral central-acting muscle relaxant (Robaxin), since a major component of perceived pain is due to muscle spasm and surgically-induced swelling and inflammation. We also use IV Decadron (steroid) for further swelling and inflammation reduction, as well as nausea reduction and giving a sense of well-being! Having these medications already on-board prior to incisions being made actually reduces the degree and severity of any pain impulses that start as spasm or inflammation. These medications are continued post-op, along with an antibiotic, and if needed, oral Vicodin, Percocet, or Tylenol with codeine (T3).

Before your tummy tuck incision is closed, we also inject a long-acting local anesthetic into the muscle sheaths where the repair is performed, and into the skin incisions and drain site(s), which provides hours or pain relief as the patient is waking up, getting dressed, and readying for transfer home. Most patients leave our facility in just over an hour, having been to the bathroom, sipped a soda, water, or coffee, and getting dressed. They do not leave until they are doing well and most are quite comfortable! Trust me, they tell me the next day, so we know this regimen works!

Every patient responds to pain stimuli differently, but careful surgery, minimal blood loss, and the protocol for anesthesia and peri-operative medications I've just described really allow the vast majority of my patients to describe this surgery as "much better than I expected."

There are plenty of patients whose surgeons do not do all or some of these things, and these surgeons' technical skills may also be of different qualities, so I do not doubt that you have read horror stories that depict true situations. But these are not the norm for most experienced plastic surgeons who operate their own accredited surgical facility, and whose livelihood and reputations rely on the careful performance of surgery and the attendant anesthesia as I have described. Not taking pain meds increases your risk for blood clot (you aren't moving as well), and increases you time of recovery (you aren't healing and resolving swelling as fast), so PROPER use of pain medications improves your recovery overall. But too much (or the wrong kind) of medications are also a problem, so you are wise to ask the question. Find someone who does things properly, and you will be fine! Best wishes! Dr. Tholen


Minneapolis Plastic Surgeon
5.0 out of 5 stars 144 reviews

What is your opinion on pain medication post-op for Tummy Tuck or Butt-Lift?

+1
    The experience of recovery is very individual.   I think that many patients require prescription pain medications for the first week or so with the transition to the use of Tylenol for the next week.

Kenneth Hughes, MD

Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 237 reviews

Tummy Tuck Pain Control

+1
  Dear roxyhess,  There are many ways to manage and control pain after surgery. Tummy tuck surgery can be painful for some and not so bad for others. In my practice I aim to control pain before it starts. We use an oral anti-inflammatory (Celebrex) in the pre-op area. Our skilled anesthesia team uses total IV anesthesia for intra-operative pain control. This is ideal to keep post-op nausea and vomiting to a minimum. I also inject a long acting local anesthetic into all the incisions before we begin and also into the muscle repair during the surgery. We keep you comfortable in the recovery room and send you home with several medications to mange your discomfort. We use Celebrex, Vicodin (or another narcotic) and Robaxin (muscle relaxant for muscle spasm). I have my patients up and moving about their homes the night of surgery and each day after surgery. Most of my patients are off of their narcotic pain pills by 4-6 days. My tummy tuck, body lift patients are some of my most happy patients. If you are considering this procedure, be sure to see an experienced body lifting surgeon(board certified and maintenance of certification certified as well). Good luck. Dr. Gervais

Douglas L. Gervais, MD
Minneapolis Plastic Surgeon
5.0 out of 5 stars 95 reviews

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Post op pain medication

+1
All surgeons have their own preference for pain management after surgery. Tummy tucks are very invasive and can be incredibly painful. 

Thank 

Melinda Lirag Lacerna-Kimbrell, MD, FACS
Sarasota Plastic Surgeon
5.0 out of 5 stars 49 reviews

Post-operative pain control

+1
There are many different medication traditionally prescribed for post-op pain control, most are narcotic based oral medications and although effective, come with a lot of side effects - sedation, nausea and vomiting, and constipation to mention a few common ones.  Because of this, I have integrated in some new compounded pain creams that are applied locally to the area of pain and thus are often more effective and do not have the side effects caused by the oral systemic medications.  Glad to help.

Ryan Stanton, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 24 reviews

What is your opinion on pain medication post-op for Tummy Tuck or Butt-Lift?

+1
It helps with recovery to have the pain well controlled so you can move around. When you choose a surgeon, they will tell you what they use. We all have different routines.

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

Tummy Tuck

+1
Non of us will be able to advise you on the proper medication without history, physical examination.
There are many strategies to control pain after surgery and should be administered based on individual basis and nased on the surgery and history of the patient.

Samir Shureih, MD
Baltimore Plastic Surgeon

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.