{"id":23847,"date":"2022-11-17T13:10:08","date_gmt":"2022-11-17T21:10:08","guid":{"rendered":"https://www.realself.com\/news\/?p=23847"},"modified":"2024-05-20T10:55:29","modified_gmt":"2024-05-20T17:55:29","slug":"exparel-pain-management","status":"publish","type":"post","link":"https://www.realself.com\/news\/exparel-pain-management","title":{"rendered":"Plastic Surgeons Share Their Best Post-Op Pain-Relief Tips and Techniques"},"content":{"rendered":"

The empowering outcomes of plastic surgery inspire millions to book cosmetic procedures every year. However, the fear of a potentially painful recovery can be a nonstarter for many others. The good news is that with careful planning (and the medical guidance of a skilled provider), significant discomfort can be largely avoided. <\/p>

One of the most effective ways to achieve a more comfortable recovery period is by scheduling a consultation with a skilled provider who is passionate about providing ERAS<\/a> (enhanced recovery after surgery) care. “Most surgeons these days have a protocol—it’s not just what you do after surgery, it’s what you do before surgery and during surgery that is key to optimizing pain control in patients,” explains Dr. Quintessa Miller<\/a>, a board-certified plastic surgeon in Destin, Florida. As with many of the providers we spoke to, using EXPAREL<\/a> (bupivacaine liposome injectable suspension) is critical to her pain-controlling protocol. <\/p>

EXPAREL is a long-lasting, non-opioid medication that is administered during surgery and can provide pain relief for up to 72 hours after surgery—the hours that tend to be the most painful for patients. “In my observation, if you can reduce immediate postoperative pain in the first day or two, it’s sort of like a reset,” says Dr. Mark Epstein<\/a>, a board-certified plastic surgeon in Hauppauge, New York. “When the pain medicine wears off, [patients are] at a lower level of pain than they would be without that medication.” It’s why he swears by EXPAREL for labiaplasty patients, who often face the most painful recovery. “Labiaplasty patients treated with EXPAREL experience less pain for the first couple of days, and then, when it wears off, they take nothing more than Tylenol or Advil,” he says.<\/p>

EXPAREL as part of ERAS protocol can greatly alleviate post-procedure discomfort. So if you’re reluctant to undergo plastic surgery due to concerns about pain (or taking opiates to relieve it), read on as board-certified plastic surgeons break down some of the best tips and tricks to stay comfortable after surgery. <\/p>

Find Doctors Near You<\/a><\/div>

Ask your doctor if they use EXPAREL; this step during surgery can make all the difference<\/h2>

“We first used EXPAREL for an abdominoplasty, and I hadn’t told the recovery-room nurse. She immediately said, ‘What’s different here? This patient has very little discomfort.’ I’d just ordered $4,000 worth of pain pumps, which I ended up pitching because I couldn’t justify using them up when I had something so much better in EXPAREL. It results in less pain, less use of narcotics, earlier ambulation, and an overall quicker recovery.” —Dr. Epstein<\/p>

“We have a combination of things we do for our surgical patients—they all work together as a team. For example, for tummy tucks or abdominal liposuction, I find that using ultrasound-guided nerve blocks works very well. That makes patients dramatically more comfortable for the first few days after surgery. These nerve blocks can be done with EXPAREL for an extended-duration effect. Using a well-studied combination of medications that work together nicely has been a step forward. We can avoid a lot of the older narcotic medications—which are prone to causing nausea, vomiting and other gastrointestinal issues—while still getting good control of the pain and inflammation from the surgery.” —Dr. Thomas Fiala<\/a>, a board-certified plastic surgeon in Altamonte Springs, Florida<\/strong><\/p>

“Pain control in the operating room with good pain control upon waking up is so important. I am a big believer in EXPAREL blocks of both the muscles in the area being operated on and the surrounding soft tissue. I’ve found patients are much more comfortable when I utilize this medication in the operating room. If you leave surgery comfortable, it’s easier to keep you that way during recovery. Thus, having an anesthesiologist skilled with outpatient anesthesia is key.” —Dr. Kelly Killeen<\/a>, a board-certified plastic surgeon in Beverly Hills, California<\/strong><\/p>

“I found that before I used EXPAREL, [when I was] just prescribing narcotics, so many patients [would be] nauseous. If you get vomiting after abdominoplasty, that is a disaster—it really increases pain. Then, when they have a 10 out of 10 level of pain and they’re not at a hospital, where there are IV pain medications, it’s really hard to make that pain manageable again. Narcotics also cause constipation.” —Dr. Miller<\/strong><\/p>

Make sure you have the right meds, meals, and compression garments on hand <\/h2>

“Taking Motrin around the clock for the first several days is very helpful. [Also,] many patients feel that CBD products, both oral and topical, are helpful with minimizing pain and inflammation following surgery.” —Dr. Killeen<\/strong><\/p>

“After anesthesia, I do everything I can to try to prevent nausea. Many times, I have patients wear a scopolamine patch. A lot of people use it for seasickness. I have them put that on before surgery because it has to be in your system beforehand. So normally, I have them put the patch behind their ear the night before surgery.” —Dr. Miller<\/strong><\/p>

“I have people in compression garments<\/a> after surgery, such as a sports bra after breast procedures. I do this to help reduce swelling as well as provide added support to the core and the area that’s just been operated on. It takes a lot of the achiness out of recovery—if your breasts are just hanging freely and they have fresh incisions, that’s going to hurt a little more.” —Dr. John Paul Tutela<\/a>, a board-certified plastic surgeon in Livingston, New Jersey<\/strong><\/p>

“When juicing was very popular, patients were not getting any protein, which is not good for wound healing. Now I make it a point to tell patients, ‘This is not the time to be juicing, this is when you need protein.’ After abdominal surgery, sometimes it’s hard to eat—you have a bit of loss of appetite. I say to drink at least three to four protein shakes a day. Whatever flavor you’d like. I tell patients to maybe eat fish or chicken and to stay away from steaks in the beginning because they can be hard to digest. Of course, [I also recommend] multivitamins and I encourage them to eat vegetables. Nothing greasy.” —Dr. Miller<\/strong><\/p>

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