How does non-opioid pain management for a tummy tuck with muscle repair works.

There are many pain medications that may be appropriate.  Each PS will prescribe the medication that he/she is most comfortable with and that seems best for each patient. I typically use whatever medication a patient has used in the past that has had success.  If the patient has never had surgery or never used pain medication, I use oral narcotic meds of varying strengths.  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.  
The pain can be managed effectively, and this aspect should not deter you from surgery.  Exparel can be injected at the time of closure for 72 hour pain relief.  Every surgeon wants his/her patients to have a satisfactory and safe experience. The PS needs to know what your concerns are so that he/she and the anesthesiologist can address your comfort and lessen your anxiety before surgery.  Select your PS based upon results generated, before and after photos, and patient reviews, not exclusively on the use of Exparel (which my patients think is too expensive) or a pain pump (patients do not want to carry it around for days).  

Hello and thank you for your question. In our practice, we use a long acting local anesthetic agent (Exparel), which is injected into the muscle planes and skin during your procedure. This will decrease the need for narcotic pain management considerably. Talk to your plastic surgeon about his/her pain management regimen. Best,
Pejman Aflaki, M.D.

Johns Hopkins-trained double board-certified plastic surgeon

Dear esr718,
Every plastic surgeon has his own postoperative protocol and pain management protocol which he recommends to his patients. I use long-lasting local anesthetic during tummy tuck surgery so my patients don't have much pain in first few days which are usually the worst. Later they can continue with non-ovoid pain killers. I would suggest you to discuss this with your plastic surgeon.
Daniel Barrett, MD

Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

With the right combination of long acting nerve blocks (Exparel), muscle relaxers, and non-opioid pain medication (Celebrex, Neurontin, etc.), most patients can avoid using opioid pain medication if need be.  Early movement is critical, and if you are a candidate for a progressive tension suture/drainless procedure then that helps even more.  The best thing to do is to have a few consultations with board certified plastic surgeons and see what will work best for you.  Please see below link for examples.

Hello and thank you for your question.  The most uncomfortable part of the TT is the muscle work involved.  I use a pain pump for all my TT's which drips numbing medicine on the muscles for up to 72 hours.  Valium really helps as well, however, everyone has different pain tolerances and most patient's need the opioid for the first week.  They can't take aspirin products until theyre 7 days post op.  You can always try the neurontin and valium and see how you do, you don't have to take pain meds unless needed.

Hello, thank you for your question, this is a very valid question. In general, most patients get by a tummy tuck without the need for using opioid pain management. The tummy tuck itself is not very painful, it's mostly discomforting because of the posture you would have during the first few days. The liposuction is the one the hurts the most, and in both cases the use of muscle relaxants and NSAIDs (aspirin type medication) will keep pain controlled. In cases where liposuction is also performed, I like to add pregabalin to better manage pain.

I have been using ERAS (Enhanced Recovery After Surgery) protocols for over 10 years and this includes non-opioids such as Tylenol, NSAIDS, Gabapentin, and nerve blocks (TAP and Rectus Sheath blocks). I also include a no-drain tummy tuck to allow for easier walking and less discomfort after the procedure. Many of my motivated patients do not use any opioids after surgery, bu those that need the, do so for only a few days. See link below for examples. 

Look for a surgeon that has implemented an ERAS (enhanced recovery after surgery) protocol. This includes education, standardized pre-operative and intraoperative medications, nerve blocks and perisurgical supplementation.  In our clinic we use a product called Vivanta which reduces inflammation and the need for post operative narcotics.Surgery will never be pain free, but can be quite tolerable without use of narcotics.

Thank you for the question. Good pain control after tummy tuck is very important for many reasons. Besides the important concern of patient comfort, good pain control allows for better/easier deep breathing exercises and ambulation. These measures may lead to decreased incidences of pulmonary complications and/or thromboembolic phenomenon.
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. The specific medications used will vary from one practice to another.
In our practice, all patients undergoing, tummy tuck surgery receive a postoperative pain control pump.  In my opinion, there is no demonstrable difference between the use of local anesthesia provided through a pain pump versus long lasting injectable anesthetics.  Best to communicate your concerns/questions directly with your selected plastic surgeon; he/she will be in the best position to provide you with more meaningful (and specific) thoughts and recommendations.Best wishes.

You are correct that pain is unique to each patient.  We often use Exparel for our tummy tuck patients.  This medication is administered during surgery and helps with pain control for the first few days after surgery.  It can be combined with other narcotic, or non narcotic pain methods to help manage post surgical pain.