I Am Allergic to Codeine. Any Suggestions for Pain Control After Mommy Makeover?
Doctor Answers 84
Non-Narcotic Medication following Mommy Makeover
Allergy to Codeine and Plastic Surgery
Ultram & Double Strength Tylenol are Great Options
Pain control is extremely important following cosmetic surgery. Patients frequently report allergies to various pain medications and as a result, pain management may require adjustment in the postoperative period.
Most patients who say they are allergic to codeine don’t have a true allergy. They usually have severe nausea, which codeine is notorious for causing.
We typically use a synthetic codeine derivative called Hydrocodone, which has a decreased incidence of nausea compared to codeine.
Examples of prescription Hydrocodone commonly used include Vicodan and Lortab. When these don’t work or patients are allergic to them as well, we use Ultram. We replace narcotic pain relievers with double strength Tylenol as soon as possible following surgery to avoid the potential for drug problems.
Pain tolerance varies from patient to patient and with appropriate care can usually be managed without difficulty. When allergies to pain medications occur, multiple alternatives exist to deal with this problem.
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Allergic to Codeine Pain Medications
The allergy to codeine in pain medicines is so common that I rarely use these pain medications in my practice. Artificial codeine, hydrocodone, is more commonly prescribed and used in products like Vicodin and Lortab and these medications are surprisingly effective on many individuals who cannot tolerate codeine but can tolerate hydrocodone.
Even when I have prescribed the hydrocodone medications, I encourage my patients to as quickly as possible to convert to anti-inflammatory medications like Advil, Nuprin and Motrin which are Ibuprofen products and Alleve which is a different anti-inflammatory product. These medications actually effect the pain problem itself instead of hiding the symptoms in one's brain and have less side effects.
Never forget the use of ice and cold packs to reduce the amount of pain on almost all areas of the body following surgery.
More than half of my patients take very few narcotic pain medications with the use of Exparel (a long acting injection of local anesthetic) and a combination of muscle relaxants and non-narcotic medications. Interestingly there is a large amount of studies to show that those patients who take fewer narcotics have fewer issues related to nausea, vomiting and constipation, and thus experience a better recovery than those who take more of them. So while most surgeons will still give narcotics (to those who are not allergic), we try to encourage everything else for pain control.
I hate narcotics
In my practice we avoid narcotics whenever possible.
Mommy makeovers can involve muscle manipulation, as in sub muscular breast augmentation and full abdominoplasty (tummy tuck) . In these I use a pain pump which drips Novacaine like local anesthetic onto the muscle right inside the wound. We add an anti muscle spasm medication like Robaxin and Tylenol and rarely even need narcotics
For the other procedures ( breast lift, breast reduction, modified tummy tuck, liposuction), using gentle surgical technique followed by long acting local anesthetic in the wound before closure, plus Tylenol plus a "chill pill' eg Xanax or Valium, we rarely need narcotics and therefore avoid their nasty side effects.
With all these techniques, let's all avoid narcotics!
Allergic to Codeine. Options for Pain Management Post Mommy Makover
move off the pain medicine to Tylenol after a few days. We try to avoid ibuprofen and aspirin products for a couple weeks post op. There are options to codeine for pain control. Best to contact your Board Certified Plastic Surgeon as each surgeon will approach the operation and the post operative management differently.
Pain control after a mommy makeover
Allergic to codeine
Allergies to codeine
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