I Am Allergic to Codeine. Any Suggestions for Pain Control After Mommy Makeover?

Doctor Answers 92

Mommy makeover with Exparel and Nucynta

I have been using Exparel for mommy makeovers for more than 5 years. In my opinion, it has been a "game changer" as far as pain relief after a tummy tuck. Patients are out of bed easily the next day and sometimes the same day as the surgery.  It makes the first 3 days much easier and patients need for less pain medication. I prefer Nucynta (tapentadol) for these procedures and have for quite some time. I have found, in my experience, that it works very well for post-surgical pain, it is great for patients that are allergic to codeine or hydrocodone (Norco/Vicodin), and it has far less constipation than any of the other pain medications. Good luck!


Houston Plastic Surgeon
4.8 out of 5 stars 41 reviews

Non-Narcotic Medication following Mommy Makeover

Most of my patients do fine with non-narcotic medications and Exparel and / or a pain pump. The surgical technique used, anesthesia administered, and intra-operative pain control all will make a significant difference in your comfort during recovery from a mommy makeover. It is also my preference that mommy makeover patients stay overnight with roind the clock medical care the night of surgery. Not every surgeon feels this way, but I beleive patients and their families feel more comfortable and have more peace of mind in tis scenario.  If you are very concerned about discomfort, you could have your mommy makeover performed in stages rather than all at once. Discuss your concerns with your plastic surgeon, and speak to other patients about their experience to determine what makes most sense for you.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 118 reviews

Allergy to Codeine and Plastic Surgery

A history of a bad reaction to codeine is not uncommon.  Usually these patients will do fine with a synthetic such as hydrocodone or oxycodone.  With the use of local anesthetics, most patients require much less narcotic.  Just explain your reactions very carefully with your plastic surgeon.

Dustin L. Reid, MD
Austin Plastic Surgeon
5.0 out of 5 stars 82 reviews

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.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 193 reviews

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.

John K. Long, MD
Houston Plastic Surgeon
5.0 out of 5 stars 9 reviews

Codeine allergy and mommy makeover

It depends quite a bit on the nature of your allergy and on whether or not you are allergic to similar, but not identical medications, such as oxycodone, hydrocodone, and morphine.  Many people who are allergic to one of these agents can tolerate some of the others.  Long-acting local anesthetic agents, like Exparel, given during surgery, can dramatically improve pain control in the first few days post-op and reduce the need for narcotic pain medication by quite a bit.  Additionally, non-narcotic meds, such as Celebrex and Toradol, can be quite effective in alleviating pain.  Good luck to you!

Joshua D. Zuckerman, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 18 reviews

Alternatives for pain control following a Mommy Makeover

For patients who are allergic to Codeine, it is first important to know what type of reaction the patient has.  In many cases, it would be acceptable to use Vicodin or Percocet as alternatives. Ultram is another alternative for patients who have had severe reactions to Codeine.  My favorite, however, is the new local anesthetic called Exparel that I inject along the incision lines at the end of a surgical procedure. This new anesthetic last for three days rather than a few hours.  It is extremely helpful at diminishing the need for oral analgesics and is associated with fewer side effects.

David Stoker, MD
Los Angeles Plastic Surgeon
4.8 out of 5 stars 47 reviews

There are many alternatives to codeine.

Codeine is not so effective for pain relief after mommy makeover. I usually use Percocet but there are other alternatives as well for people that are sensitive to a particular type of pain medication. Long-acting local anesthetic after the procedure will also reduce the immediate need for narcotics. I usually also prescribed Valium works well as a muscle relaxant since much of the discomfort is related to spasm in the muscles that we tighten in the tummy tuck part of the procedure. I am quite sure that your sensitivity to codeine will not be a problem.

Rodney A. Green, MD
Cleveland Plastic Surgeon
4.9 out of 5 stars 23 reviews

Pain Control after Mommy Makeover

Omaha1470.     You are not alone!  There are numerous options for controlling pain after this surgery other than codeine. I usually use a long acting anesthetic injected at the end of the surgery, which usually decreases the need for narcotics.  Other options for pain include hydrocodone and extra strength Tylenol.  I usually tailor the pain control regimen to each patient's needs. Be sure to consult with a board certified plastic surgeon. Good luck!

Robert M. Tornambe, MD
New York Plastic Surgeon
5.0 out of 5 stars 27 reviews

No Codeine Needed!

Hi Omaha1470, I don't  believe many surgeons use codeine after surgery. Most patients aren't truly allergic, it just causes server stomach upset, but regardless it isn't used because there are much better options available. Speak to your surgeon before hand and they will prescribe any range of options. You can also speak to them about using a pain pump or a better option, Exparel, that will provide localized numbing for a few days after your surgery to keep you comfortable. You should be fine!

William Aiello, MD
Orange County Plastic Surgeon
4.9 out of 5 stars 45 reviews

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.