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

Doctor Answers 76

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.

Raleigh-Durham Plastic Surgeon
5.0 out of 5 stars 89 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 71 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.

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 4 reviews

Pain control after Mommy Makeover

Great Question.  Be sure to talk this over with your Plastic Surgeon before surgery.   This was he or she can be sure to provide you with adequate long acting local anesthesia, such as Exparel or a pain pump.  For the most part extra strength Tylenol and high dose ibuprofen can help a great deal. There is a synthetic narcotic called Ultram, that often does not cross react with those people who suffer from Codeine allergies.

I hope this helps :)

John Paul Tutela, MD
West Orange Plastic Surgeon
5.0 out of 5 stars 6 reviews

Pain control options after mommy makeover

Your question is a common one, and many people are sensitive to codeine. In my practice, most patients are able to control their pain with Percocet (oxycodone). In addition, all of my tummy tuck patients receive a pain pump which is filled with a long-acting local anesthetic. This pain pump is then removed in about 3-5 days after surgery after it is depleted. This helps greatly with pain control so that the patient does not have to take as much pain medication during their recovery period. They report that their recovery is not as bad as they have heard from others who have not had a pain pump. Our patients also find that taking a muscle relaxant helps quite a bit and again, the need to be dependent only on their narcotic pain medication is decreased. I hope that this helps.

Rapid Recovery From a Mommy Makeover Without Narotics Like Codiene or Hydrocodone

Surgery recovery has made some great strides in the last few years in general. Following the lead from orthopedic surgery recovery where they get you moving as soon as possible, similar techniques can be applied to plastic surgery. As a result, we can now have women back to doing things the next day without the use of narcotics!

How is this possible? We use a combination of motion, heat and anti-inflammatories. For a mommy makeover, where a tummy tuck is done we also use some long acting local anesthetics as well as the No Drain technique. You are not healed (that takes a couple of weeks), but you are back to doing things like driving, shopping and going out to dinner within a day or so.

I hope that helps.

Best regards.

Brian Windle, MD
Kirkland Plastic Surgeon
5.0 out of 5 stars 39 reviews

Pain control after mommy makeover

Pain management after mommy makeover usually involves using intravenous narcotics during the first 12-24 hours followed by oral narcotics for 1-2 weeks.  Afterwards, non-narcotic analgesics like Tylenol and Advil are used.  Sometimes long-acting local anesthetics are injected during surgery to reduce the need for higher dosages of oral narcotics.  When lower narcotic dosages are used, side effects like nausea and vomiting are experienced to a lesser degree.  Many patients misinterpret the side effects of nausea and vomiting as "allergy" to the narcotic being used.  In reality, these side effects are not considered allergies since all patients will experience them in a dose-dependent manner.  Best of luck!

Paul Fortes, MD
Houston Plastic Surgeon
4.0 out of 5 stars 7 reviews

Allergy to Codeine

First, it is best to ensure that you are truly allergic to codeine. Some patients experience unpleasant side effects to medications such as nausea. However, that is not a true allergic reaction. An allergic reaction normally involves a rash or anaphylaxis (throat swelling). If you are in fact allergic to codeine be sure to inform your doctor so a different pain medication can be substituted.

Scott Chapin, MD, FACS
Philadelphia Plastic Surgeon
4.5 out of 5 stars 12 reviews

Codeine is a Lousy Drug. There are Superior Alternatives.

Codeine causes a lot of nausea.  I have not used it for twenty years. There are many great narcotic and non-narcotic alternatives which have fewer side effects. 

Most of my patients find recovery from combination procedures quite manageable. Many have related it to be similar to a c-section or hysterectomy. Sometimes they find it easier.

I have seen a profound improvement in the last few years related to 3 game-changers:

1. Exparel gives a 3 day effect of local anesthesia which gets patients off to a great start.

2. Elimination of drains decreases pain and hassle and gets patients moving faster.

3. Anesthesia improvements using our proprietary combinations has markedly decreased the pain and nausea.

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.