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

Doctor Answers 85

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
4.8 out of 5 stars 110 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 78 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 8 reviews

Allergy to Codeine

Thanks for your question. There are several alternatives to Codeine based mediations to control pain after surgery. I will often prescribe Tramadol. I also use a On-Q pain relief system to help with relief immediately in the abdominal area. Many patients find they only need over the counter pain relief after that. Your Doctor can work with you to keep your pain under control.

Best wishes!  

Codeine allergy

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.

Manish Raj Gupta, MD
Toledo Plastic Surgeon
5.0 out of 5 stars 7 reviews

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!

Richard A. D’Amico, MD, FACS
Englewood Plastic Surgeon
4.9 out of 5 stars 19 reviews

Allergic to Codeine. Options for Pain Management Post Mommy Makover

Thank you for your question.  Our office takes post operative pain management seriously.  Our current protocol includes a pain pump, (with numbing medicine), that will instill the numbing medicine in the area for the first three days after abdominoplasty.  Patients typically
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.

Jeffrey J. Roth, MD, FACS
Las Vegas Plastic Surgeon
4.6 out of 5 stars 16 reviews

Pain control after a mommy makeover

This is a super important subject for me since if  a patient is not comfortable post-op they will not be able to recover and heal in an ideal manner.  Not to mention who wants to be in a lot of pain?  In generally I use a large amount of long acting "novocaine" (called Marcaine or bupivacaine) during surgery.  I typically give dilaudid as a pain pill to be taken by mouth.  This medication is ideal since it can be combined easily with Tylenol without worrying about combining tylenol in two medications.  For those who are more sensitive to pain (or are having a more uncomfortable operation)  I typically also give lyrica and celebrex.  These two oral non-narcotic pain meds also serve to reduce the discomfort and narcotic need in patients.  Best of luck!

Allergic to codeine

Many patients are allergic to codeine.  For these patients, tramadol usually works well.  Sometimes, Celebrex or a Celebrex-like medication are added for pain relief.  Best of luck. 

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.