Are there different types of nerve blocks for explant? My doc says it last 6 hours, but some reviews say 3 days?

Thank you for sharing your excellent question.  There are alternative numbing agents that can last for longer periods of time and your surgeons are discussing between Marcaine administration and Exparel.  Hope this helps.

Dear meglyons,
You are right, there are different types of local anesthetics. Some will last for a few hours but there are also long-lasting local anesthetics which will last for 72 hours. I 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

Hello!We have some great innovations in pain management to get away from narcotic use. Local anesthetic using Marcaine will last up to 8 hours. For a minor implant removal this would be totally appropriate. There is a medication called Exparel that is a slow release Marcaine that lasts up to 3-4 days. This might be helpful if you are undergoing a more complicated surgery, like capsulectomy with the implant removal. Exparel runs in the range of $300 additional. We use it for our tummy tucks routinely.Best of luck to you. Be sure you are seeing a board certified plastic surgeon!

Thank you for your question.
There are different anesthetics that can be used during your surgery. Duration varies from anesthetic to anesthetic so it is best to discuss this with your plastic surgeon.
Best of luck,

Yes, there are different medications and different types of blocks.  Each may produce varying lengths of pain relief.  Your surgeon will be most familiar with the type he uses, so his estimation will be most accurate with regard to what you can expect.

For a standard breast implant removal without capsulectomy, a long acting block is not needed as there is very little pain. I typically remove implants with patients awake and just a standard local anesthetic. 

Generally speaking, the discomfort tends to be much less than that associated with initial breast augmentation surgery. There are a variety of different types of local anesthetic "blocks" that can be utilized;  practices will vary in this regard.   Most of our patients do very well, from the discomfort standpoint, requiring minimal to no postoperative narcotic medications. My best advice: select your plastic surgeon carefully.  Communicate your concerns/goals/questions carefully as well.  Best wishes.

Many surgeons, myself included, use a long acting form of a local anesthetic to help with early postoperative pain relief, not only from breast procedures like explant or augmentation, but also tummy tuck, facelift, and many other procedures where early postoperative pain relief might be difficult to obtain with oral medications alone.  There are a number of different local anesthetics out there, and one of the things that differentiates them is the duration of effect.  One of them is called marcaine, and it is probably the most common "long acting" local anesthetic used because of its availability, reliability, and safety when used properly.  Lidocaine is also a very reliable local anesthetic, but it wears off relatively soon, so it's great for procedures themselves under local, but if longer duration is required, it's not as good.  It may last a couple of hours at the most.  Marcaine typically lasts about 6 hours, and this is the "block" that your doctor is probably talking about, and the one that I think most surgeons use.  There is another "form" of marcaine, however, that is quite commonly used for much longer lasting effect, and I myself use this one too.  It will in fact last 72 hours, or about 3 days like the other surgeon's website says.  It is called "Exparel," and it is what is known as "liposomal" marcaine.  This means that the marcaine local anesthetic - the same one your doctor uses for only 6 hours effect - is "packaged" into these little things called "liposomes," which are little microscopic dissolvable packets much like your laundry detergent comes in, and the packets are suspended in a solution for injection and designed to be "timed release" and dissolve over differing time courses, such that some dissolve in a few hours, some in a day, some take as long as 3 days to dissolve.  That way your body is constantly getting "little doses" of the marcaine over that time, and the effect lasts longer.  
Thus, both surgeons are correct - your doctor is correct that plain, straight-up marcaine lasts only about 6 hours (if he is suggesting lidocaine alone will, however, that is not accurate).  The other doctor is correct too, in that there is a "block" out there that will last 3 days.  It is the same stuff your doctor uses (marcaine), just in a different "form."  There are a couple of things that prevent some surgeons from wanting to use the Exparel, and that may be why you find some who don't.  The first concern is simply the cost.  While it won't totally break the bank, and my own patients find that it is well worth the extra expense, it will add to the cost of the surgery somewhat.  Hi-tech innovations always cost a little more than "old school" methods, even though "old school" often gets us by just fine.  This is just a decision that you and your surgeon will have to make together.  The other concern I hear most frequently is the risk of "overdose" of the Exparel.  While this is a theoretical risk, I can say that I have been using Exparel since it came on the market many years ago, as have many of my colleagues, and I haven't seen one case in which this has happened.  The one caveat is that Exparel cannot be mixed directly with lidocaine (something some surgeons might consider to get more rapid onset from lidocaine with longer duration from Exparel) because the lidocaine solution due to the chemistry of the whole thing will dissolve the Exparel "packets," and then you will risk toxicity, or overdose.  Used properly, however, Exparel is a great drug, it is very safe and effective, and it is a great addition to my own tool box for pain control.

Yes, there are different types of anesthesia that can be used.  Your surgeon may have been referring to marcaine administration and exparel.  Best to discuss this with your surgeon.