Very concerned. Non-narcotic pain management for "mommy makeover"?

I have a breast augmentation (under muscle) and mini tummy tuck scheduled for the end of this month. I have been given a list of my prescriptions for pain management following the surgery. NO pain pump, NO exparel are being issued . Here is what I have been prescribed : ONLY 3 pills of percocet,8 pills gabopentin,8 pills celebrex,12 pills valium. Does this seem adequate for managing pain post-operative for such major surgeries? I am very concerned.

Doctor Answers 10

Pain management after breast and abdominal surgery

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I have found the use of local anaesthetic pain pumps to have completely transformed my post-op pain management, particularly for abdominoplasty, but also breast augmentation. I now rarely use any form of opiate pain relief and patients are discharged with paracetamol (acetaminophen or Tylenol) and an anti-inflammatory drug such as diclofenac. This has almost completely eliminated post-operative nausea and has massively improved recovery rates.

Very concerned. Non-narcotic pain management for "mommy makeover

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Thank you for your question. Your post op medications should be discussed with your surgeon.  You may need more percocet especially in the first 2 days.  I have never found pain pumps to work very well.  Best Wishes.

Managing pain after surgery

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Thank you for your question. There are many things that can make your post-operative pain tolerable:
1) Injectable numbing done at the time of surgery (some can last for several days)
2) Muscle relaxants so your muscle is not as tense
3) Narcotics to help address pain. Usually more effective if you stay ahead of it
4) Non-narcotic medications (e.g. anti-inflammatories such as Advil)
You often find that discomfort does correlate with size of the implant and the degree of stretching of the soft tissue of the breast.

In your specific situation, I would ask your surgeon what the contingencies are if you are in pain despite sticking with the regimen.  You may also inquire about using Exparel.

Pain control after a mommy make-over

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Thank you for your question about your mommy make-over.

  • Every surgeon does things differently and the best approach is to ask your surgeon what happens if the medicines prescribed aren't enough.
  • Pain pumps in my experience do not work - I no longer use them. No problem there.
  • Exparel works but costs, in our area, $1000 and because of its cost is available only at a hospital.'
  • Ask your surgeon if this is available for you.
  • If your implants are going over your muscle, you will have little pain.
  • If only the lower abdominal muscle is being tightened, again, pain is less than usual.
  • But if you have under the muscle breast implants, this seems on the light side.

Always consult a Board Certified Plastic Surgeon.
Hope you find this information helpful. Best wishes.

Pain is real after abdomen and breast surgery

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For breast augmentation I give 40 Percocet and have never regretted it.   In addition I give Ambien for sleep.   Gabapentin is fine as a supplement and helps but I don't find it useful  for pain control in the first 4 pr 5 days.Your regimen seems quite light but every surgeon is different.  Talk to your surgeon.  My Best,  Dr Cr

Plastic surgeons tailor pain medications to the individual needs of the patient.

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The medications you list are a good place to start. Your surgeon will be available to change the regimen if it's inadequate. Pain pumps have not been shown to be of any particular benefit.

Pain control

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Every surgeon is different and treats postoperative pain differently however I don't understand why there is no Experel being used. I tend to use this amazing pain med intraoperatively too decrease narcotic requirements. I would discuss this with your surgeon prior to surgery. 

Mommy makeover post-op protocol

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Speak with your PS and discuss your concerns regarding adequate pain control.  (S)/he may be able to allay your fears, especially since Percocet and Celebrex are analgesics (pain tablets).  I have occasionally "run" some post-op patients on Valium and Tylenol, especially if they are intolerant of narcotics, i.e. get significant post-op nausea and vomiting.  In order to provide "pre-emptive" analgesia, I typically use liberal amounts of local anesthesia, pre-op and intra-op.  Most of my patients wean themselves off narcotic pain tablets at a week, which facilitates the return of their bowel function.  Over-prescription of narcotic analgesics are associated with complications such as respiratory depression, constipation, nausea, vomiting and dependence.  Good luck.

Lavinia K. Chong, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 58 reviews

Mommy Makeover

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It is my pleasure to answer your question. I recommend you to talk to your plastic surgeon. If he has taken that decision of prescribing those medicines he needs to explain to you everything.

Aramis Vega, MD
Dominican Republic Plastic Surgeon

Very concerned. Non-narcotic pain management for "mommy makeover"?

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Your concerns are understandable; why not clarify your concerns directly with your plastic surgeon? Hopefully, you have done your due diligence carefully and selected your plastic surgeon carefully. If so, clarifying concerns should not be a problem.  Asking for the rationale behind any instruction…is certainly acceptable. Best wishes.

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.