I vomit narcotics - how can I manage facelift pain?

I rarely prescribe any narcotics after a facelift. The reason being is that facelifts do not tend to have much pain associated with them. I have a good relationship with our anesthesiologist who pre-treats my patients before surgery with Tylenol and Gabapentin, the incisions and the area that we are going to work on are injected with long-acting Marcaine and postoperatively we use cool compresses immediately on the area that was operated on. Tylenol is given for the post operative period. This has proven to be an excellent way of managing people after their facelift. I hope this is helpful. Best wishes.

The good news is that facelifts are not typically among the more painful procedures that we do. For all of our surgical patients we are using what is called the ERAS protocol (Enhanced Recovery After Surgery) which minimizes the need for pain medications. This includes a medication called gabapentin, which you should tolerate well. Consider also the use of extended release local anesthesia such as Exparel.

Its possible to use a long-acting local anesthetic like Experel during your facelift procedudre. The use of tramadol post op would also be helpful for pain control. Pre-op use of Emend (a powerful anti-nausea medication used for chemotherapy patients) might also be helpful.

Thanks for your question! Fortunately, a facelift doesn't have much pain associated with it. Many patients get by with just Tylenol. Also, we offer Gabapentin which is a non-narcotic that can help. Good luck!

Typically, post operative pain following a facelift is mild. Most of my patients take mainly Tylenol, perhaps with one narcotic the evening just after surgery. Some only take the high doses of Tylenol for a few days. There is pain pill called Nucynta that was specifically designed for patients who tend to experience nausea/vomiting with narcotics, and I have seen good results with it in such patients.

Thank you for the question. There are numerous ways to avoid the need of narcotic pain medications, also to minimize post-operative nausea. I almost never have to administer narcotic pain medications for post-operative pain control. I wish you the best of luck. Vasileios Vasilakis, MD. Double board-certified, fellowship-trained plastic surgeon, Houston. TX.

I routinely use exparel infiltration of the facelift wound before closure. With use of this injection, there is minimal need for post op narcotics. It does usually carry an additional cost because the injection med is expensive. If your doctor doesn't use it, he may not offer it but ask.

I have my facelift patients use a Scopolamine patch starting 24hr before surgery and then they take only Tylenol after surgery if they have history of severe narcotic related nausea.
Facelift should not be a painful surgery.
Regards
Dr. J

Thank you for your question.
Most of my patients receive a script for a small number of hydrocodone/acetaminophen tabs, but about 90% take 2 tabs or less. I use a long acting local anesthetic which greatly helps with post operative pain. Additionally, pain is usually described as a "swelling or tightness" rather than sharp pain, and this can be manages with many modalities (medications, cool compresses, positions, lymphatic massage, etc.).
My patient's are always provided medication for nausea and I discuss best ways to time medications following surgery to minimize nausea. Sometimes it is a combination of taking an anti-nausea medication, getting some food in your stomach, and then taking the pain medication. I find Hydrocodone containing narcotics to be less nausea inducing than Oxycodone containing pain medications.
I am a fan of Celebrex-- but I understand that would not work for you. I do not want my patient's taking NSAIDS in the post operative period, but you can take Tylenol. There are other pain medications that are not opiates that can also be prescribed by your surgeon after they review your medical history and allergies.
I would recommend discussing with your surgeon your concerns about post operative pain, as well as your experience with pain medication/nausea in the past and I am sure they will be able to come up with a personalized plan for you.
Best,Rosa B Lipin, MDFacial Plastic Surgeon