Why not use Exparel for Tummy Tuck procedure?

I'm interested in getting an abdominoplasty, but the two (very reputable) surgeons I've found in Beverly Hills don't offer Exparel or a pain pump because they believe these approaches to be unnecessary. What are the downsides of Exparel in particular? Why would any PS overlook the relationship between appropriate mobility and pain management? What's missing, here?

Doctor Answers 13

Why Not Use Exparel for a Tummy Tuck

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Good question. Indeed, why not use Exparel for a Tummy Tuck. It improves patient comfort, lowers the need for pain medications, allows for better mobilization, and generally overall enhances the patient experience. It is a no brainer. The only reason that I can think they wouldn't, is to save money at your expense (pain that is).

Another question is why would you travel to BH to have an abdominoplasty when there are a number of extremely capable surgeons who do great work right here in the Seattle area. There is nothing exceptional  that they can offer other than the celebrity experience, likely for more money than you would pay here, without Exparel.  It doesn't really add up.

Why not use Exparel for Tummy Tuck procedure?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Exparel is an excellent way to help diminish post-operative pain after a tummy tuck.  I have used it with success as I have also used pain pumps as well.  Both help reduce but do not take away all of the pain.  The only downside is the added cost but that seems to not be a problem with most patients if you tell them their post-operative pain will be less.  

Robert J. Spies, MD
Paradise Valley Plastic Surgeon
5.0 out of 5 stars 94 reviews

Exparel Helps with Pain after Tummy Tucks

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
  • I routinely use Exparel for my abdominoplasty (tummy tuck) patients. 
  • Exparel is a long acting local anesthetic that I have found to help diminish postoperative pain.
  • I inject it just under the fascia where my plication sutures are placed.  These plication sutures can be uncomfortable, but they help flatten the abdomen and improve its contour. 
  • The only downside, perhaps, to Exparel is its cost. 
  • Thanks for your question!

Exparel Great for Adominoplasty Comfort

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
What is missing is maximum Comfort. 
Essentially Exparel is a very long-acting local anesthetic that works great. It lasts approximately 3 or more days following injection. This is the same length of time that a pain pump lasts and will therefore take the place of a pain pump. This means patients can enjoy the same effect of a pain pump, but without any catheters and no pain pump to carry around plus decreases spasm of muscles after a tummy tuck.
Exparel will be available for those concerned about minimizing discomfort after surgeries such as tummy tuck and breast augmentation.
Exparel costs the same as a pain pump and produces the same result but with less hassle. I use if in virtually all of my tummy tuck patients.

YES to Exparel for tummy tucks

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
With Exparel placed during a tummy tuck, patients feel better, move better, and I believe recover better than without. In fact, we participated in a study proving that. Exparel patients needed only half as many pain pills and had 50% lower pain scores. Pain pumps also work but are a bit of a nuisance since they are en external device connected to a catheter. The only issue is cost, about the same for pain pumps and Exparel.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

Why not use Exparel for Tummy Tuck procedure?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Obviously none of those surgeons experienced any abdominal procedures. Exparel is an excellent medication (liposomal marcaine) I have been using over two years in my practice. I inject it into the muscle at the end of the muscle tightening during the abdominoplasty. It can be diluted with 20-40cc of saline, and it is very effective for the first 72 hours. I stopped using the pain pump (the cost is the same for both, but a pain pump is more labor intensive for the surgeon and the assistant). Matter of fact, I took my own Exparel from my office to have my orthopedic surgeon injected it during my osteotomy and bone grafting procedure. The hospital did not carry it! I can tell you, my recovery was almost painless. I had two previous surgeries on the same leg and the pain was severe enough that I was on narcotics for one week. With Exparel, I was on Tylenol only from day two. Some surgeons are set in their ways and follow their strict protocol that "works for them". Get another opinion from another board certified plastic surgeon, who keeps up with the times and is interested in the comfort of their patients during recovery. Good luck.

Exparel for tummy tucks.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Exparel is an excellent drug to help with your recovery in the first 48 to 72 hours. It does not remove all your pain helps diminish the use of narcotics and their side effects. I use it on all of my tummy tucks and the cost is worth it for the benefit it provides.

John D. Smoot, MD
La Jolla Plastic Surgeon
4.7 out of 5 stars 14 reviews

Why not use Exparel for Tummy Tuck procedure?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
For years I have found the TT patients with pain pumps do far better than those without. I don't use Exparel because the amount you can use is quite limited and the pain pumps last 4 days, exparel is shorter.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

Tummy tuck

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
I routinely use Exparel, which is a long lasting (72 hours) local anasthetic for my patients.  I find it gives great post operative pain relief especially when plicating the muscles during a tummy tuck and allows patient to be home sooner.
The only downside I can see would be cost.  On average it can cost up to $300 for a single use. 
Good luck on your pursuit for an abdominoplasty.

Why not use Exparel for Tummy Tuck procedure?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thank you for the question. These days plastic surgeons have many options when it comes to pain control after tummy tuck surgery. The use of narcotic medication, muscle relaxants, non-narcotics, pain control pumps, and long-lasting local anesthetics have made the postoperative experience much better than in the past. In my opinion, there is no demonstrable difference between the use of local anesthesia provided through a pain pump versus long lasting injectable anesthetics. There are certainly no objective studies that demonstrate the superiority of one or the other. 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.