My tummy tuck is in two weeks. Exparel vs pain pump?

Thank you for your question. I switched to Exparel when it was released and FDA approved. In my practice, this was a great advancement over a pain pump. It saved me 20 minutes in operating time (filling of the pump, placement and tunneling  of the tubes that carry the anesthetic under the muscle fascia), by easily injecting the Exparel under the fascia. I dilute the Exparel with 40-60cc of saline for wide distribution. The pain pump has a 2mm tube with multiple holes in it like a garden hose and the local anesthetic  drips out locally without wide diffusion. The added advantage is no extra tubes that the patient has to worry about. The pain control is not complete, but allows for less narcotic medication use. Pain management is multimodal. I start my patients on Gabapentin 3 days prior to surgery and continue it for a month (I use extensive liposuction of the whole torso with my tummy tucks). BTW, Exparel is somewhat more expensive than a pain pump. There's nothing wrong with your surgeon using a pain pump if she/he is comfortable with it. Good luck with your surgery.

It is not unreasonable to request something like this, but your surgeon may have a reason for not using this in your particular case.  

however one is an injection on table and the other requires catheters, Realize, your surgeon may NOT use exparel, may not have experience with it, and IF they do not use it, he/she likely won't start with you as it is $$(more than pain pump) AND has to be ordered in large quantities, which drives up the cost even more as it sits on the shelf between pts it would actually be used on. Unlike a previous reply, it has been used on TT's and Breast cases, I know bc I wrote the papers. Some older surgeons are simply uninformed/uneducated on materials that have been out on the market for several years now. Bottom line, either work, if you like your surgeon, accept his method of tx. 

I have used both, and both work. I have a few concerns about Exparel though.  It contains a medication (marcaine) with known serious side effects on the heart, and it has only been studied for hemorrhoid and bunion surgery - very small areas of the body. So my concern is how to withdraw that medication in a case  you had a side effect.  The pain pump can simply be turned off, the Exparel cannot.  Also with the pain pump, you can cover  larger area which is useful for tummy tuck surgery.

I routinely use a pain pump for the first 20 hrs or so immediately after tummy tuck and body lift surgery. It works by delivering a slow continuous dose of local anaesthetic into the abdominal wall as soon as you wake up after surgery. I've found it to be a really effective pain relief method with really no side effects. Because of the effectiveness of the pain relief, it means that less narcotic analgesia needs to be used (so less side effects like nausea, vomiting and constipation) and my patients feel more able to move and get out of bed (which helps prevent venous thrombosis).

This is also the rationale for exparel use.

So, I think either would be a good option, and really it comes down to possibly cost! I don't think you could go too far wrong with either option!