What is the most effective oral pain medication after Tummy Tuck/Mommy Makeover with Breast Augmentation?

Question

Hi everyone, I'm about a month pre op and researching pain management. My surgeon does not offer a pain pump. What is the most effective oral pain medication after tummy tuck/mommy makeover with breast at?? Thank you, Timberel

Shayne Webb, MD · Answer

I find that pain pumps are excellent, and I won't do a case without them if I am doing a muscle plication.  Many surgeons chose to not provide them based on cost.  I find that if a patient is willing to pay for a tummy tuck, then they are willing to pay a little more for better pain control.  Additionally, the fact that the patient can move around better post op keeps the risk of blood clots much lower.  However, if that is your doctor's preference, then so be it.As far as oral pain meds, I have found that percocet works very well as does Dilaudid as a second choice.  Good luck and best wishes.

Vincent N. Zubowicz, MD · Answer

I inject the abdominal wall with a long acting anesthetic during and abdominoplasty. Most patients do not require narcotics but if so only for a few days. The patients are also given strong nonsteroidal anti-inflammatories which help with musculoskeletal pain.

Hampton A. Howell, MD · Answer

Each surgeon will have their preference based on their experience and other factors for pain control following a mommy makeover.  There are pros and cons to various approaches, and your surgeon can also go over those with you in consultation.  I have done tummy tucks for years without the use of pain pumps or Exparel, and had patients do very well with the appropriate postoperative pain medications.  Now that Exparel is available, however, I have found it to be a very helpful adjunct for pain control, and use it in almost all of my tummy tucks or mommy makeovers.  Discuss your concerns with your surgeon before your surgery so that you are comfortable with the overall plan beforehand.  I would, of course, recommend you meet with a board-certified plastic surgeon. Best of luck.Take care, Dr. Howell

Michael Law, MD · Answer

Mommy makeover recovery can be quite tolerable with the use of pain pumps and / or Exparel. I avoid the use of narcotics after surgery. Patients feel better and recover more quickly when pain is controlled by use of intra-operative pain control with Exparel.When pain control devices pain pumps) or Exparel is used,  patients can recover comfortably without narcotics.  The videos about how to select a tummy tuck surgeon and the gallery of tummy tuck before and after  procedures on Realself will provide more information about pain control following a mommy makeover and / or a tummy tuck.

Jeffrey Umansky, MD · Answer

Thanks for your question. Pain control can be a challenging part of surgery. For a mommy makeover I usually prescribe either Percocet or Norco. I also see my patients the following day and start them on ibuprofen, which more directly treats the muscle pain after surgery. I suggest you rely on the advice of your board certified Plastic Surgeon and I wish you good luck on your upcoming surgery!

Aaron D. Gorin, MD, FACS · Answer

Thanks for the question.  Each surgeon will have their own specific protocol for postop pain management.  Narcotics, like percoset, are common place.  I Rx these for my patients.  However, I also like to use a muscle relaxant (like soma or flexeril), Neurontin (gabapentin), and Celebrex.  All are non narcotic and can go a long way to reducing the # of narcotics that you would need.  Additionally, you should also research Exparel which is a long lasting type of pain medicine that I have found extremely helpful, esp after tummy tucks.  This is injected into the muscle layer before completion of the tummy tuck and can last 3-4 days.

Tom J. Pousti, MD · Answer

Thank you for the question. Good pain control after tummy tuck is very important for many reasons. Besides the important concern of patient comfort, good pain control allows for better/easier deep breathing exercises and ambulation. These measures may lead to decreased incidences of pulmonary complications and/or thromboembolic phenomenon.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. The specific medications used will vary from one practice to another.In our practice, all patients undergoing, tummy tuck surgery receive a postoperative pain control pump. I have yet to have a patient complain of the "hassle" factor. 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 over the other. Best wishes.

Heather J. Furnas, MD · Answer

Because my patients tell me they do fine with long acting local anesthesia and taking Percocet prescription pain pills for typically 2 to 6 days after surgery, I don't use a pain pump either. Patients sometimes request a different pain pill if they have had problems with Percocet in the past, but that's unusual. Positioning, with the back propped up around 30 degrees and the knees flexed along with ice packs along the sides of the breasts and over upper breasts (20 minutes on, 20 off) help my patients minimize their level of pain.Click on the link below to see a tummy tuck case after full recovery.All the best for a smooth recovery.

Frederick G. Weniger, MD, FACS, MBA · Answer

I do not like pain pumps either.  I have tried several different oral pain meds, and we now like oral Dilaudid.

Douglas Leppink, MD · Answer

Pain management is always tailored to the patient's specific needs and the extent of their surgery. Most often a combination of medications (multi-modal approach) are used to help patients feel comfortable after surgery. These options include pre- and post-op anti-inflammatory medications (Celebrex), intra-operative local anesthesia blocks with long-acting local anesthetics, muscle relaxants (Valium) and narcotic pain medication (or non-narcotic Tramadol). Following post-op instructions with ice, elevation and rest also help to decrease swelling and pain. Some patients need more medication than others, and your Plastic Surgeon should work with you to find the combination that works well for you and has minimal side-effects.

What is the most effective oral pain medication after Tummy Tuck/Mommy Makeover with Breast Augmentation?

Answers (16)

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