Why would some doctors use lidocaine instead of Exparel for a tummy tuck?

Question

I would like to have a tummy tuck and have been researching pain management that goes along with the recovery, I have heard of Surgeons using Exparel, But I read that some Drs have or use lidocaine instead? What’s the difference between Exparel and Lidocaine?

John J. Corey, MD · Answer

Exparel is numbing medication that has a fat molecule attached to help it stay in the body longer usually 4 to 5 days. I used to use marcaine  on a pain pump that would slowly squeeze numbing medicine through the muscle but I now inject Exparel directly into the muscle during the tummy tuck and I found it works 10 times better. Your surgeon just may not be familiar with it but maybe willing to try! But also remember, it is expensive, about $350 per bottle (20cc). I dilute it with 60cc saline and inject 40cc into the muscle  on each side of midline. It’s great

William Bruno, MD · Answer

Exparel is a long acting local anesthetic that lasts up to 72 hours and is useful for tummy tucks and other procedures; it can cost between $300-350 to administer.  Lidocaine is also a local anesthetic but only lasts a few hours and is relatively inexpensive. If you are concerned about post-operative pain control then Exparel is a great way to reduce the number of narcotics or pain pills you may need to take- especially for a tummy tuck. Discuss this in more detail with your plastic surgeon.Best wishes,Dr.Bruno

Richard Baxter, MD · Answer

Exparel reduces the amount of pain experienced for the first 3 days after tummy tuck by about half. Lidocaine lasts only an hour or two. Less pain over 3 days means less reliance on opioid medications and their side-effects. It is fairly expensive but well worth it.

Austin Hayes, MD · Answer

It's a great question. Every plastic surgeon has a different technique that they use for pain control after tummy tuck surgery. During your consults make sure to speak with each surgeon about their protocol for pain control after surgery.

Francis Johns, MD · Answer

Thank you for your question.The reason one doctor uses one thing over another is completely their preferences and known to them alone.  In this situation, I use Lidocaine to numb the skin and it is mixed with the solution for liposuction as well to help with discomfort. When I do a muscle repair during a tummy tuck, I use Marcaine because it does last longer and help with discomfort. These injections do not replace the need for oral pain control.

Daniel Barrett, MD · Answer

Dear  timetogetmyglowback68,every plastic surgeon has his own postoperative protocol which he uses. I use Exparel and it provides great results. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

Exparel is a product that is injected during surgery for pain management.  It lasts two to three days after surgery to give longer lasting relief.  Lidocaine provides pain relief for a shorter time frame but is less expensive.  I encourage you to speak with your surgeon about your concerns.

Curtis Wong, MD · Answer

and it costs more than a pain pump with Xylocaine or Marcaine so I prefer to use the pain pump for the first 2 days... at which point most patients are able to manage their discomfort with oral pills.

Daniel Brown, MD, FACS · Answer

Hello and thanks for your questions.  Exparel is a longer-acting drug in essentially the same class as lidocaine.  Lidocaine only lasts for a few hours after a procedure, but Exparel can last for up to 3 days.  Lidocaine can be administered by a pump that can last for 3 days also, but this requires a small catheter inserted through the skin, carrying the pump around with you, and only gives pain relief in the area where the catheter is placed - Exparel can be injected throughout the entire area that has been operated on for optimal pain relief in all areas. One reason to choose lidocaine over Exparel is that it is much much less expensive.  I personally recommend Exparel to all of my tummy tuck patients and use it on every case to ensure that my patients are as comfortable as possible after their procedure.  If this is something that you would like to explore using, most definitely discuss it with your surgeon. Best wishes!Daniel Brown, MD, FACSBoard Certified, American Board of Plastic SurgeryMember, American Society of Aesthetic Plastic SurgeonsMember American Society of  Plastic SurgeonsCastle Connolly Top DocReal Self Top 500

Why would some doctors use lidocaine instead of Exparel for a tummy tuck?

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