Are Exparel Injections Used Only for Drainless Tt, and if So, Why Not Used for Regular Tt?

Doctor Answers 21

Expired for tummy tucks

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Thanks for your question -

You can use exparel in any tummy tuck.  The medication is injected below the fascia and soft tissue.  Drains will not significantly reduce the efficacy.  

We have started offering patients Exparel for tummy tucks and other procedures. We find it offers exceptional pain relief without the downsides of narcotics or muscle relaxants.

While pain pumps are similar in function, our patients get slightly longer pain relief with Exparel and don't have the inconvenience of having the pain pump hanging around their waist and avoid the catheters that have to be placed under the skin with pain pumps.

Exparel Great for Tummy Tucks

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 Exparel is a very long-acting local anesthetic that lasts approximately 3 or more days following injection and great for Tummy Tucks whether or not drains are used. Not only does it prevent pain but also most muscle spasms. It lasts 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.
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.

Exparel for tummy tucks

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Exparel (liposomal delivered bupivicaine or marcaine) is a fantastic new "tool" that has improved post operative pain control after abominoplasty or tummy tuck. I use this routinely in all my tummy tuck cases and have found that patients are able to go home as an outpatient and they require far less narcotic after surgery.  I am not sure where the notion of "drainless" tummy tuck or regular tummy tuck has anything to do with exparel.  Exparel works best if it is injected under the muscle fascia.  Some plastic surgeons use quilting sutures on their tummy tucks and therefore no drains while others use drains.  Either option would not have any effect on exparel working.  I hope this helps.

Exparel for Abdominoplasty

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Thank you for the question. Exparel is a local anesthetic (bupivacaine) that is encased in a liposome to act as a slow release mechanism, that can give up to 72 hours of relief when injected into the muscles and tissue. There is no reason why it cannot be used for post operative analgesia in an abdominoplasty (tummy tuck) or other procedures.

This is a discussion best had with your chosen surgeon. I hope this helps.

Best wishes.

Exparel for Pain Relief

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Exparel is a long-acting formulation of a commonly used local anesthetic (bupivicaine). It became available for use last year and I have been using it reguarly with both breast and body surgery with very good results.Patients have been very satisfied and are experiencing pain control similar to with the pain pump systems. Since the medication is injected into the muscle layer, it can be used in all types of tummy tucks and other cosmetic surgery, especially breast surgery.

I encourage you to discuss obtaining this with your surgeon.

Lawrence Iteld, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 48 reviews

Use of Exparel in Tummy Tucks

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Dear chris59,

Exparel is a sustained release version of a commonly used local anesthestic called bupivacaine. It may be used with all types of tummy tucks (eg. with or without drains), as well as other types of surgery including breast augmentation, etc.

Hope this helps.

Warmest wishes,

Larry Fan, MD

Larry Fan, MD
San Francisco Plastic Surgeon


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Exparel is a time released form of the long acting local anesthetic Bupivicaine. When used with drains, the drains will just suck it out, defeating its purpose. There is no evidence that it is effective in tummy tucks and has only been used for a short period of time. The main problem is that it is really expensive. Find out how much you will be charged for it. I doubt it is being used free of charge unless you are in a study.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 30 reviews

Exparel use in drainless tummy tuck

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Exparel can be used in any type of cosmetic surgery.  Specifically for tummy tucks, it does not matter if drains are placed or not.  Exparel is injected into the muscles and tissue, so the drains should not remove the medication.

Naveen Setty, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 78 reviews

Exparel is an good adjunct for post op pain control

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Exparel is a long-acting local anesthetic that can be infiltrated into the tissues during a tummy tuck. The medication can be used for any sort of tummy tuck procedure in addition to breast augmentation and other cosmetic procedures. The use of drains in abdominoplasty is still relatively common. The use of drains has nothing to do with the use of Exparel.

Use of Exparel in tummy tuck surgery

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The usual cause for pain after a tummy tuck is the row of sutures down the middle which ties the two main abdominal muscles together.  During pregnancy, with major weight gain or sometimes just naturally, those muscles spread apart.  Virtually all tummy tucks include suturing of those muscles together -- and it is the pull of the muscles against the sutures which causes pain for the first few days after surgery.


Exparel is a terrific, long-lasting (3 days) local anesthetic which can help with that muscle pain.  It is usually injected into the muscles after the sutures have been placed -- it is not free floating under the flap.


Yes, it is expensive but it can take the pain edge off for the first three days after surgery -- which is when the pain is most intense.  Discuss the use of Exparel with your surgeon.


Good luck!


Elliot Jacobs, MD

New York City

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.