Pain Medication Injected into Abdominal Muscle During Tummy Tuck?

Minimizing pain after a tummy tuck is very important in my practice.  This is typically done with oral pain medicine after the procedure, but I also inject numbing medicine into the muscles during the procedure.  This medicine is called marcaine and it's great at minimizing pain immediately after the procedure and for a long period of time afterward.  This way, you can concentrate on healing and getting back to your normal routine instead of worrying about pain control.  Even more, I place drains that are painless when they are removed and all of my stitches are dissolvable.  These things contribute greatly to making the tummy tuck experience as comfortable as possible.  Thank you for your question!  Dr. Schreiber....Baltimore plastic surgeon

If you wish to avoid narcotic pain medications then I recommend the use of Celebrex and Acetominophen (does not make you drowsy) plus intraoperative use of Exparel. Exparel is a very long-acting local anesthetic that lasts approximately 3 or more days following injection and great for Tummy Tucks and other surgeries. 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 and works great. It is not "Snake Oil".

    Exparel can be injected at the time of closure for 72 hour pain relief.  This can add several hundred dollars to the cost.  Kenneth Hughes, MD Los Angeles, CA

Exparel is a long acting local anesthetic that can be used with tummy tucks.  It lasts approximately 72 hours.  It can be expensive but if this is something that you are interested in, I would talk to my surgeon and see if they are willing to use it.

Pain after the tummy tuck procedure is not uncommon, especially if plication (tightening of your abdominal wall has been performed.  Various things can be done to alleviate pain after this procedure.  The local anesthetic bupivacaine may be injected directly into the sheath enveloping the muscles to provide pain relief, usually for up to a day.  Also, the medication Exparel is an extended release, long-acting form of this anesthetic that may last up to 3 days.   Some surgeons may also place pain pumps, which continuously drip this anesthetic atop your abdominal wall to give pain relief for up to 5 days.   All are very effective in controlling some of the pain post-tummy tuck procedure, however,  with a small extra cost involved, but may be worth it.  Hope that this helps!  Thank you for the question!

Thank you  for your question.

I have  been using  exparel  for the  last  year for my  breast augmentation  and  tummy  tuck procedures.  It gives pain relief for up  to 72 hours after surgery.  I have noticed patients require less narcotics for pain relief after surgery. If you are considering  a tummy tuck you may  want to discuss it with your surgeon.

Good  Luck!

Brian Joseph  MD FACS

The medication is called Exparel and I have been using it for my cosmetic procedures since it's FDA approval about 9 months ago.  It has been a godsend for patients, reducing the use of narcotics greatly.  My patient coordinator can give more information.  Brian Reedy, M.D. , Wyomissing PA

The medication you are referring to is called Exparel, which I have found very useful with tummy tucks to minimize pain. It is a numbing agent not a narcotic medication and lasts up to 72 hours. It has been in use for about a year so many surgeons may not have heard about it yet.

Marcaine or bupivacaine is the medication most commonly injected into the muscle fascia during a tummy tuck.  It doesn't quite last 72 hours. Pain pumps containing marcaine can be used but they are somewhat impractical.  Marcaine with epinephrine should not be used as it can cause muscle atrophy.  It is helpful in conjunction with postop pain medications.

In my practice i have never had a patient regret having done this procedure. But a great outcome requires the patient to follow directions, and the doctor to give patients a realistic expectation rather than "sell" the procedure. Not everyone is a great candidate for every procedure like fancy adds may claim. Also, every doctor has a different approach that works for him/her. In my office, I tell patents, back to work in 10 days (take off the weekend on either side of a work weeks). I tell themyou will walk and shower the next day and there is no restrictions on walking. I prefer to keep people walking a bit hunched for the first three days to keep the incision as low as possible. Drains are out about 5-7 days. Increase cardio after two weeks and full workouts after 8 weeks. They may have intercourse (let your body dictate your comfort level) after 3 weeks. In my practice I also give Exparel, a three day anesthetic which helps tremendously with pain. Also, I give free personal training intro sessions and dietetics counseling to get you started on the right path during your dealing. I want the tummy tuck to be just the start of the journey and I want my patients to lead a happy and healthy lifestyle. Hope this helps.