Scheduled for a BBL but I am on suboxone. Am I a candidate?

Question

I have asked a similar question before but that was when I was just doing liposuction, now I am doing a bbl and the PS thinks not taking pain meds with just lipo can be done but with a BBL I am gonna need pain meds. I am on subutext for an opioid addiction and now I am in a bit of a predicament. If I stop taking it I will go into withdrawal and since I have been on it so long the pain meds might not even work but without pain meds I will be in pain, I need advice.

Luis A. Mejia, MD · Answer

hello thank you for your question and provided information as well;..based in your question its difficulted evaulate your case if the question dont have a picture, its recommended to get a consultation in personal with a plastic surgeon.

Mats Hagstrom, MD (license on probation) · Answer

at elite body sculpture we don't give anyone narcotics after either liposuction or fat transfer.  There are six clinics across the country. All procedures are done with patients awake using local Anastasia and mild sedation for the procedure itself. After surgery the standard is 800 mg of ibuprofen.  The key is getting you through it general anesthesia and early recovery in the recovery room.  If your plastic surgeon is willing to inject local anesthetic correctly and all the areas being treated then this part will be easy.  Unfortunately the great majority of liposuction and fat transfer procedures done under general Anastasia did not have sufficient injections of local anesthetics.  The recovery can easily be done without narcotics.  Do you really want to put yourself in a relapse behavior and start taking drugs?  Is your sobriety worth having a Brazilian butt lift?   You have two options. Get off the Suboxone and bridge using opiates for the surgery then withdraw off the opiates and get back on Suboxone.  The second option is to bump up your Suboxone dose to get better pain relief from that medication after surgery.  Much of this depends on what your current Suboxone dose is. If you're taking 2 to 4 bupenorphine then you have lots of wiggle room to increase the dose after surgery.  If you're in a high dose like 16 or 20 mg then going up on the dose is not going to do too much.  Your plastic surgeon will either do the surgery in a way where you're comfortable in the recovery area or not.  No one but yourself can figure this out before the procedure.  If you're on Suboxone then count on opiates not working.  Overriding Suboxone is challenging and most medical providers will get skittish about using the appropriate doses.  Let's say they give you 20 mg of morphine.  Typical dose and recovery room might be 5 mg. If you're still having pain they're probably not gonna keep going.  If your numb from local anesthesia you won't need anything.  After injuries and surgeries the most acute pain subsides in 2 to 4 hours.  You must have had some injury in the past. Like if you burn yourself it hurts at first but after an hour the pain is much much better.  Surgery is the same. The local anesthetics can carry you through that. Then hit the high dose ibuprofen.  Plastic surgeons who can do this procedure with local anesthesia get patients number every time but doctors who use general anesthesia don't really know how to do it correctly because they don't know the  difference. I can say so because I used to do this with general anesthesia then I saw the light and learn to do it with my patients awake.  Perhaps you should have one more discussion with your plastic surgeon about exactly how much and how they're going to place local anesthetic for both liposuction and fat transfer part of the procedure. It's easy for me to sit here a long distance away dictating how your procedure should be done. You either have faith in your plastic surgeon or get a different plastic surgeon or don't do the procedure. If you bridge off Suboxone then you better have one tight recovery program.  To me that seems like not the smartest thing to do. Best, Mats Hagstrom MD

Manuel Belen, MD - Account Suspended · Answer

Hello,
  
Thank you for sharing the information, it is a pleasure for me to answer your question.
  
It is difficult to evaluate the options without seeing photos,
It is advisable to consult with a certified plastic surgeon, for a good evaluation, to provide you with all the information you need to know about the appropriate recommendations, so that you can achieve the desired goals in your body.
I hope this answer will help you
  
My best wishes for you...

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