Marcaine vs. exparel? Is one better than the other?

I've been on a few consultations for tummy tuck, some doctors use long acting marcaine, others use exparel. Does one help the pain more than the other? Thank you

Doctor Answers 19


Exparel is a great pain medication if it is available to you.  The only real downside compared to marcaine is the cost.  Marcaine generally lasts about 12 hours, but Exparel is a special formulation of marcaine that allows it to last up to 72 hours.  My recommendation would be to use it if your surgeon recommends it and feels it is appropriate in your case.

Chevy Chase Plastic Surgeon
5.0 out of 5 stars 36 reviews

Exparel vs Marcaine

Exparel is touted as being a long-acting anesthetic that may last up to 3 days. A careful look at their FDA studies, however, indicates that its effect may not be that prolonged. Some now question whether it is really much more effective than that of the traditional use of Marcaine. I have not been that impressed that Exparel has such a prolonged local anesthetic effect.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 reviews


Exparel is a long acting marcaine solution mixed with liposomes.  It can last up to 3 days.  In many patients it helps to relieve the early pain after a procedure.  It is useful in patients who have difficulty with pain medications.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

Comparison of marcaine and Exparel

Thank you for your question! Marcaine and Exparel are very similar local anesthetics however Exparel lasts significantly longer. This means that Exparel can help provide pain relief for about 72 hours whereas marcaine only lasts the day of surgery. The only downside to Exparel is the added expense but I strongly recommend it to my patients for procedures such as a tummy tuck. Hope that helps answer your question!

Brian K. Reedy, MD
Reading Plastic Surgeon
4.9 out of 5 stars 144 reviews

Marcaine vs. exparel

Great question. I feel that exparel is superior over marcaine. They both work the same way, but exparel lasts significantly longer. My patients have had great results with it. I had one patient go out to a coffee shop the night of surgery! This is a decision you should make with your surgeon understanding the benefits and drawbacks of each. Exparel works better, but is more expensive.

I wish you the best.

Dr. Gabbay.

Joubin Gabbay, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 22 reviews

Local Anesthesia and Tummy Tuck Surgery

If you want an anesthetic in the sheath of the muscle that gets sewn together for tummy tuck surgery, and your doctor plans to use Exparel, Marcaine will be mixed with it to cover the early discomfort, then Exparel will take over.  Although the company says it will last 3 days it usually lasts a little more than 48 hours.  It must be injected into the tissues.  It doesn't work if it just is pooled on the tissues the way a pain pump works.

Not all surgical facilities are allowing the use of Exparel yet so it isn't universally available. Sometimes the limitation for allowing it to be used is the cost to the pharmacy of the facility.  Your surgeon is not allowed to bring it to the facility either, usually.

That being said the worst discomfort is in the first evening after surgery and Marcaine, which has been used safely for years, will cover that time.

Deborah Ekstrom, MD
Worcester Plastic Surgeon
4.7 out of 5 stars 39 reviews

Marcaine versus Exparel

Marcaine is a long acting local anesthetic which may provide pain relief for up to 7 hours following a procedure.    Exparel and Marcaine are both bupivicaine.   They are produced differently.   The advantage of Exparel is that it lasts for 3 days.   The disadvantage of Exparel is cost which is usually in excess of $500 per patient.   

Joseph Franklin, MD
Durham Plastic Surgeon
5.0 out of 5 stars 8 reviews


Exparel last 2 to 3 days, but it costs more than marcaine, so your surgeon may charge you to use it. It is probably most useful when a muscle separation is being repaired since this part hurts the most, but it also can be used around the skin incision. Although there is little downside besides cost, I am not aware of any controlled study that using Exparel decreases the need for narcotic pain medications after a tummy tuck.

Keith J. Attkiss, MD
Greenwich Plastic Surgeon
5.0 out of 5 stars 2 reviews

Marcaine vs. exparel? Is one better than the other

Exparel wil give you a longer lasting effect compared to the Marcaine due to the method it is applied and then asorbed

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews

Marcaine vs. Exparel for pain management

Thank you for the question. Marcaine has a shorter half life than Exparel. 
Exparel is basically Marcaine in liposomes and is released slowly to last up to 3 days. 
The other main difference is the cost. 
Exparel is more costly than Marcaine. 

Good luck with your surgery!

Dr. Khuthaila

Dana Khuthaila, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 68 reviews

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.