Pain relief following tummy tuck?

Question

I'm very nervous about proper pain relief following my upcoming tummy tuck. I had a terrible experience with post op pain after having a transternal thymectomy, and had my blood pressure bottom out and collapsing. I also have a condition that can be aggravated by pain and stress. I have a threshold due to treatment for chronic pain. Is Percocet and Valium a good/common treatment for managing post op tummy tuck pain?

Andrew Wolfe, MD · Answer

Many patients are concerned with the discomfort they may feel after a tummy tuck.  Tightening the muscle layer does result is some pain after the surgery, which may require oral narcotics for 4-5 days, on average.  I have had great success with a medication called Exparel, which is an injected local anesthetic that lasts for 2 1/2 to 3 days.  The entire muscle layer and the skin can be injected, and patients report markedly decreased discomfort.  I have even had some patients use zero narcotics after a tummy tuck with Exparel.  It isn't cheap (approx $500 extra cost) but for patients with significant pain issues it has proven to be very worthwhile!

Aisha White, MD · Answer

In general, Norco (hydrocodone/acetaminophen) and Percocet (oxycodone/acetaminophen) tend to be common medications prescribed following abdominoplasty.  Of course, medications vary from surgeon to surgeon.  If you tend to have issues with pain control, it is best you discuss the plan for post-op pain control with your surgeon.  Often times, if you have chronic pain the best option is to have your current pain managment doctor handle the post op medications to avoid having multiple doctors prescribing narcotics.

Francis Johns, MD · Answer

Thank you for your question.Every surgeon is different on their post-op pain protocol. Typically Percocet is given to help with pain, along with a Benzodiazipine (Valium, Ativan..) to help you relax and sleep. Another option is muscle relaxers if you are having the muscles repaired to help with spasms and also relax you during the first week. If you are already on pain medication, this is something you want to discuss with your pain management doctor and your surgeon so that they can work together to best control your pain. Good luck with your decision.

Daniel Barrett, MD · Answer

Dear Jall823,every plastic surgeon has his own postoperative and pain management protocol which he recommends to his patients. I would suggest you to discuss this with your plastic surgeon.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Steven Varkony, MD · Answer

Medication preferences vary between surgeons. With your
previous post-op experience, it is best to discuss all your concerns and a
post-op plan with your board certified plastic surgeon.

Camille Cash, MD · Answer

At our office we use Exparel in surgery which helps control post op pain the first few days after surgery.  This can be supplemented with other pain medications to keep the patient comfortable.  I recommend speaking with your surgeon about your concerns and discussing options to find what is best for you.

H. Daniel Zegzula, MD · Answer

Tummy tuck is one of the more uncomfortable procedure to go through because there is usually a muscle repair involved.  Suturing the muscle layer causes deep pain which is usually most uncomfortable during the first 48 hours.  Thinking in advance about your pain control is a good idea.  Percocet and Valium are common medicines used for post operative pain control after tummy tuck.  Valium does not reduce pain but it can relieve the muscle spasms that some patients experience after TT.  Have an open and frank discussion with your surgeon about your current mediation usage and your concerns about pain control post op.

Ronald V. DeMars, MD (Retired) · Answer

Sine you already have a surgeon chosen, you will need to have this discussion with him. It's easy to understand your concern with your past experience. In truth, tummy tuck with muscle repair can be pretty sore for the first few days and percocet is a good drug for surgical pain control. The problem with it and all narcotics are the side effects, the most common one I hear about is constipation. It may help to be on a clear liquid diet the day before surgery and an enema the morning of the surgery. We use pain pumps in my practice and they use a nonnarcotic drug so no side effects, but the patients still need a few pain pills. You may be one of the few patients who can get just as good a result without muscle repair, in which case the degree of pain after surgery is dramatically less. In any case, the pain is very short lived and your satisfaction with the surgical results will last a lifetime.

Pain relief following tummy tuck?

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