What are your thoughts on getting Exparel?

Question

I'm getting a Mommy Makeover including Breast Lift, Breast Aug, Tummy Tuck and Lipo of flanks and inner & outer thighs. My PS said he will get Exparel for me, but doesn't usually use it because he feels that the body tells you when there is a problem through pain. He said that he doesn't want to mask the pain and find out there is an issue later due to this. I am curious on your expert opinions of the need/recommendation for this. Do you recommend the use of it and why or why not? Thanks for your insight.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

This is a very good question. While I agree with your surgeon that pain is a good indicator a potential problem pain must still be controlled. Atypical pain plus other symptoms that are not customary to the procedure clue a surgeon in to a potential problem thus the decision not to use Exparel based on masking pain is not why I do not use it. My reasoning for not using Experal is based on added expense, possible interactions with other medications in surgery, possible aftercare mishaps and in my opinion it is not clearly superior to what I do in surgery to minimize pain after surgeryYou and your surgeon should develop a plan that you are both comfortable with.

Camille Cash, MD · Answer

Many of my patients have elected to receive Exparel during surgery.  This medication helps manage pain during the first few days after surgery.  If you choose not to use it, narcotic pain medication is commonly used to manage post operative pain.

Sheila S. Nazarian, MD · Answer

As you can see, every surgeon is going to have his or her opinion. I think that pain management is important and if this is something that worries you  then using exparel might make sense for you. It's really going to come down to a personal decision between you and your surgeon. My best,Dr. Sheila Nazarian@drsheilanazarian on Instagram

Kenneth Hughes, MD · Answer

I do not use it for similar reasons stated by the surgeon.Kenneth Hughes, MDBeverly Hills, CA.......

Richard Baxter, MD · Answer

In my experience, using Exparel with mommy makeover surgery reduces pain levels and the need for narcotic pain medication by about half. That means fewer side-effects from pain pills such as nausea and constipation. I say yes to Exparel for mommy makeovers.

Jeffrey D. Wagner, MD · Answer

I routinely use Exparel in this procedure and it has revolutionized the early mobilization of my patients in the first 36-48 hours after surgery.  They definitely use less narcotics, have fewer problems with nausea and vomiting, constipation and urinary retention, are out of bed sooner with much less discomfort, and have fewer pulmonary toilet issues.  It is not difficult to imagine they might experience fewer DVT's as well (although this is not proven).  It does not mask pain to the extent that major problems are not identifiable. I highly recommend it.

What are your thoughts on getting Exparel?

Answers (6)