I’m on methadone and worried about controlling the pain after surgery, what can be done?

Dear sammieee1008,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Pain management for patients who are on medication that alters routine pain management need to have an individual plan of action put in place. This can either be done by the surgeon, the Doctor Who is prescribing your methadone or pain management physician.

People with a long history of opiate use disorder will have tolerance and standard hydrocodone, tramadol or similar pain medication‘s will have less affect on those who are habituated.

Since methadone is an opioid agonist increasing the dose of methadone may be an option as well.

I perform all of my BBL procedures with patients awake using local anesthesia with mild sedation. By using local anesthesia appropriately and thoroughly during the procedure the patients are not only comfortable during surgery but are also comfortable for hours after the procedure because every area treated has been properly numbed up.

When done under general anesthesia surgeons do not spend the effort and time injecting numbing solution into every area being treated and patients can expect to wake up with discomfort but typically at that point there’s an anesthesiologist and recovery room nurse they can give appropriate medication to control pain.

The first person to discuss this with is the plastic surgeon the second doctor to discuss this with the doctor prescribing your methadone and if you cannot get an adequate plan put together with those two and seek a second opinion from the pain management physician.

Another option is to do have a consultation with the anesthesia group before your surgery which is sometimes done for unusual cases.

Best,

Mats Hagstrom MD

Hello and thanks for your question. You will certainly receive pain medication during surgery. It will be up to your specific physician whether or not they feel comfortable prescribing you an opioid after surgery with your history. Many women do just fine with ibuprofen and tylenol after surgery. You will just have to ask around and get opinions. Please see a board-certified physician for your consultation. Best of luck to you!

Sincerely, James Fernau, MD
FACS Aesthetic Surgery Certified, American Board of Plastic Surgery Certified, American Board of Otolaryngology/Head & Neck Surgery Member: American Society of Plastic Surgery (ASPS) American Society of Aesthetic Plastic Surgery (ASAPS) International Society of Aesthetic Plastic Surgery (ISAPS) American Academy of Facial Plastic Reconstructive Surgery (AAFPRS) American Academy of Otolaryngology/Head & Neck Surgery (AAOHNS) American Society for Laser Medicine and Surgery (ASLMS) The Rhinoplasty Society