Tummy Tuck W/ Pain Pump Vs. Without?

I carefully read the other responses of my colleagues.  I think they make valid points for and against the need of a pain pump.  I use a pain pump on almost every tummy tuck.  The two detracting comments I see are that pain pumps do not completely eliminate narcotic use and since pain is a very individual response, it is difficult to know if it has helped.  I will relate two points.  First, I routinely ask my patients who have had a tummy tuck (remember they had a pain pump) to compare their experience of pain compared to colleagues of theirs who might have a tummy tuck by another surgeon.  I usually ask this question around the tenth day and my patients routinely tell me their subjective pain control was better than their peers and they are pleasantly surprised.  Clearly, there are confounding variables being two different surgeon and patient experiences.  Secondly, I had a patient last year who was in more pain then my usual patient experience at the six hours post-operative mark.   I took down the dressings to check and I found that the pain pump was accidently left clamped off and thus was not working.  I got the device working and the patient's pain diminished in half within two hours and by the next morning had decreased significantly more.  Narcotics have significant side effects and any reasonable strategies to diminish their use is another plus of the pain pump. However lastly, do not pick your surgeon based on if they use pain pumps and find out what you were exactly allergic to in the dentist's office.  Good luck.

I recommend the use of Celebrex and Acetominophen (does not make you drowsy and less chance of nausea) plus intraoperative use of Exparel. Exparel is a very long-acting local anesthetic that lasts approximately 3 or more days following injection and great for Tummy Tucks and other surgeries. Not only does it prevent pain but also most muscle spasms. It lasts the same length of time that a pain pump lasts and will therefore take the place of a pain pump. This means patients can enjoy the same effect of a pain pump, but without any catheters and no pain pump to carry around.Exparel will be available for those concerned about minimizing discomfort after surgeries such as tummy tuck and breast augmentation.Exparel costs the same as a pain pump and produces the same result but with less hassle and works great.Narcotics are used only as needed (as cause nausea, vomiting and constipation as frequent sided effects).

Thank you for your question.  Yes, pain pumps can be beneficial and at a relatively low cost compared to the entire surgery.  Discuss with your surgeon that you may have an allergy to local anesthesia before proceeding.

I have performed tummy tucks with and without pain pumps.  In my opinion, well-placed injections of long-acting anesthestic right before you wake up provides the best pain relief.  With this technique, I have had patients almost pain free for the first 24 hours. 

Thank you for your post.In considering the cost of a Tummy Tuck, you should look at the components of the cost:1. Surgeons Fee. This is usually the greatest part of the overall cost and can vary immensly from location to location (just like the cost of living varies in each location) as well as in the same location, it can vary from surgeon to surgeon. Usually, a surgeon commanding a higher price is very experienced and has very good results reliably, and is very busy due to the above. This also depends on if a circumferential, tummy tuck, extended tummy tuck, full tummy tuck, mini tummy tuck, and skin only tummy tuck is performed. These are usually less expensive in decreasing order.2. Anesthesia Fee. This can vary depending on if a board certified MD anesthesiologist is used, vs. a nurse anesthetist, vs. a non-certified nurse, vs. only local anesthesia (an awake procedure). Obviously, the further you go down the line, the cheaper the price. You do get what you pay for.3. Facility Fee. This can vary if it is a a state/medicare certified facility, vs. the back of a doc's office.4. Accessories. This includes things like a pain pump, Exparol injections (72 hour long lasting numbing), garments, tissue glues, etc. These are not necessary for a great result, just add to the comfort of a result.5. Revision. Usually a revision such as dog ears or lowering the scar, or a seroma, is much less that the original surgery, but this depends entirely on what exactly is being done.6. Add on surgeries are usually discounted, as in a mommy makeover.7. Insurance. If an insurance based surgery, such as a hernia repair is done at the same time, the tummy tuck may be discounted.As with anything in life, buyer beware of risks of cutting corners in surgery.Real Self has average costs of every operations in your location that you can peruse before seeing a surgeon, but keep in mind that the above quality can change from office to office. Choose a surgeon that you are very comfortable with and is board certified.Best Wishes,Pablo Prichard, MD

Thanks to a new medication, Exparel, pain pumps are not needed any more for tummy tuck procedures.  Exparel is placed at the time of the procedure and it relieves the pain for 3-4 days after a tummy tuck.  It uses the same medication as a pain pump, but the delivery system is different, the medication is dispersed through liposome technology.

You can certainly have a full tummy tuck procedure without the use of a pain pump. Most of my patients opt to do just that.  However, I do urge patients to get the pump placed for post operative comfort but ultimately allow them to decide.  The extra cost for the pain pump is ~$350 so not too expensive and well worth the price, but I let the patient choose.  The pump decreases consumption of oral narcotics, which have their own side effects, and makes it easier to get up without too much pain. 

As far as your concern about reaction to the pain medicine. I wouldn't worry about that.  The medication we place into the pump is much different than the xylocaine you had at the dentist, so this shouldn't be an issue. Good luck.

 

It is feasible to have a tummy tuck and manage your postoperative pain with oral medications. However you may require more of these  medications and as a result, have more side effects from the oral medications. This may include nausea, vomiting, and constipation--- all of which you would want to avoid with that surgical procedure.

I don't use the pain pump. It's expensive and doesnt eliminate the need for oral pain medication. I find that the appropriate oral medication can manage post-op pain effectively. Nothing will eliminate pain and I think you have to go with the plastic surgeon with whom you are most comfortable. In terms of a reaction to anesthetic at the dentist's office, it would be wise to call and find out what agent was used but anesthesia and pain medication are two separate things.

Thank you for the question.

You will find that there are many good plastic surgeons who use pain control pumps and there are many who do not. Personally, I use pain control pumps for every tummy tuck patient;  whether these devices are helpful or not it is difficult to prove.

Best wishes.