I am currently consulting with several plastic surgeons about getting a full tummy tuck. I have noticed that some use pain pumps, particularly the On-Q Pump for post-op recovery and some choose not to. When it comes to the recovery, how necessary is a pain pump to being comfortable? Is it enough of a difference to sway my decision of surgeon? Also, I once had hives as a reaction to anesthetic at the Dentist's office. Does this possibly mean I cannot have a pain pump? Thank you!!
Tummy Tuck W/ Pain Pump Vs. Without?
Doctor Answers 14
Exparel Better than a Pain Pump for Tummy Tuck
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).
Pain pump and tummy tuck
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.
Tolerated just fine without pain pumps, but if it is a big deal, can ask other surgeon for them as well.
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.
Pablo Prichard, MD
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Pain pumps not needed any more
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.
Tummy tuck with Pain Pump?
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.
Recommend pain pump after tummy tuck
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.
Improving your tummy tuck recovery
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.
Data on pain pumps for abdominoplasty is very "soft" in my opinion
convincing scientific proof that pain pumps make a significant difference is lacking in my opinion. nothing wrong in using them if patient ok with additional cost for something that may be of marginal value.
Pain pumps can reduce the need for stronger oral pain meds
I have been using pain pumps for all my abdominoplasty patients for several years now. It is hard to quantify but I do feel it allows my patients to get by with less oral narcotic medications. Clearly this operation can be performed with or without the use of pain pumps. You should select your surgeon based on your confidence and comfort with them performing your surgery. If you select a board certified plastic surgeon you can be sure they will care for you in a safe and thoughtful manner with your comfort and safety being paramount. I do agree with my colleague on checking with your dentist regarding your prior reaction to local. 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.
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.