Is there a big difference between Exparel and something like Marcaine for pain mgmt. after abdominoplasty?

I'm having TT next wk and spoke to my surgeon about Exparel and he said he has a lot of luck with Marcaine. (I THINK it was Marcaine...or something similar.) I am seeing him for preop tomorrow and will bring it up again. I am seeing good things about Exparel. I'm worried about post op pain because I had a TAH 16 yrs ago and had 10/10 pain for probably 24 hrs with MS PAC. I'd appreciate your thoughts. Thank you.

Doctor Answers 9

Pain Medications per Specific Surgeon

I do not use drains any more with this procedure and have switched from pain pumps to Exparel which is a long acting injectable pain medicine like Lidocaine or Marcaine but lasts for three days. This is injected all along the muscle and skin to provide pain relief. This is termed the Pain-less, Drainless Tummy Tuck.

Now, if your surgeon has had positive results with the medication he recommends in relation to the procedures he has completed in the past then it should be worth trusting. If you still find that you have questions or concerns you should be able to visit additional local board certified surgeons for consultations in order to find the surgeon with whom you find the most confidence in their before and after results and the recommendations they offer your for procedure and healing process. Good luck!

Orange County Plastic Surgeon
4.9 out of 5 stars 110 reviews


Exparel is basically a long lasting version of Marcaine. It will deliver pain relief for 3-4 days. However, each patient reacts differently. If your surgeon thinks that you are a good candidate and you are ok paying the extra cost then yes, I would definitely recommend this in your case. Patients who respond well to Exparel have a much easier recovery.


Kouros Azar

Kouros Azar, MD
Thousand Oaks Plastic Surgeon
4.8 out of 5 stars 35 reviews

Exparel better than marcaine

Exparel is effectively Marcaine in a long acting form.  Marcaine alone will work for about 12 hours only.  My patients with exparel blocks are pain free for 3 to 4 days.  The advantage of that is obvious but there is also a benefit to never having the pain start in the first place.  Patients will often not require any narcotics at all when exparel is used and the block is properly placed.

Michael Zenn, MD
Durham Plastic Surgeon
5.0 out of 5 stars 65 reviews

Is there a big difference between Exparel and something like Marcaine for pain mgmt. after abdominoplasty?

Expired has variable degree of efficacy. That means - it works better with some people than with others. If your Doctor recommends it- and you're willing to pay the extra amount then it may be a value for you.

Thomas Trevisani, Sr., MD
Orlando Plastic Surgeon
4.9 out of 5 stars 64 reviews

Is there a big difference between Exparel and something like Marcaine for pain mgmt. after abdominoplasty

Thank you for your question. Exparel is long acting local anesthetic and it is a different form of marcaine. Exparel is more expensive than marcaine.

Ven Erella, MD
Austin Plastic Surgeon
4.9 out of 5 stars 36 reviews

Marcaine or Exparel?

Hello and thank you for your question. Exparel is a form of Marcaine that lasts longer. I use it all the time. The problem is that it is considerably more expensive than marcaine.

Peter Fisher M.D 

Peter Fisher, MD
San Antonio Plastic Surgeon
4.9 out of 5 stars 52 reviews

Exparel vs Marcaine

Technically, these are the same chemical compound, but the exparel is encased in a lipid (fat) molecule that allows it to slowly release into the tissues over 3 days. Marcaine usually lasts between 6 and 12 hours depending on how much was used and whether it was used with epinephrine (which constricts blood vessels allowing the product to stay in the area longer. 

 I have thought about trying Exparel to help for my patients several times. However, a review of studies showed it was more effective for joint surgery than surgery on muscle and skin. I also talked with several surgeons who tried it and did not notice differences in patients' pain levels after surgery. 

Ultimately, you should choose your surgeon based on who you think will do the best job and who you trust to take good care of you. The details should be left in his or her hands. 

Dana Goldberg, MD
Jupiter Plastic Surgeon
5.0 out of 5 stars 34 reviews

Exparel versus Marcaine

Thank you for your question. First, experel and marcaine are both brand names for the same medication (bupivicaine) with a significant difference. Exparel has a coating around a molecule that keeps the medication in the place it was injected AND slowly releases anesthetic dose over three days.  So patients get 24/7 pain relief for three days. Marcaine is not slow release. It is simply injected and gradually wears off over 4-6 hours.  Exparel is expensive, but in my opinion, worth the cost.  I include it on nearly every case in the overall cost of surgery.  In my mind, less surgical pain means you will walk sooner (decrease complications of blood clots and pneumonia), less narcotic related complications (constipation, driving restrictions, mental clarity) and in general, return to your life sooner.  The overall better surgical experience by Exparel has made a difference to me and to my patients.  Hope this helps!! 

Raj S. Ambay, MD
Tampa Plastic Surgeon
4.3 out of 5 stars 35 reviews

Is there a big difference between Exparel and something like Marcaine for pain mgmt. after abdominoplasty?

Exparel is very expensive option. Plus must have experience with its use. Most patients do not desire the added $$.

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

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.