Pain management is an important part of every tummy tuck in my practice.
I use On-Q pain pumps on 95% plus of the tummy tucks I perform. I have used Exparel as part of tummy tucks before.
It is best placed as part of a deep muscle block that many anesthesiologists no how to do, but does need some some special equipment including ultrasound.
The greatest resistance to this drug’s use is that it is expensive and not stocked by many facilities.
I am surprised that no one in your area would be able to offer you a pain pump-please ask again. (Vishnu Rumalla, MD, Dallas Plastic Surgeon)
Pain medicine
It is an expensive product. It is not available per the pharmacy board in most hospitals. The pain catheters work very well and are available readily. $15,000 seems a really high cost for a tummy tuck, at least to me here in Virginia where it is about $7000 with a pain pump. Please seek out a board certified plastic surgeon. (Gregory Lynam, MD, Richmond Plastic Surgeon)
Why are doctors not willing to use Exparel Pain Relief?
Many doctors, like myself, use Exparel routinely. The cost for patients at our facility is $295. You may want to find a physician that offers the options that you want and always us a board-certified plastic surgeon. You should be comfortable with your choices before proceeding for an elective procedure. (Janet Woodyard, MD, Baltimore Plastic Surgeon)
Pain relief after cosmetic surgery
I agree pain relief is very important and we personally use the newer methods. The cost of the medication is really not that much different from the cost of a pain pump with Local Anesthesia. If I remember correctly the cost of exparel is $300-$400. (John Paletta, MD, Savannah Plastic Surgeon)
Exparel for tummy tuck vs pain pump
Your question is valid. The answer can vary. I use Exparel or a 4 day pain pump on all cases where I tighten the muscle fascia, or work under the pectoralis for Augmentation. To get Exparel, the doctor would have to buy 10 vials. The facility will likely not have it because of its cost. The facility may not let the doctor bring in outside meds. All facilities should approve of pumps, since they can open them sterile and fill them on site.
Since patients cost shop, using it adds to the price and may eliminate the best surgeon (ie the one who cares about your pain) because he is marginally more expensive. You can demand that the surgeon use one or the other, or find someone who will use it. The difference in pain is worth the cost! (David Janssen, MD, FACS, Oshkosh Plastic Surgeon)
Exparel post tummy tuck
I routinely use a pain pump post tummy tucks to help with the pain. I have found them to be very effective and not that expensive. Patients use much less narcotics when I have used the pain pump so now it is on all tummy tuck.
I have been trying to get exparel into the center where I perform my surgeries, but committee action takes time. Hopefully soon so we will have options. Not sure where you are located but 15K for just a tummy tuck seems high. Why not bring up the question to your surgeon? (Rick Rosen, MD, Norwalk Plastic Surgeon)
Exparel is a long lasting medication like marcaine or lidocaine. The 72 hours you mention was the best result obtained. On the average the study showed 12 hours. This was in bunion surgery and hemorroidectomy both are very small areas where the maximum amount of exparel was injected.
Tummy tuck is a very large area. Exparel has a toxicity and only a limited amount can be injected. There are no studies currently on its use in tummy tuck. Pain management has not been an issue with combination of muscle relaxants an pain medications and lidocaine injections. (Shahriar Mabourakh, MD, FACS, Sacramento Plastic Surgeon)
You are correct in that there are a variety of modalities that help with pain control after tummy tuck surgery. There are many surgeons across the country who use each one of the modalities available. In my practice, I use pain pumps for every patient undergoing this procedure.
I find that this tool, along with the use of narcotics and muscle relaxants postoperatively, provide very good pain control for the majority of patients who undergo this procedure. Online consultants will not be able to answer your question about your specific plastic surgeon’s practice. Best to raise your concerns with him/her directly. (Tom J. Pousti, MD, FACS, San Diego Plastic Surgeon)