December 30th, 2013 Miguel A. Delgado Jr, MD
San Francisco, California- Abdominoplasty or tummy tuck surgery is noted as having one of the highest satisfaction rates for cosmetic surgery. For women the most popular procedures are: breast surgery, liposuction and a tummy tuck, which can be combined making for a “mommy makeover” procedure. For men the most popular procedures are: male breast reduction (also known as gynecomastia), liposuction and abdominoplasty. The only downside for the tummy tuck procedure is the long hip to hip scar and discomfort from the first few days of healing.
Most men and women find the scar is an easy tradeoff for their new flat tummy, and in fact, most are pleased to find that after about a year of healing the scar fades to white or silver and is much less noticeable.
In the past, the pain has been managed quite well by a pain pump. The pain pump is a device that disperses an anesthetic to the surgical area by way of a couple of tubes, positioned by the surgeon at the end of surgery, through the skin of the upper abdomen. The anesthetic solution is stored in a bulb about the size of a tennis ball and is automatically dispersed over a period of about three days. The system has worked quite well in keeping the patient comfortable, however, the device is in a bag worn by the patient with a strap going around the neck, proving to be somewhat cumbersome and restricting the patient’s movements.
In keeping up to date with the latest innovations, Dr. Delgado now uses Exparel for his tummy tuck patient’s pain control.
Exparel is a slow release numbing agent that is a onetime injectable done by the surgeon at the end of surgery. This injectable lasts for about 72 hours, which is the duration of the worst part of the post-surgical pain. Exparel allows the patient the freedom of not having the pain pump tethered to them.
When the brain receives signals of pain, Exparel will block the nerve impulses, providing relief to the patient. The anesthetic used in Exparel is bupivacaine, more commonly known as Marcaine, which is suspended in liposomes that slowly release the drug.
Dr. Delgado’s anesthesiologist, Dr. Randy Gaynor, will need to know if you have had any problems in the past with anesthesia. Most patients tolerate Exparel very well, but it is important to know if you have any history of; kidney or liver problems, any history of seizures, heart rhythm disorders or heart disease.
It is not unusual for tummy tuck patients to need some narcotic pain relief in addition to the Exparel. However, studies show that patients that had the Exparel injections took about a third less pain relievers than the non-Exparel patient, and the Exparel patient had a faster recovery time with less discomfort.
Exparel is comparable in cost to a pain pump, so it is mostly used in extensive surgeries. For the patient with a low pain threshold or for one who is overly anxious about an upcoming surgery, it would be worthwhile to discuss pain management with Dr. Delgado.
To schedule a consultation, call (415) 898-4161 or send an email.