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Exparel Controls Pain for Tummy Tuck Surgery

December 30th, 2013 Miguel A. Delgado Jr, MD


This is a Marin County, California 45 year old mother of two children. She is 5’5″ tall and weighs 135 pounds. She had a full tummy tuck with liposuction of the flanks at Marin Cosmetic Surgery Center.


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.Exparel

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.

Haute MD Invites Dr. Miguel Delgado to Join Their Select Group of Doctors

April 30th, 2013 Miguel A. Delgado Jr, MD



San Francisco, California-Haute MD is an upscale internet publication with current articles on health and beauty trends. This trusted online publication offers readers concierge access to premiere cosmetic specialists around the country. Dr. Delgado was selected for his exceptional reputation and talents in plastic surgery, with emphasis on surgical procedures of the body, such as; breast augmentation, breast reduction, tummy tuck, mommy makeover, and gynecomastia.

Along with a referral to top physicians, Haute MD includes a detailed profile with the doctor’s before and after pictures of actual patients, videos (if submitted) and testimonials.

The informative website offers San Francisco Bay Area men and women fascinating reading with articles like:

·       “Cupping Celebrity Health Fad: Groundbreaking or Totally Useless?”

·       “Benefits of Dead Sea Salt”

·       “Power Juice and How it Helps You”


“Haute MD connects the most trusted doctors and specialists with the country’s most discerning affluent audience. The network is an exclusive, invite only membership circle with only one representative per market for each of the nine medical specialties.”

The Difference Between a “Mini” Tummy Tuck and a Full Tummy Tuck

February 15th, 2013 Miguel A. Delgado Jr, MD

Before and After Full Tummy Tuck



A frequent question San Francisco Bay Area patients ask during consultation for a tummy tuck, is can they get a “mini” tummy tuck? They are hoping for a smaller scar and less involved surgery.

Although the names sound similar, the procedures treat different issues. The mini treats patients with minimal skin laxity, mild to moderate abdominal fat and mild to moderate stretched or separated abdominal muscle. There is a limited amount of tightening of the abdominal muscle, and it is only tightened below the belly button. The removal of stretch marks with this procedure is also limited. The incision is much smaller than for the full tummy tuck. Patients that are within 10% of their ideal body weight may be good candidates for the mini.

The full tummy tuck is usually recommended for women who have had children and have completed their child bearing. The full tummy tuck tightens all of the abdominal wall skin and muscle above and below the belly button. The incision generally goes from hip to hip but is placed so that it is hidden in the panty line. There is also an incision around the belly button. For the optimal result, a waist enhancement procedure can be done to give more definition to the waist line.

Many Marin County women opt to have breast surgery done at the same time, this may be a breast lift with or without implants, or breast augmentation or in some cases a breast reduction to have what is known as a “mommy makeover”, one of the highest patient satisfaction procedures available.


Before and After Mommy Makeover

When is it a Good Time to Get a Mommy Makeover?

September 28th, 2012 Miguel A. Delgado Jr, MD


29 year old female, breast lift, tummy tuck liposuction of back and flanks

Many Marin County women ask, “How soon can I have a mommy makeover after having a baby?” The mommy makeover procedure usually includes some type of breast surgery (breast augmentation, and/or breast lift, or breast reduction), a tummy tuck and some liposuction. A woman can proceed with the mommy makeover procedure once she has finished having children and it has been at least 6 months since she has stopped breast feeding. It is important for a woman to wait until she is finished having children because  other than destroying the tummy tuck result, if she should become pregnant the abdomen may not expand properly while the fetus is growing.

62 year old female, staged mommy makeover. Tummy tuck followed by breast reduction 1 year later.

The Mommy Makeover procedure is not only for the young!! Women today are eating healthy, not smoking, and have an active life style including regular exercise programs. This makes them excellent candidates for elective surgery. Cosmetic plastic surgery is reaching all time highs; San Francisco Bay Area women want to look as good as they feel, and for many older women they now can afford to treat themselves after the time and expense of raising a family has past.