San Francisco, CA-Abdominoplasty, also known as a tummy tuck, is one of the most patient pleasing surgeries performed. The long hip to hip resulting scar, for most women, is a small tradeoff for their new flat stomach. The only other downside to the procedure is the discomfort for the first few days. The tummy tuck procedure is not just for women, it is a very popular procedure for men as well, usually after substantial weight loss and many will have the procedure done in conjunction with gynecomastia surgery.
In the past, to ease the pain after surgery, a pain pump was used. At the end of surgery, the surgeon would place; two small catheters through the skin of the upper abdomen. The pump disperses local anesthetic directly into the surgical site and lasts for about three days. The pumps are fed by a supply of local anesthetic that is in a bulb about the size of a tennis ball. The device is kept in bag with a strap that goes around the neck. The pain pump provides relief, but the device is somewhat bulky and freedom of movement is somewhat restricted as the patient is tethered to a machine.
Always looking for the best treatment for his patients, Dr. Delgado is now using Exparel for tummy tucks instead of the pain pump. Exparel is not a narcotic but an injectable slow release numbing agent injected at the close of surgery. It is a onetime injection lasting up to 72 hours, which is usually as long as the most intense post-surgical pain.
Exparel is an anesthetic that blocks the nerve impulses that send signals of pain to the brain. Exparel contains bupivacaine which is commonly known as Marcaine, and it is suspended in liposomes, which are a delivery vehicle for pharmaceutical drugs over a period of time.
Most patients tolerate the anesthetic well, but your surgeon will need to know if you have; liver, kidney, or heart disease, heart rhythm disorder or history of seizures, also if you have had a reaction to any type of anesthetic.
Patients who have had surgery using Exparel may still need some narcotic pain relief following surgery, but in clinical trials patients took about a third less narcotic pain relievers than non-Exparel patients and they seem to recuperate faster with a lot less discomfort.
The cost for Exparel is about the same as the cost for a pain pump so it is not deemed worthwhile for less extensive surgeries such as breast augmentation or breast reduction. However, for the patient who has a low pain threshold or is overly anxious about upcoming surgery, a discussion with Dr. Delgado about pain control is recommended.
In keeping abreast of the latest innovations for his patients, in addition to Exparel, Dr. Delgado now has the exciting non-surgical fat reducing “CoolSculpting” available. See September’s blog for more information and schedule a consultation with Dr. Delgado to see if you may be a candidate.