Summary: One of the serious roadblocks for candidates thinking about plastic surgery is pain. That’s why plastic surgeons spend a great deal of time thinking about—and training for—pain management. A few years ago, pain pumps became a revolutionary way to mitigate pain after particularly intense operations. Now, doctors are jumping on board the Exparel bandwagon—although it’s looking like Exparel is worthy of the hype. Instead of a surgically implanted pain pump, patients now have the option to get a single injection which will numb their pain for up to 72 hours.
A Pain in the … Well, Everywhere
Despite all its benefits, pain is one of the consistent downsides of plastic surgery is the pain—the pain after surgery and the pain of recovery. Yet, it’s necessary—you can’t have plastic surgery without it. So surgeons are always looking for a way to mitigate and control pain as much as possible. Traditionally, this was usually accomplished during surgery and post-surgically by something called a pain pump.
A pain pump is a device, such as ON-Q, which administers painkilling medication via a catheter that is implanted during surgery. Pain pumps are typically prescribed to be worn for up to five days after surgery. By excreting a numbing agent into the effected area, pain pumps are a great way to manage pain without the use of narcotics.
But there are some downsides to the pain pump:
- It is a hassle: first and foremost, it requires surgical insertion and removal, and patients have to be careful of it. Pain pumps are connected to the patients via catheters, which must be removed by a medical professional.
- Pain pumps can be unreliable. Some patients simply don’t respond to them as effectively as one would expect (though, in most cases, they can diminish pain by up to 40%).
- Pumps can be unsightly: they’re worn in a pouch, much like a purse, that you carry with you for up to five days. (Not that you should be getting out much after your operation, of course.)
But there’s a novel way to administer pain management medication called Exparel. Where as a pain pump is connected via a catheter, Exparel is actually an injectable that works as a time-release pain reliever. What’s better is that Exparel, as with a pain pump, does not rely on narcotics and, therefore, you don’t get any of those particularly troubling side-effects.
When we say that Exparel is an injectable, we mean it: your plastic surgeon will inject Exparel directly into the deep tissues, usually during surgery, and the numbing agent will last for up to three days. Yes, they use a giant syringe to do it, but it’s okay, because you’re usually knocked out and won’t ever see it.
Tummy tucks have a well earned reputation as being an exceptionally painful procedure. Part of the reason for this is the nature of the technique: tissue is pulled very tightly after the removal of fat and skin because that’s what the desired outcome is: tight skin. And while this insures a certain result, it also insures a certain amount of pain (as your tissue is literally stretched to a painful point, meeting at a painful incision).
As such, tummy tucks were among the first procedures to see patients use a pain pump, and now they’re a popular procedure for the Exparel alternative. In both cases, the numbing agent is administered first during the procedure, so many patients wake up with a significantly diminished sense of pain. The advantage of Exparel, is that there is no follow up maintenance—the numbing agent will itself last for up to 72 hours, so the pump is unnecessary.
Big Surgery v. Little Surgery
Pain pumps generally aren’t administered with less invasive surgeries, though ultimately this is up to the doctor and to the patient. Much, after all, depends on your threshold for pain and discomfort. Generally, however, something like a breast augmentation is less invasive and will not require a pain pump or even Exparel. To be sure, either a pain pump or Exparel might be nice to have with any and every surgery, but price does become a factor. Both Exparel and pain pumps are competitively priced, but they do account for additional costs. In procedures where pain is more tolerable, they simply may not be worth the investment.
It’s Your Pain
Ultimately, pain mitigation decisions are between you and your plastic surgeon. For many, a pain pump will be an excellent option. For others, Exparel is the clear choice. As your plastic surgeon will be performing the operation and will be able to reasonably anticipate your discomfort, it’s important to discuss your pain expectations and limitations before the surgery begins.
Because while your plastic surgeon can feel empathy, only you can feel your pain. With a pain pump or Exparel, you can also numb your pain—and improve your recovery.