Until recently, many plastic surgeons didn’t hesitate to prescribe the likes of Vicodin, Percocet, and oxycodone to address a patient’s discomfort that could follow a procedure. But an opioid epidemic that claimed tens of thousands of lives last year alone has prompted the field to take a closer look at pain management.
Narcotics are often necessary for controlling pain after major operations, like large-volume liposuction and tummy tucks. But more and more plastic surgeons are finding alternatives and using anti-inflammatories, local anesthetics, and numbing medications to attack different pain pathways.
And, increasingly, patients are asking their surgeons not to prescribe them any pain medication.
Redefining recovery with Experal & Celebrex
As reducing narcotics use becomes a greater priority, innovations like Experal are becoming commonplace and changing the recovery experience. Experal is a drug that contains bupivacaine, a longer-acting numbing agent. Injected at the site of the incision, it binds to fat molecules in a microscopic honeycomb. In some cases, an ultrasound is used to place it precisely where the nerves are.
Experal dissolves over the course of 72 hours, which enables plastic surgeons to significantly decrease the narcotic requirements for a number of procedures and get patients off of them a lot sooner.
Similarly, some doctors are incorporating Celebrex, an anti-inflammatory arthritis medication and pain reliever, and a nerve medication called Lyrica into their pre-surgery pain-management plan. The first is taken the day before surgery, the second, several hours before and four to five days afterward. The combination is able to cover a lot of a patient’s discomfort for certain cosmetic procedures.
And, believe it or not, Tylenol has garnered some renewed interest as an alternative. It’s been found to be particularly effective at blunting pain when it’s taken in frequent doses.
Voice your concern
Well before that point, doctors are also being more vigilant about screening patients for a history of substance use disorder. But medical records aren’t always a reliable reference for such a condition. Not to mention, there’s no way to take into account those who have a genetic predisposition for addiction.
Plenty of people are able to take opioids as they were prescribed and never use them again. But then there are others who aren’t able to stop taking them. Until you’re in that position, you can’t know for sure what you’ll be inclined to do.
If you have any concern about being prescribed a narcotic before or after your procedure, discuss it with your board-certified plastic surgeon. If an alternative isn’t readily available, your surgeon may be able to refer you to a pain management therapist, who can at least monitor your behavior when taking a small, controlled prescription.
