Mommy Makeover: Info, Photos, Rewiews, Q&A

Pain management in patients allergic to codeine

In instances where patients are allergic to narcotic analgesics, we tend to use a combination of darvocet, ultram, and/or celebrex for pain management. (Otto Joseph Placik, MD, Chicago Plastic Surgeon)

Codeine allergy

Other drugs can be used to control postoperative pain like antinflamatories, generally opiates pain killers are not used postoperative, but they can be substituted by other ones. (Kemil Issa, MD, Dominican Republic Plastic Surgeon)

Options beyond codeine

You have alot of options beyond codeine. During sugery, your surgeon can give you some local anesthesia, use exparel or pain pumps.

After surgery when you are at home recovering, there are many options of oral pain medications that do not include codeine.

Speak with your plastic surgeon and discuss your options before surgery and talk to him or her about expectations after surgery as well. (Kiran Polavarapu, MD, Fort Worth Plastic Surgeon)

Staying comfortable after a mommy makeover

There are lots of options for keeping you comfortable after a mommy makeover. I usually use a variety of things so that you get all the benefit and little in the way of side-effects.

Some options include different combinations of: tylenol, gabepentin, opioids (tramadol, oxycodone, morphine, demerol, dilaudid), NSAID’s and can all be use effectively so that you are comfortable following surgery.

I wouldn’t worry about the allergy, you have lots of options. (Rodger Shortt, FRCSC, Toronto Plastic Surgeon)

Many options for Pain Management

Whenever a patient tells me they have an allergy to a medicine the first thing I asked them is what happens when you take the medicine. Most the time when it comes to narcotics the patients experience an upset stomach or nausea. This would not be a true allergy but what we were referred to as a intolerance. Although the breast portion of a mommy makeover usually does not have much discomfort, the abdomen can be a very different story.

In an effort to alleviate postoperative pain or at the very least to minimize it I usually recommend to my patients either the use of Experal, a long acting injectable or an On-Q pain pump. Additionally I will usually have the patience take some form of a nonsteroidal such as Motrin or Toradol.

Some patients experience postoperative muscle spasms and this can be addressed with a low dose of Valium. Finally the mainstay of any postoperative pain management program will be a narcotic. Even for patients who say they are codiene allergic medicine such as hydrocodone or oxycodone can usually be used with success.

But keep in mind all of these medications must be taken on a full stomach otherwise nausea is assured. Also keep in mind that everybody has a different pain tolerance and their experience does not nessisarily mean it will be the same as yours. (John Mancoll, MD, Virginia Beach Plastic Surgeon)

Pain Medication for Boca Raton Mommy Makeover

Here are our practice in Boca Raton, mommy makeover patients find that Percocet or Vicodin are excellent for discomfort. Neither have the drawbacks of codeine (nausea, etc) and both can be used for patients who are actually allergic to codeine.

Some patients find that discomfort is lessened by the following:

1. Getting enough rest. Rest is the primary treatment for surgical discomfort!
2. Absolutely avoid lifting anything over 15 lb. This includes taking young children in and out of the tub, the carseat and the highchair, as well as bags of groceries. Don’t run the vac or do other strenuous household tasks and definitely avoid exercise until you’re cleared to return to the gym.
3. Keeping things moving! Constipation is common after any surgery, especially abdominal surgery. Eat plenty of fruit and veggies and drink lots of water to avoid becoming constipated, which can increase abdominal discomfort.
4. Contact your surgeon if the discomfort is not controlled by pain meds. (Jonathan Berman, MD, Boca Raton Plastic Surgeon)

Allergic to codeine, considering Mommy makeover

I recommend that patients allergic to codeine consider the use of a pain pump or injected Exparel( a slowly released local anesthetic). In addition to this, patients allergic to codeine are often able to take other narcotics such as oral Demerol or hydrocodone, or non-narcotics such as Toradol (John Zavell, MD, FACS, Toledo Plastic Surgeon)

There are a number or other meds that can be used instead of codeine for post operative mommy makeover pain management.

One of the most effective ways to control the discomfort is to ask for a pain pump.

This is a medical device that we, the surgeon, inserts into the tummy tuck region that trickles Marcaine anesthetic over the undermined region.

It is placed under the skin and infuses at a very slow rate so that when the discomfort is at its greatest, usually the first three days, you will be able to tolerate the discomfort very well.

Also, I have used Celebrex in conjunction with the typical pain meds such as Loratab, Vicodin, and or Percocet.

The Celebrex helps with inflammation, doesn’t thin your blood (important post Mommy Makeover), and doesn’t cause nausea or vomiting.

It also allows the patient to not use as much of the narcotic pain meds as mentioned above. Any of the meds above, including Codeine can cause malaise, nausea, vomiting, and especially constipation. (Joel B. Beck, MD, FACS, Bay Area Plastic Surgeon)

Alternatives to codeine for pain relief

All narcotic pain relievers have some resemblance in their chemical structure, and an allergy to one can mean being allergic to others. Many times when patients tell me they are allergic to codeine it is not a true allergy, but rather a sensitivity, meaning they get nauseated or have some other side effect, rather than a rash, hives or other true allergic reaction.

It is best to define this first, and then look at some of the alternatives, both narcotic and non-narcotic.Although we have relied on the use of narcotic pain relievers for pain since the Civil War, they have some negatives and some patients just don’t tolerate them.

Or, in the case of recovering addicts, they never want to touch them again. Does this prevent us from being able to do surgery because of inability to deal with the pain? Not at all.

There are non-narcotic alternatives available which may be sufficient with proper mental preparation and good planning.

Discuss this with your doctor at length and I am sure a good program me can be planned to give you peace of mind going into surgery (Benjamin Gelfant, MD, Vancouver Plastic Surgeon)

Pain Control After Mommy Makeover

Mommy makeover pain management is usually approached from many different ways. Post-operative pain pills are less important than some intraoperative medications that can provide long term pain relief.

Recently, we have began using EXPAREL, which is a special form of local anesthesia that gives profound relief of pain for up to 72 hours after surgery. This coupled with no drains using a progressive tension style tummy tuck helps cut down on the pain experience after surgery.

The EXPAREL can be used all over the tummy to help the incisional pain as well as the deep pain that you may experience from the tightening of the muscles. As for oral pain medications, we typically use Nucynta which is a new narcotic pain medication with a lower incidence of nausea and vomiting as well as less constipation. This may be a good alternative for you. You should ask your plastic surgeon for their recommendations. (Kent V. Hasen, MD, Naples Plastic Surgeon)

Mommy Makeover comprises a spectrum of tightening/lifting procedures of the breast and abdomen. Tummy tuck is often performed to tighten muscles, address fat in the waist, and remove redundant skin and stretch marks.

Mommy makeover pain management has evolved an enormous amount. Today with have a medication called Exparel which may be injected into the abdominal wall intraoperatively and this is a slow release numbing medicine that lasts 4-5 days.

There is no associated nausea or constipation like we see with narcotics. There is an extra fee, but it’s well worth it! (Michele A. Shermak, MD, Baltimore Plastic Surgeon)

Pain management options following surgery

There are numerous options for pain management following surgery. There are several different types of narcotics that are available should you have problems with codeine.

Non narcotic medications such as advil and tylenol are useful as well. Intraoperatively, your surgeon may employ long acting local anesthesia such as Exparel which lasts for 3 days post-op.

The treatment for pain often involves all of the above. (Stephen M. Chen, MD, Richmond Plastic Surgeon)

Pain medication

I would recommend percocet (oxycodone based) or vicodin (hydrocodone based) – neither of which are codeine narcotics. The best choice of medication depends on the nature of your allergy – best to discuss with your doctor. (Grant Stevens, MD, Los Angeles Plastic Surgeon)

Allergy to Codeine and Plastic Surgery

A history of a bad reaction to codeine is not uncommon. Usually these patients will do fine with a synthetic such as hydrocodone or oxycodone. With the use of local anesthetics, most patients require much less narcotic. Just explain your reactions very carefully with your plastic surgeon. (Dustin L. Reid, MD, Austin Plastic Surgeon)

A long acting local anesthetic will reduce your need for codeine

Most oral pain medicines used after this surgery are cousins of codeine. If there is one in particular that works for you, then you can us it.

There are also a few modern pain medications which have much less of the side effects of narcotics like codeine; these will be more expensive.

I inject Exparel into the abdomenal wall and incision as well as the breast incisions at the time of a Mommy Makeover.

Exparel is a long acting local anesthetic which keeps these areas numb for three days after surgery .Patients take less than half of the usual number of pain pills after this surgery if Exparel is injected.

Without the side effects of codeine, like nausea, vomiting, sweats, dizziness, and constipation, patients feel much better after surgery.

When the patients have good pain control and minimal side effects, they are up and walking around earlier.

This ensures that patients don’t get blood clots and helps with deep breathing. Being able to walk and move around comfortably early after Mommy Makeover really speeds the entire recovery! (Stephan Finical, MD, Charlotte Plastic Surgeon)

Pain mommy makeover control after surgery

There are many pain medications that can be used after surgery. Vicodin is the most common but there are people that can not tolerate vicodin or codeine.

Ask your surgeon for a different form of pain medication. I also use a muscle relaxant in combination with pain meds that reduce the need for narcotics and helps reduce recovery time. (Shahriar Mabourakh, MD, FACS, Sacramento Plastic Surgeon)

The abdominoplasty pain of the MM can be greatly decreased by using Exparel. It’s FDA approved and limit the use of codeine or Percocet. I recommend it to my patients. (Frank J. Ferraro, MD, Paramus Plastic Surgeon)

Mommy makeover and pain control. Allergic to codeine

This is a very doctor specific question but it is important for you to know that there are other ways of controling pain.

It might be with the use of intraop injection of nerve specific areas with a long acting anesthetic, marcaine, or with the use of lidocaine given with a pain pump.

Pain control can be with other medications that can be listed by your doctor but there will be one that you will be able to use that will control your pain. (Steven M. Lynch, MD, Albany Plastic Surgeon)

Exparel for post operative pain control in mommy makeover

If you have a true allergy to codeine or cannot take any other narcotic pain medication such as hydrocodone or oxycodone, I would use Exparel at the time of surgery. This is a long acting local pain medication which when used properly can make post operative pain very tolerable. I have had patients that have had tummy tuck and never used a narcotic pain medication following the surgery when using Exparel. (Ralph Trey Aquadro, MD, Auburn Plastic Surgeon)

Allergic to codeine, any alternatives for pain control

I would make sure you have a true allergy to Codeine. If you have a history of an anaphylactic reaction or severe rash with Codeine, I would try using Tramadol or Toradol for your pain control. (Robert Najera, MD, Frisco Plastic Surgeon)

Codeine is metabolized to morphine in your body and morphine frequently causes a histamine release and occasionally nausea. I recommend speaking with your physician about your symptoms after codeine. Your surgeon can prescribe powerful anti-nausea and anti-histamine drugs to prevent your side effects. Other alternatives are available to the opiate family, but most are not as effective and do not have the safety profile that opiates have. (Jason Mussman, MD, Phoenix Plastic Surgeon)

Exparel for Post-operative Pain Control

I have been very impressed with the new formulation of Marcaine called Exparel. (I do not have any stock or interest in the company, I just like my patients to have less pain!)My breast augmentation patients usually complain of discomfort and pressure, but very rarely complain of deep muscle ache, pain or spasm. MOST of my breast augmentation patients take Tylenol only.

I often have difficulty keeping them away from activities over the first several days because they have tended to feel so well.The tummy tuck is the most painful operation that I perform, especially when muscle tightening is involved, which is usually the case. I have seen a DRAMATIC decrease in the amount of pain postoperatively when using Exparel.

I do not inject it into the skin; rather I place it as a nerve block (called “TAP Block” for “Transversus Abdominis Plane”) where I directly inject the anesthetic between the internal oblique and transversus abdominis muscle. My patients are able to take much less with regard to pain medications because of this technique.

In patients with narcotic intolerences, I use one of three medications for postoperative pain (in addition to the Exparel TAP block): Valium; Tramadol, or Flexeril. I  think most of the pain of the tummy tuck is related to muscles spasm (early) and lower back pain (later. after the first week).

I have had good success with these medications and narcotics are not always the most beneficial for postoperative pain. In addition, I recommend around the clock Tylenol as well as a nerve medication called Gabapentin before and after surgery. Hopefully your surgeon is sensitive about your needs and can help devise a medication regimen and nerve block plan that will minimize your pain! (Adam J. Oppenheimer, MD, Orlando Plastic Surgeon)

Various modalities can help

We have various modalities these days that minimize our dependence on opiates or codeine.

One of those includes doing an abdominoplasty under a spinal anesthetic which is excellent for postoperative pain control but it does require an overnight stay at the hospital.

The other is the use of Exparel which is a long lasting local anesthetic and that will improve pain control for the breasts and the tummy, and again will minimize one’s dependence on opiates.

Most patients aren’t allergic to opiates, per se, but they may be sensitive to them which may cause more nausea or vomiting.

Also using intravenous Tylenol during surgery helps a great deal. (Glynn Bolitho, PhD, MD, FACS, San Diego Plastic Surgeon)

Hydrocodone

If you have an allergy to codeine, you can still take Vicodin or Percocet. Both are very good narcotics for pain relief. In fact I would use them instead of codeine in every case. (Gary Lawton, MD, FACS, San Antonio Plastic Surgeon)

One option for post-operative pain control is Sprix Nasal Spray or intra-nasal toradol.

Toradol is one of the most powerful NSAID’s and has none of the negative side effects of opiate based pain medication (percocet/vicodin/norco) such as nausea, dizziness, constipation.

Ask your doctor if it is safe for you to try Sprix as a post op pain control medication.

NSAID’s impact the clotting cascade and increase the risk of bleeding, hematoma, as well as gastritis. (James H. Rosing, MD, Newport Beach Plastic Surgeon)

Pain control after mommy makeover

There are several options for reducing discomfort after surgery. Patients most commonly use a narcotic oral medication but certain individuals are sensitive to narcotics with headaches, stomach distress, and constipation. Sometimes one narcotic may work better than another.

My patients have had excellent response to dilaudid, especially when used along with valium to minimize muscle spasm and long acting local anesthetics. Discuss your concerns with your surgeon to find what solution will work best for your unique needs. (Andrew Goldberg, MD, Fairfax Plastic Surgeon)

Pain Control After Mommy Makeover

What is your reaction to Codeine and what pain medications have you safely taken in the past? If you have a sensitivity to Codeine (nausea, light-headedness, constipation), you may be fine with other narcotic pain relievers (Vicodin, Percocet, Demerol), especially if you have had no problems with them in the past. If you have a true allergy (rash, hives, swelling, shortness of breath), you may also be allergic to other narcotic pain relievers. In this case, Tramadol may be a safe option.

No matter what you take for pain relief, I recommend a muscle relaxer as well. I also recommend placing a pain pump to supplement your medications. This is similar to an epidural in that catheters are placed in the surgical area. These catheters are attached to a reservoir which continually pumps local anesthetic into the surgical area for pain relief without narcotics and can be refilled. Another option is Exparel, which is a long-acting local anesthetic that is injected during surgery.As you can see, there are a few good options for pain control. It’s best to talk with your surgeon about your allergies and devise a plan that suits your needs. (Gabriel Chiu, DO, Beverly Hills Plastic Surgeon)

Pain control after mommy makeover surgery.

Some patients have post-operative nausea and vomiting due to the narcotics they are using.We find that patients label this an allergy when it may be due to simply taking the medication on an empty stomach. If there is any question, a different pain medication should be substituted such as demerol, percoset, etc. In our practice, we use an injectable medication called Exparel which is fantstic.

It provides pain relief for about 72 hours and really makes a difference. You will use less pain medicine and hopefully have less problems with post operative nausea. I often will get my patients to start using Advil or Alleve very soon post op and get off the narcotics ASAP as well. (Paul Watterson, MD, Charlotte Plastic Surgeon)

Pain Control After Mommy Makeover!

Alternative analgesics if you’re allergic to codeine, you may also be to oxycodone or hydrocodone.

Toradol is an alternative medication which is equally as potent as narcotics like codeine without the side effects from narcotics.

If you are allergic to ASA or ibuprofen, you wont be able to take Toradol as it is in the same class as aspirin/ ibuprofen. (Mel T. Ortega, MD, Miami Plastic Surgeon)

Medicine after surgery

A pain pump is a big help. Also Nucynta a newer narcotic has less nausea but is expensive. (Gregory T. Lynam, MD, Richmond Plastic Surgeon)

Many patients mention this type of allergy. You need to discuss this with your board certified plastic surgeon because many carry issues with potential for bleeding.

Don’t figure this out with anyone other than your own surgeon as he will have a good suggestion in his armamentarium. (Ricardo A. Meade, MD, Dallas Plastic Surgeon)

Pain Pump an Ultram

Many people have a problem with codeine and its derivatives because it makes them nauseated. Due to the limited alternatives I generally recommend a pain pump which secretes long acting local medication directly to the operating sight as well as Ultram.Ultram generally dose not have the side effects of the other opiods.

This is particularly important in someone undergoing a tummy tuck.

Because the last thing we want to happen is for you to retch and or vomit which could be extremely painful as well as counterproductive in healing after surgery. (Ritu Chopra, MD, Beverly Hills Plastic Surgeon)

“Codeine Allergy”

Often when patients say they are “allergic” to codeine, they are really just remembering that they happen to be sensitive to the nausea side effect of narcotics.

If your allergy is nausea & vomiting, it is reasonable to try some other medication in the same family, as the side effect profile varies for each drug (and for every patient as an individual.)

You might do fine with oxycodone (Percocet) or hydrocodone (Norco). Compared to most other pain medications, the narcotic class is one of the most effective for pain relief, so don’t be too quick to discard them.

Additionally, if you did not use an anti-emetic, certainly add one to your postoperative regime. (Michael A. Bogdan, MD, FACS, Dallas Plastic Surgeon)

Pain management After Tummy Tuck and Mommy Makeover

The best way of managing pain after surgery is to prevent it from happening using medication and techniques before and during surgery. For example, I routinely give my patients Celecoxib before surgery, which is a powerful anti-inflammatory medication; this continues for 1 week after surgery. During surgery I do injections with local anesthesia to freeze the nerves around the tummy muscles to prevent them from becoming sensitized and painful.

Also, I prefer to use a “Local Anesthesia Pump”, which slowly infuses a solution over the coming muscles that helps to prevent pain and stays in place for 2 days following surgery.

Through these techniques and others most of the pain after surgery can be avoided. However, with that I usually prescribe alternatives to codeine for those who are allergic. These alternatives include Morphine, Demeral, Tramacet, Tramadol, Fentanyl Patch, Percocet (Oxycocet). (Cory Goldberg, MD, Toronto Plastic Surgeon)

Cosmetic Surgery is an Art and a Science

Pain relief after surgery is an integral part of the practice. Most patients don’t understand the difference between an allergy and a side effect of medicine.

A true allergy will make the patient break out in hives. Nausea, vomitting and irritable behavior are side effects. In my experience, change the medicine to another drug i.e. hydrocodone, where there a fewer side effects. (Thomas A. Narsete, MD, Greenwood Village Plastic Surgeon)

Many people experience nausea or vomiting with codeine – this is not a true “allergy”, but an unfortunate side effect. If you had a rash, or throat swelling or wheezing – those are true allergy reactions. There are plenty of options for you, fortunately. If you had a true allergy reaction, you want to select a medication that is unrelated to codeine. Tramadol or Nucynta would be unlikely to give you a reaction, since they are structurally different drug molecules. Speak to your surgeon about your concerns.there are plenty of choices. All the best, (Thomas Fiala, MD, Orlando Plastic Surgeon)

I rarely use codeine for pain control. The patients have the option to use pain pumps and we use hydocodone or vicodin. I also use muscle relaxants in combination with anti inflammatories with very good success (Norman Bakshandeh, MD, FACS, New York Plastic Surgeon)

I Am Allergic to Codeine. Any Suggestions for Pain Control After Mommy Makeover?

Many patients get very nauseous after taking Codeine and feel that they have any allergy to it. Usually these reactions are just a bad side effect of the medication. An alternative would be Hydrocodone or Tramadol to control pain. (Thomas Guillot, MD, Baton Rouge Plastic Surgeon)

Pain control after surgery

Many patients are either allergic to, or have bad side effects of Codeine. Reducing the amount of pain, and need for post operative narcotics, is the really the goal. Pain reduction should begin in the OR. Long acting numbing medicine can be used. Regional blocks can be performed. And pain pumps are available. Intravenous Ibuprofen and Tylenol can be given so that you are comfortable when you wake up.

After surgery, NSAIDs should be started. Finally, low strength narcotics can be added as well. For those patients who can’t take Codeine, I generally use either Dilaudid or Demerol. If nausea develops there are other medications that can be used to treat the nausea. Let your surgeon help you. (Ronald Schuster, MD, Baltimore Plastic Surgeon)

Pain management after Tummy Tuck?

There are many alternatives for oral medications effective after tummy tuck surgery. It would be best to avoid confusion and discuss the issue with your plastic surgeon who may have his/her preferences. The use of a postoperative pain control pump (long-acting local anesthesia drip) may also be helpful. (Tom J. Pousti, MD, FACS, San Diego Plastic Surgeon)

There are many pain medication choices. Your surgeon will discuss his/her choice of pain medication base on the anticipated discomfort, your allergic reaction to codeine and the surgeon’s preference for alternatives to codeine. (Earl Stephenson, Jr., MD, DDS, FACS, Atlanta Plastic Surgeon)

There are many medication and ways to control pain after any surgery. Discuss your specific situation with your doctor. (Samir Shureih, MD, Baltimore Plastic Surgeon)

Demerol is very good at controlling pain after a cosmetic procedure. Make sure your local pharmacy carries it before giving them your prescription. (Jeffrey E. Schreiber, MD, FACS, Baltimore Plastic Surgeon)

There is a big difference between a drug sensitivity and a drug allergy, with that being said, I would defer to your Board Certified Plastic Surgeon to prescribe you an alternative pain medication. (Christine Sullivan, MD, Columbus Plastic Surgeon)

Codiene allergy.

Many patients feel that they are allergic to codeine because they became nauseated when they took it once. This is not a true allergy to the medication and can be caused by almost any type of medication.

Codeine is rarely prescribed today as the synthetic codeine derivatives, such as Vicodin, are usually used and generally have a better profile regarding side effects. If you do have a true allergy to codeine we previously used a drug called Darvocet which was a Davon compounded with Tylenol, however this medication has been removed from the market as of this month by the FDA. We are currently using Ultram as an alternative. (Paul Vitenas, Jr., MD, Houston Plastic Surgeon)

Codeine allergy or intolerance very common

Your reaction with codeine is common. Other alternative postoperative pain medications include hydrocodone products such as Vicodin; Ultram (tramadol); Toradol (NSAID). Talk to your plastic surgeon to see what she/he recommends for you. (C. Bob Basu, MD, FACS, Houston Plastic Surgeon)

Pain medication substitutes

This is something that you should review with your surgeon. I am not a big fan of the anti-inflammatories because they can cause bleeding. (Steven Wallach, MD, New York Plastic Surgeon)

Pain after Mommy Makeover

The discomfort after mommy makeover procedures is often less than expected if the surgeon follows a few simple guidelines.

Treatment with non-opioid pain medications at the start of the procedure as well as the use of local anesthetic can prevent activation of some pain mediated pathways.

This limits the amount of anesthesia and pain medication required as well as decreases the discomfort and recovery after your procedure.

Exparel has become a wonderful addition to procedures in appropriate patients and can provide some degree of pain relief for up to 72 hours if used at the time of the procedure.

There are many non-opioid alternatives to codeine and your plastic surgeon can evaluate your particular allergy and make recommendations.

As with any procedure there will be some discomfort after a mommy makeover, however, with appropriate steps this can be dramatically improved. (Ryan Diederich, MD, Saint Louis Plastic Surgeon)

I Am Allergic to Codeine. Any Suggestions for pain management After Mommy Makeover?

I am using a long acting local anesthesia that is applied at the end of the operative procedure and will keep the patient pain free for 3 days.

Also, during the operation under general anesthesia the tumescent process prior to excision and dissection limits swelling and therefore keeps the pain low.

This combination of techniques could then be augmented with a non narcotic oral pain medication. (Thomas Trevisani, Sr., MD, Orlando Plastic Surgeon)

Codeine Allergy

It is important to discuss your allergy with your treating plastic surgeon. There are several alternatives to codeine available.

Also, be sure to describe what your reaction was to your plastic surgeon, as oftentimes patients mistake side effects (such as nausea) for an allergy. I’m sure he or she will find an adequate alternative! (Bryan Correa, MD, Houston Plastic Surgeon)

Meds to Control Pain After Mommy Makeover

There are many options for pain management after a mommy makeover. In addition to narcotics other than codeine (Percocet, Tramacet, Dilaudid) there are several effective non-narcotic pain medications (Toradol, Celebrex, etc.).

Many plastic surgeons use nerve blocks during surgery or insert pain pumps after surgery. (William Andrade, MD, Toronto Plastic Surgeon)

Pain relief after tummy tuck

There are many codeine alternatives that are suitable for a tummy tuck procedure. Once you speak to your surgeon, I am sure you can be prescribed an alternative medicine. (Raffy Karamanoukian, MD, FACS, Los Angeles Plastic Surgeon)

Pain management following Mommy Makeover

Many people have adverse reaction to pain relief medications containing narcotics such as codeine (Tylenol #3), hydrocodone (Vicodan) and oxycodone (Percocet). Rarely is it a true allergy but rather a sensitivity causing symptoms such as itching, nausea or grogginess.

Alternatives like extra strength Tylenol may not be strong enough and anti-inflammatory meds like Advil, Motrin, Aleve or Ultram can have the undesirable side effect of excessive bruising or even hematoma formation. I am a strong proponent of the marcaine pain pump (On-Q) for all my abdominoplasty patients and have also used it in combination with breast surgery procedures.

The medication is automatically delivered through very thin catheters under the skin anesthetizing the muscles where most discomfort is felt. After 3 days the pump becomes depleted, but it can be refill by the doctor if necessary, or removed by the patient if not. (Scott A. Brenman, MD, FACS, Philadelphia Plastic Surgeon)

There are codeine alternatives that can help you feel comfortable after surgery.

A true allergic reaction to codeine requires an alternative for pain management — but luckily there are several excellent alternatives to choose from. Be sure to discuss your concerns with your surgeon, and you can also do some research on your own to find out the different classes of drugs that are safe for people allergic to codeine. If you have a negative reaction to codeine (such as severe nausea) rather than an allergic response, bring this question up to your surgeon to see what he or she recommends as an alternative. In either case, a strong NSAID may work to help keep your discomfort manageable after surgery without the need for opiates. (Frank Campanile, MD, Denver Plastic Surgeon)