One of the deterrents to patients seeking plastic surgery is the fear of pain after a plastic surgery procedure. Realistically, why would anyone choose to have pain when the surgery causing the pain is not medically necessary?

Instead of looking at the situation as producing pain, I encourage patients to regard the situation as a temporary sacrifice for permanent gain. Patients are seeking a physical change in their image. In order to achieve their goals,  they must have temporary discomfort, temporary inconvenience, and sometimes a loss of work income.

What they gain is permanent physical improvement in attractiveness, vigor and strength from their new self-image. I have seen some plastic surgery patients even have a permanent increased earning potential. We all know attractive people make more money over a lifetime, given that all other variables such as intelligence and skill are the same.

Pain does not need to be feared. Over the past 15 years I have completely changed the way I deal with surgical pain. The first thing I do is inject almost every incision at the end of the surgery with Marcaine. Marcaine is an intermediate-length acting anesthetic that essentially results in almost no post-op incisional pain. This lasts for 6-8 hours. It reduces the need for more stronger narcotics in the recovery area, such as fentanyl, and leads to less post-op nausea. By the time the patient has some pain, they are home on the couch, have eaten, and can take other oral pain meds.

The second new thing I do is use Exparel, a liposomal version of Marcaine, for deep muscular or nerve injection to give 48-72 hours of deep pain relief. This is used on breast reconstruction cases and abdominoplasties, where I put sutures in muscle, rib, and fascia. Some large orthopedic cases can be done outpatient now with the use of Exparel. It is quite expensive, so I use it when it reduces the overall cost of pain management for larger cases.

The third new thing I do is give patients who are not sulfa-allergic Celebrex. Celebrex is a non-steroidal pain medication that is not a narcotic,and reduces inflammation and swelling. Adding Celebrex to the oral narcotic regimen results in a dual pathway attack on pain.

The fourth not so new thing I do is to really listen to the patient. I hear their complaints, and try to explain to them that tightness, swelling, shooting sensations, are not pain, but scar tissue formation necessary for healing, swelling from doing too much, and nerves regenerating. Not all discomfort is pain. Every day surgical pain improves by 50% each day. By the third day, natural endorphins kick in which are produced by the body and some people have almost no pain.

You don’t have to be afraid of the pain from plastic surgery. With a variety of tools, pain can be managed and it will be worth it in the end. Call my office to schedule an initial consult!