POSTOPERATIVE PAIN CONTROL

At Monarch Plastic Surgery and Skin Renewal Center, we want to make your journey as comfortable as possible. Whether streamlining your paperwork through TouchMD, educating you on procedures and treatments before your in-person consultation, or simulating your potential surgical results with Vectra 3D imaging, we hope you will be informed and confident in your choice to trust us with your aesthetic needs.

For us, that attention to detail continues from the first phone call until your last visit with us. Should you choose to undergo surgery with us, your postoperative comfort is also an essential part of that journey, and we pay special attention to managing your postoperative needs effectively.

At Monarch Plastic Surgery and Skin Renewal Center, we will tailor your postoperative pain control to your specific needs, considering your personal medical history and prior experience with certain medications.

In general, pain after surgery results from multiple processes occurring in the body. Firstly, generalized pain occurs following surgery simply from the procedure itself. Surgery also stimulates an inflammatory response in the body. Inflammation is necessary for healing but also causes a downstream effect of swelling, which results in the treated areas being tender and sore following surgery. Thirdly, nerves that give us sensations become irritated after surgery. When nerves are irritated, they cause us to feel strange sensations such as stinging, burning, or static electricity-like shocks. This is very similar to the sensations you might experience when your hand “falls asleep” after being in an unusual position for a period of time. Lastly, when surgery is performed in or on muscles, the muscles respond by cramping or spasms, which can be uncomfortable in the same way an intense workout leaves you sore.

To address these causes of pain, we use the ERAS (Enhance Recovery After Surgery) protocol for our pain management following surgery. This protocol utilizes a targeted approach to keeping our patients comfortable by treating the sources of pain with specific medical therapies rather than masking the pain with a single pill. Components of the ERAS protocol include:

Acetaminophen (Tylenol)
Acetaminophen is prescribed on a scheduled basis for the first five days following surgery. This medication acts as a general analgesic or pain-reducing medication. It acts on pain receptors in the brain and spinal cord to decrease generalized pain.

Celecoxib (Celebrex)
Celecoxib is prescribed on a scheduled basis for the first five days following surgery. This medication acts not only as a pain reliever but also as a potent anti-inflammatory, decreasing swelling. Celecoxib works similarly to ibuprofen. However, it has a decreased risk of stomach ulcers and bleeding compared to ibuprofen, making it a safer medication in the acute post-surgical period.

Gabapentin (Neurontin)
Gabapentin is prescribed on a scheduled basis for the first five days following surgery. This medication decreases nerve pain, reducing skin and soft tissue sensitivity.

Methocarbamol (Robaxin) or Cyclobenzaprine (Flexeril)
If the surgery has included work in or on muscles, methocarbamol or cyclobenzaprine is prescribed on a scheduled basis for the first five days following surgery. These medications relax muscles, thereby decreasing pain caused by muscle soreness and cramping.

Oxycodone
Oxycodone is a narcotic medication that is a potent general analgesic or pain-reducing medication. It acts on pain receptors, blocking pain signals to the brain, thereby reducing the patient’s perception of pain. Oxycodone can be an excellent agent for managing pain not controlled by the previously listed medications, but adverse side effects accompany it. As such, we aim to limit its use whenever possible. We prescribe this medication as a backup to the other drugs and only recommend using it on an as-needed basis.

Pain Pump
In certain surgeries, such as abdominoplasty, our plastic surgeons use an On-Q pain pump to deliver numbing medicine for postoperative pain relief. The medicine is delivered automatically—you don’t need to do anything. We have found that our patients using the On-Q pain pump need fewer narcotics and have a generally quicker recovery than those who don’t.

Utilization of the ERAS protocol has been shown to keep patients more comfortable, decrease their duration of need for pain medication in general, and decrease the need for narcotic medication, which comes with adverse side effects and addictive potential.

Of course, we tailor every pain management regimen to our patient’s needs, but our philosophy is to continue improving patients’ experiences while prioritizing their safety.