One of the best ways to speed your recovery from plastic surgeyr is with the use of tumescent fluid. This fluid contains a combination of dilute local anesthetic agents to reduce pain as well as epinephrine to constrict blood vessels to decrease bleeding.
It is amazing how much this can reduce pain after surgery and speed up your recovery. Particularly since a combination of short and long acting local anesthetics are often used to provide as much pain relief as possible. I have had patients take nothing but aceaminophen (Tylenol®) after procedures such as breast augmentation and tummy tucks with the use of tumescent fluid infiltration at the time of surgery. It is amazing that more surgeons do not do this as it only takes a few minutes and costs nothing.
To obtain even longer lasting pain relief, Pacira Pharmaceuticals has developed liposomal bupivacaine for use in larger cases. Bupivacaine is a long acting local anesthetic, which Pacira has essentially encapsulated in liposomes, which slowly dissolve; releasing bupivacaine gradually over three days. This produce, known as Exparel®, can provide substantial pain releif for up to three days after surgery. At this time, there is an additional charge for Exparel® as it must be ordered separately for each procedure. However, virtually all patients have found it very beneficial and definetely worth the additional cost.
Last week, as I was walking through the recovery room at the surgery center, our medical director and head of anesthesia asked me if I would please teach other plastic surgeons how to infiltrate local anesthesia into their patients at the time of surgery. He says that my patients do so much better than those of my colleagues both in the recovery room and at home. I'm not sure why I seem to be the only one concerned about how well my patients do after surgery.
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