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Pain Management & Cosmetic Surgery
By Dr. Kenneth Dickie
Mar 13, 2007 - 12:19:42 PM

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Pain management is one of the most important aspects of patient care.   One very important issue doctors face is how to take away the pain without causing negative side-effects.


It is important that pain management be addressed after ambulatory cosmetic plastic surgery.   One must recognize the importance of educating patients about what to expect following surgery and about monitoring patient comfort throughout the immediate postoperative period.


Major advances in pain management techniques, and an evolution in products, now provide significant relief to cosmetic surgery patients and give surgeons a greater variety of options for patient care:

  •   In reconstructive surgical procedures, controlled and continuous infusion of local anaesthesia to the surgical site with the use of Pain Pumps offers pain control for up to three days
  • For regional pain management in procedures such as breast augmentation and Abdominoplasty, large area local anaesthesia (LALA) is very effective.   This protocol has been successfully used by doctors for over 70 years, and has been modified over time for increased efficacy.
  • Cox-2 inhibitors, such as Celebrex, can be used before and after surgery.   Cox-2 inhibitors control systemic pain without causing bleeding (a common side-effect of ibuprofen, aspirin and naproxen).
  • Oral opioid combinations, such as acetaminophen and codeine, for immediate postoperative pain control are still utilized.   However, these are known to have certain negative side-effects.


Sometimes the side-effects from a pain management protocol are worse than the pain from the surgery.   All doctors strive to give their patients the best outcome with the least amount of pain possible.


In the long run, most patients focus on the positive outcome of the surgery, not on the discomfort involved.   I regularly hear my patients tell prospective patients how pleased they are with their decision to have surgery, that there was not much pain, and they only regret they didn’t do it sooner.   Effective pain management contributes greatly to overall patient satisfaction with cosmetic surgery.   As patient advocates, plastic surgeons see it as intrinsic to the surgical experience.

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