“Is it going to hurt?” This is probably one of the two most common questions I get from my Boston area patients. It doesn’t matter if it’s a non-surgical patient who’s come in to discuss dermal fillers or a woman who’s interested in a breast augmentation. As an intrinsic part of our survival instinct, the desire to avoid pain is universal for all humans. Furthermore, you can feel pain both physically and emotionally. So, if you are anxious about an aesthetic procedure being painful, this can ramp up your body’s nervous system, making you more sensitive to pain. This is why I spend considerable time during your initial consultation discussing the procedure, what you can expect in terms of your recovery as well as your pain management options. My goal is to make your procedure as comfortable as possible. I utilize a number of different pain management tactics including over-the-counter (OTC) medications, prescription narcotics, anti-inflammatories, and muscle relaxers. The right recipe for you will depend on the procedure we perform, your body’s unique pain tolerance, and any anxiety you may have.
Pain Management Tactics for Non-Surgical Procedures
There are some non-surgical procedures that will induce more post-treatment swelling such as:
- Neurotoxins (Botox® and Dysport®)
- Dermal Fillers
- Microneedling with SkinPen®
- Lip Augmentation
These procedures generally require minimal downtime which correlates to less post-procedure pain. However, even something as benign as a Botox® treatment may result in some swelling and/or bruising. Although bruising may look awful, it is actually the swelling that can cause discomfort. While I don’t usually prescribe pain medication for an injectables treatment, if you find that you are uncomfortable, this can easily be eliminated with Acetaminophen (Tylenol) or Ibuprofen. Patients typically describe an injectable treatment as uncomfortable, not painful. However, every patient is different, and I am all about honoring whatever your body needs.
Non-Surgical Does Not Mean Not Uncomfortable
An outpatient surgery center is basically a smaller version of a hospital. Our anesthesiologists can administer all levels of anesthesia:
- Laser Skin Resurfacing
Since one of the most important things when it comes to pain management is staying ahead of the pain, I generally tell patients to take a course of over-the-counter pain meds such as Acetaminophen or Ibuprofen if needed. Again, it is all going to depend on the size of the treatment area as well as the type of procedure. A laser skin resurfacing procedure with Clear + Brilliant® is extremely well tolerated. Some patients even describe it as the laser equivalent of a facial. However, a treatment with a CO2 laser is going to be significantly more intense.
Pain Management Tactics for Surgical Procedures
With any surgical procedure, you can expect some post-operative pain. I always tell my surgical patients to anticipate tolerable discomfort. But it’s not always as bad as many patients think. One of my favorite body contouring procedures is liposuction. If we treat a small area such as that pocket of fat at the chin/neck juncture that bothers so many of my male and female patients, I will usually do so under local anesthesia with Acetaminophen or Ibuprofen as needed afterward. But a bigger liposuction procedure such as one for the abdomen, flanks, and buttocks may need to be done under general anesthesia and may require the addition of narcotics and anti-inflammatories such as Celebrex.
Breast augmentation, which is one of my specialties, can create moderate discomfort post-operatively. It is the manipulation of the pectoralis muscle that can create pain. Breast procedures, whether an augmentation or a lift, may need a narcotic. If so, I generally recommend a short course of Oxycodone or Vicodin or a narcotic alternative like Ultram.
Downside of Narcotic Pain Medications
Narcotic pain medications are an appropriate way to manage post-op pain. However, they can be addictive which is why I only prescribe them in short doses and stay in close contact with my patients throughout their recovery. Another issue with narcotics is that they generally cause constipation. This can really be a problem with any surgery, but especially if you’ve had a tummy tuck or a body contouring procedure that requires a compression garment.
An abdominoplasty is probably the most painful procedure post-operatively as it’s hard to move in any direction without activating your abdominal muscles. And these muscles are often surgically tightened (diastasis recti) to create a smoother, flatter abdominal contour. If you have a tummy tuck, I may prescribe a muscle relaxer in addition to your pain medication as a way to make you feel more comfortable without the need for more narcotics. Bottom line, I have a lot of experience with pain management so I know how to help you remain pain-free and comfortable following your procedure.