Prioritizing pain relief after plastic surgery with non-opioid pain therapies

Business Journals

12-05-2025

Plastic surgery has become increasingly popular, with millions of Americans undergoing procedures such as tummy tucks, breast augmentations, rhinoplasties and more each year. Here in Miami, my patients not only come to me with clear aesthetic goals but, just as often, they voice concerns about the recovery and how painful it may be.
As a plastic surgeon, I recognize that my patients have busy lives and that they can't wait for a long recovery period. And while recovery can be one of the most stressful parts of the surgical journey, I've found that effective pain management isn't just about comfort. It's essential for patient safety, a smoother recovery and long-term satisfaction as well.
For years, opioids have been the go-to solution for managing postsurgical pain. However, they are often associated with several unwanted side effects that can complicate and delay recovery such as nausea, constipation, drowsiness and the risk of dependence. Considering that overdose remains the leading cause of death for Americans aged 18-44, I believe it's our responsibility as health care providers to do better. That's why I've made it a priority in my practice to reduce the use of opioids and turn to safer, non-opioid therapies that still give my patients the relief they need.
A 'pain package' that puts patients first
In nearly every procedure I perform, I use EXPAREL® (bupivacaine liposome injectable suspension) to help manage my patients' pain during recovery. EXPAREL is a long-acting local anesthetic that is injected directly into the surgical site and provides targeted pain relief for the first 48 to 72 hours after surgery. This window is crucial because it is when pain is usually the most intense, and often when patients typically turn to opioids to manage the pain.
I combine EXPAREL with intravenous (IV) Tylenol and gabapentin as part of an extended, multimodal 'pain package.' This approach allows me to stay ahead of pain from the beginning, so patients wake up from surgery feeling more at ease and less anxious about what's ahead. With this strategy, many of my patients can significantly reduce and, in some cases, completely avoid opioids altogether.
Reducing risks and enhancing recovery
Since incorporating EXPAREL into my pain management protocol, I've seen a remarkable shift in the overall recovery experience for my patients. Most notably, patients can get out of bed and start moving sooner. This is an important recovery milestone because it helps reduce swelling and lowers the risk of blood clots, a serious concern following many plastic surgery procedures.
Another major advantage of minimizing the use of opioids is avoiding often-overlooked side effects like constipation. This is especially important for abdominoplasty patients, many of whom used to tell me that the pain from constipation was worse than the surgery itself. It's not always a comfortable topic, but it's a real issue. And, since using EXPAREL, I've seen a noticeable reduction in these complaints, along with fewer calls from patients struggling with pain or discomfort in the early days of healing.
Encouraging patient empowerment
Whether you're considering cosmetic surgery for yourself or supporting a loved one through the process, pain management is a critical part of the surgical journey. It's not just about getting through the first few days; it can completely shape your recovery experience and have a lasting impact on how you feel about your results. In every consultation, I take time to walk patients through how EXPAREL works and how it fits into their personalized care plan.
I encourage anyone preparing for surgery to ask their health care provider about non-opioid options like EXPAREL. Having these conversations is the first step toward a smoother, simpler recovery that lets you focus on feeling like yourself again.
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*Dr. Zuriarrain is a consultant of Pacira BioSciences, Inc. This is based on Dr. Zuriarrain's experiences. Individual patient experiences may vary.
Indication:
EXPAREL® (bupivacaine liposome injectable suspension) is indicated to produce postsurgical local analgesia via infiltration in patients aged 6 years and older and regional analgesia in adults via an interscalene brachial plexus nerve block, sciatic nerve block in the popliteal fossa, and an adductor canal block. Safety and efficacy have not been established in other nerve blocks.
Important safety information:
EXPAREL should not be used in obstetrical paracervical block anesthesia.
In studies in adults where EXPAREL was injected into a wound, the most common side effects were nausea, constipation, and vomiting.
In studies in adults where EXPAREL was injected near a nerve, the most common side effects were nausea, fever, headache, and constipation.
In the study where EXPAREL was given to children, the most common side effects were nausea, vomiting, constipation, low blood pressure, low number of red blood cells, muscle twitching, blurred vision, itching, and rapid heartbeat.
EXPAREL can cause a temporary loss of feeling and/or loss of muscle movement. How much and how long the loss of feeling and/or muscle movement depends on where and how much of EXPAREL was injected and may last for up to five days.
EXPAREL is not recommended to be used in patients younger than 6 years old for injection into the wound, for patients younger than 18 years old for injection near a nerve, and/or in pregnant women.
Tell your health care provider if you or your child has liver disease, since this may affect how the active ingredient (bupivacaine) in EXPAREL is eliminated from the body.
EXPAREL should not be injected into the spine, joints, or veins.
The active ingredient in EXPAREL can affect the nervous system and the cardiovascular system; may cause an allergic reaction; may cause damage if injected into the joints; and can cause a rare blood disorder.
Full Prescribing Information is available at .