Hi, I’m Dr .Lista, and here we are at The
Plastic Surgery Clinic. This is Exam Room 4. This is one of the post-op rooms that we
see post-op patients in. We’re operating today and one of the patients before surgery said,
“how much pain will I be in after I have plastic surgery?” And that’s a really common question.
So here we’re really interested in controlling pain and keeping pain at bay. We don’t want
patients to have pain. The reason – there’s two reasons why we don’t want them to have
pain. First of all, we don’t want patients to have pain because it’s not nice to have
pain, but second of all, pain interferes with healing because if you have pain after surgery,
you need to take pain pills, and pain pills make you feel nauseated, nausea can make you
throw up, and throwing up’s not good for facial surgery or breast surgery or tummy tuck surgery,
so we don’t want you to have pain. We know that patients who don’t have pain heal better
and have fewer complications than patients who do. So we take three approaches to preventing
pain. What we do before surgery, what we do during surgery, and what we do after surgery.
So before surgery, we give you medications which, when given before surgery can actually
block the pain pathways and prevent pain from occurring during later on during the operation.
And they’re more effective before surgery than after. Those drugs are drugs like acetaminophen,
gabapentin, and celebrex. Those drugs block the pain pathway and block inflammation and
so will give you less pain even when the drugs are gone, you’ll have less pain. Not very
many places use pre-op medication, even big hospitals sometimes use them, sometimes don’t.
We use it all the time. During surgery one of the things that we do is we give local
anaesthetic into the area even when you’re asleep. So often I have visiting surgeons
who say to me, “Dr. Lista, the patient is sleeping, why are you giving local anaesthetic?”
You know, like dental freezing, but into the area that we’re going to operate. Well, there’s
lots of studies – and again, you have to review the literature – lots of studies show that
if you block the pain pathways during surgery (so even though the patient’s asleep, putting
in local anaesthetic) that prevents them from having pain afterwards and also lowers the
dosage of anaesthetic that’s necessary to keep you asleep. So it’s just a better thing,
we do that in every patient, we give local anaesthetic before we make the first incision,
but after you’re asleep. Then, after surgery, we have the pain pump. So when you wake up,
you’ll have this little device – that, there it is, it’s a pain pump, it’s a little box
with a pump inside, the pump’s in here. And it’s connected to you by this tiny little
microscopic cord, it’s about as thick as a hair, and it goes into the area, whatever
area we’re going to operate. It’s called a catheter, but it’s tiny tiny tiny, you can’t
feel it. And then the pain solution goes from here into the area that we’ve operated on,
it goes, you put it in this little package here, you put it in this little package and
then you go home wearing this little thing around your waist attached to your pajamas
and all night long it runs automatically, you don’t have to do anything and it circulates
pain medication or freezing solution all around the area so you won’t have any pain. So those
three things – the pre-op medication, the intra-operative administration of local anaesthetic,
and the post-operative pain pump prevents our patients from having pain and one of the
things that surprised me when I first started doing all of this is that, not only do patients
feel better, but they actually recover faster and their plastic surgery looks better because
the muscles are relaxed and everything heals better. And so those are some of the innovations
that we do here at The Plastic Surgery Clinic to make your recovery from plastic surgery
uneventful. So the answer is: it shouldn’t hurt much! And most patients are really surprised
and all of them say to me, “you know what? It hurt a lot less than I thought.” I’m Dr.
Frank Lista from The Plastic Surgery Clinic. Follow us on Twitter, or Facebook, or go to
our website to watch our video blogs every day. Thanks!