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Dr. Michaels' Blog

Painless Tummy Tuck?

Painless Tummy Tuck?


I have several core beliefs about cosmetic surgery. First, and most important, it must be safe. To protect patients from the risks inherent in hospital stays, I also think all cosmetic surgery should be performed on an outpatient basis.

A safe outpatient abdominoplasty, or tummy tuck, must be as painless as possible. We must avoid narcotic medication to help prevent post-operative nausea. The patient must walk immediately, to avoid Deep Vein Thromboses (DVT), or blood clots in the legs.  Using pre-emptive analgesia, I have developed a technique to achieve these goals and more.

Pre-emptive analgesia prevents pain before it happens. If pain can be “pre-empted,” the release of inflammatory factors and neurotransmitters that ultimately worsen pain can be prevented as well.

I began performing rib-block anesthesia in abdominoplasties about ten years ago. Our team found that by preventing the perception of pain during the operation, less anesthesia was necessary, specifically inhalational gases and intravenous narcotics.  Patients no longer suffered post-operative nausea or vomiting. We also observed that patients could literally walk off the operating table.

We combined this technique with pumps to deliver the same medicine used in the rib blocks for the first three days after surgery.  A new problem emerged:  Some patients had no pain at all and forgot they had just had surgery.  They moved too much too fast, popping some stitches. Now we warn all patients that, even though they have no pain, they did have a tummy tuck and need to take it easy. You can read the data we published at the link below.