Will It Hurt?

The answer is yes, most likely it will hurt, especially if “it” is a surgical procedure. And if the term “no pain, no gain” is relevant anywhere, it is in the world of cosmetic surgery.

With effective pain management, however, you can enjoy your enhanced appearance without too much discomfort. To manage pain successfully after cosmetic surgery, it is crucial to work closely with your doctor and nurses and follow postoperative instructions. Knowledge can be extremely important when managing pain. If you know how much pain is normally experienced with your procedure, you will be better prepared to deal with it successfully. Learning the facts of pain management will help you make the right choices and achieve the best possible outcome.

Pain facts

The extent and degree of pain you will feel after any cosmetic procedure— surgical, minimally invasive or non invasive—depends on a number of factors:

  • The type of procedure you will undergo.
  • Your previous experiences with pain.
  • The use of anaesthesia during the procedure.
  • Your gender. In general, males tend to have a lower pain threshold than females.
  • Your age. Younger patients tend to feel more pain than adults.

Here are some facts about pain that your surgeon will take into consideration when prescribing pain medication:

  • Different people perceive and experience pain differently. There is no such thing as “standard pain”.
  • It is better to treat pain early than to wait until it becomes unmanageable.
  • You get no extra points for being stoic about pain—quite the opposite is true. When pain is under control, healing is faster. So, for best results, your surgeon will always want to minimise and relieve your pain.
  • Because pain affects heart rate, blood pressure, appetite and general mood or sense of wellbeing, controlling pain may help reduce the risk of such post-surgical complications as blood clots.
  • There are many types and degrees of pain: sharp, dull, cramping, stabbing, throbbing etc. Pain can also be constant or intermittent, occurring on and off from time to time.
  • Besides the pain you may experience from incision sites after surgery, you may also feel pain elsewhere. Muscle pain can occur in the back, shoulders, chest or neck area as a result of lying down for a long period of time. You may find that your throat is sore or scratchy immediately following surgery. You may feel pain when you move—while sitting, coughing, walking or bending. Pain near incision sites may also feel worse when you move. Often, referred pain may be experienced at a site remote from the surgical site due to nerve conduction.

Pain management methods

Pain management is a key aspect of postoperative care and involves all the things that are done or prevented to ensure you suffer as little pain or discomfort as possible.

Effective management includes pain medication as well as medication to prevent nausea, a common side effect of pain meds. It also includes advice and guidance on what you should and should not do after the surgery and, if relevant, suggestions and instructions on supportive garments or accessories.

Advances in techniques and products have added to the pain-management options your surgeon can offer to manage your pain after surgery. Which methods or combination strategies will be best depends on the type and magnitude of pain and the type of procedure you have undergone. It will also depend on whether the procedure was performed under a local or general anaesthetic.

In this article we briefly discuss the many options your surgeon may prescribe for you after the procedure and during the recovery period.

All treatments discussed here are relatively safe, but no treatment is entirely risk free. Although dangerous side effects are rare, nausea, itching, vomiting and drowsiness can occur when you are on pain medications. In most cases and with timely action any undesirable effects can usually easily be controlled. Allergic reactions are always a possibility and unexpected reactions may become dangerous. Make sure your surgeon knows about any allergies you might have.

Regional or local anaesthesia

Large-area local anaesthesia (LALA) or regional anaesthesia is often used in procedures such as eyelid surgery and liposuction. LALA’s are also useful for biopsies requiring skin or tissue samples, during childbirth, for surgeries of the hands, arms, feet and legs, in eye surgery and in surgeries of the urinary tract and sex organs.

Local anaesthesia can be delivered to the surgical site using a pain pump, which releases medication whenever a button is pushed. The patient can control the intravenous infusion from the pain pump or it can be given as a continuous flow. Patient-controlled pain pumps decrease pain and reliance on medication, and enable anaesthesia to be administered only as required.

Patients cannot over-dose on this method because the amount of medication in the pump is limited. Only so much will be released regardless of how many times the release button is pushed. If, however, someone else controls the amount of medication, more pain reliefthan necessary may be released.

Pain pumps do not always control pain completely, in which case, other alternatives may be offered.

Nerve blocks

Nerve blocks are used to control pain affecting a limited area, usually delivered via a small catheter near the site of an incision. They control pain for a longer period than a local pain injection would.

Surgery on the hands and legs, facial surgical procedures and dental treatments all use nerve blocks. Some surgeons use nerve blocks as the main anaesthetic during surgery.

Nerve blocks reduce the amount of narcotic substances needed to control pain, resulting in potentially fewer side effects.

Oral pain medications

During your recovery you may be prescribed pain medications to be taken by mouth. There is a wide variety of oral pain medication, including narcotic and non-narcotic pain relievers and non-steroidal anti-inflammatory drugs.

Most, but not all, oral pain medications should be taken every four hours to be effective. Before you are discharged, clarify this with your doctor. Follow your doctor’s instructions carefully and read the label on the medication. Some medications should be taken with food to help prevent nausea and vomiting, whereas other medications need to be taken on an empty stomach to assist their complete absorption.

Oral pain medications you may be given include:

  • After surgery opioids (narcotics) – Including morphine, fentanyl and hydromorphine. There are many ways to take these strong pain relievers. Opioids may cause vomiting, nausea, drowsiness, itching and constipation. Taken as directed, your risk of addiction to them is very rare.
  • Opioids to be taken at home – Including Endone, Panadeine Forte, Darvocet, and others. They too have many options to choose from and are effective in controlling moderate to severe pain. These may also cause nausea, vomiting, drowsiness, itching and constipation. These medications often contain paracetamol. Too much paracetamol can damage your liver, so make sure that you are not taking other medications that contain paracetamol. In addition, prescription medication can be addictive.
    Before you are given any pain medication, tell your doctor about oral medications you have been prescribed, what you are buying over-the-counter and whether you are taking any vitamins or supplements.
  • Non-opioid (non-narcotic) pain relievers –These include Panadol among others. They can control mild to moderate pain. Because they have very few side effects, they are suitable for most patients, and using them properly reduces the need for stronger medications that may have serious side effects. If taken in excessive amounts, these pain relievers can contribute to liver damage, so follow directions carefully. People who already have liver problems and those who consume a lot of alcohol may face a higher level of risk when on these medications.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) – Drugs such as Nurophen can relieve mild pain and reduce inflammation and swelling. Some are available as over-the-counter medicines, but check with your doctor before taking them. They can reduce the amount of narcotic pain meds you take, helping reduce unpleasant side effects. However, many people experience stomach upsets and dizziness while on nonsteroidal anti-inflammatories, and if you suffer from kidney problems, stomach ulcers or heart failure, do not take them without a doctor’s approval. Never exceed the recommended dose. Just because they can be purchased without a prescription doesn’t mean they can’t do you harm if abused.

Before you go home

A few points to remember before you go home following a surgical cosmetic procedure:

  • If you have not been given pain medication, make sure to ask for a prescription in case you do feel pain later on.
  • Fill the prescription before going home. You do not want to be in severe pain and have to wait for someone to fill the prescription for you.
  • Get your surgeon’s phone numbers. If your pain becomes severe or you have an unusual reaction to the medication, contact your surgeon.

Your recovery is a priority for your surgeon, just as it is for you. Severe pain can affect the positive outcome of the procedure and good pain management can speed up your recovery. Knowing this, your surgeon will make his or her best effort to prescribe the most effective combination of pain relieving treatments.

Pain medications for cosmetic non-surgical treatments

Pain medications for non-surgical treatments depend upon the type of treatment you will undergo. Most are performed under local anaesthesia, while some may not require any at all. Localised injections, topical applications, or oral pain medications may be used if needed.

If a doctor is treating you, tell him or her about all the other medications you are taking, so that the best pain solution for your circumstances can be chosen. A beauty therapist or non-medical professional can legally perform some cosmetic treatments, but only a qualified doctor is in a position to take into account your medical history, perform a physical assessment and consider various other factors before recommending a treatment plan suitable for you. This is why the Cosmetic Physicians Society of Australasia (CPSA), The Australasian College of Cosmetic Surgery (ACCS) and the Australasian Society of Aesthetic Plastic Surgeons (ASAPS) recommends that you always check a practitioner’s credentials and speak to a registered doctor to ensure you are receiving treatment from an appropriately trained and qualified expert. Remember, your choice of a service provider goes a long way towards keeping you safe.

As is always the case, your best defense is information. The more you know about the procedure and its possible outcomes, and the better informed you are about what pain to expect, the better your experience will be.

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