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Anshu K. Gupta, MD, is a Founder and Plastic Surgeon at Verve Plastic Surgery in Encinitas.
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Non-Opioid Pain Relief: A Game Changer in Enhancing Recovery After Plastic Surgery

In recent years, the U.S. witnessed a surge in the popularity of plastic surgery procedures, with a 54% increase from 2020 to 2021, as reported by The Aesthetic Surgery Society. While the demand for plastic surgery continues to rise, so does the need for effective treatments to alleviate pain and enhance the surgical experience. While opioids have been used as a first-line option for pain relief in the past, there are effective non-opioid options available today. The shift towards non-opioid pain management is a significant move towards a safer, patient-centric approach to post-operative care in the field of plastic surgery.

Prioritizing Postsurgical Care for Rapid Healing

 Of the 15.6 million cosmetic surgeries conducted in 2020 throughout the U.S., 92% of patients were women. A recent survey on women and surgery found that 96% of them (ages 30-50) are motivated to get back to their daily routine following a procedure. A quick return to a normal life after surgery may seem like a challenge, especially in more complex procedures, such as a “mommy makeover”. In this specialized procedure, patients typically undergo any combination of a tummy tuck, breast augmentation, breast lift, or liposuction surgery. Prioritizing postoperative care and recovery is important for achieving a rapid recovery. I have found it crucial in my experience as a surgeon to turn to treatments that have proved effective in enhancing the overall recovery process.

Innovative and Effective Postsurgical Pain Management

As a plastic surgeon, one way I prioritize a safe surgical experience is by utilizing opioid alternatives as part of my multimodal pain management approach to aid my patients throughout their recovery. Administering local injections at the surgical site is a common approach to eliminating the need for prescription opioids for postsurgical pain management, but in some cases, these only provide short-term relief. A longer-term formulation I have had success with is EXPAREL® (bupivacaine liposome injectable suspension). This long-acting, numbing medication is injected directly into the surgical site to help patients manage pain for the first few days following surgery when pain is typically the worst. Patients given EXPAREL have reported less pain, required fewer opioids, were ready to leave the hospital sooner, and had fewer complications after surgery. Please see Indication and Important Safety Information at the end of this article.

I’ve been using EXPAREL for over 5 years and have administered it in around 150 various plastic surgery procedures, including tummy tucks, breast reductions, breast reconstructions, arm/thigh lifts, and gluteal augmentations. My patients who have received EXPAREL during their surgery have shared positive experiences, including many that report needing little to no opioid medications for postsurgical pain relief. This is certainly an added benefit for patients, knowing that opioids can come with many side effects, including sedation, dizziness, nausea, vomiting, constipation, physical dependence, tolerance, and respiratory depression.

EXPAREL has helped patients feel more comfortable in the days following surgery, which are typically when pain is at its worst, helping aid a smooth transition back to everyday life.

Empowering Patients for an Optimal Recovery

Effective pain management is a pivotal aspect of the recovery process, and it is important for patients to have a say in how their pain is managed after surgery. In my practice, EXPAREL has proven instrumental in alleviating discomfort while simultaneously minimizing exposure to opioids and their associated risks. If you are considering plastic surgery, talk to your doctor about the various pain management options that are available to you. Engaging openly with your healthcare provider regarding options like EXPAREL can significantly impact your overall recovery.

For more information, please visit

This article is sponsored by Pacira BioSciences, Inc., manufacturer of EXPAREL

Dr. Anshu Gupta of Verve Plastic Surgery in Encinitas, CA is a consultant of Pacira BioSciences, Inc.

* This is based on Dr. Gupta’s own experience using EXPAREL. Results may vary.


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 5 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

For more information, please visit or call 1-855-793-9727.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit or call 1-800-FDA-1088.


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