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Non-Narcotic Protocol

By: Robert Sigal, MD



Not a pretty word.

Nobody wants it, but we're going to have to deal with it if we're going to talk about cosmetic surgery.

Whether you're interested in eyelid surgery, liposuction, a tummy tuck, or a facelift, we're going to have to deal with the post operative discomfort.

Fortunately, there's good news and then there is even better news!

The good news is that over the years, our anesthetic techniques with local anesthesia have been refined and made so much better, that what used to be an eight out of 10 on a pain scale is now at a three. By using long-acting anesthetics like Marcaine before waking up, or by using dilute tumescent anesthesia in conjunction with general anesthesia, we are able to make huge inroads on the pain spectrum.

The better news, is the introduction of our "non-narcotic protocol."  In the past, even with the use of our local anesthesia's, we would always prescribe narcotics afterwards. While the use of narcotics is an occasional godsend, it can be associated with problems like constipation that can be even more problematic than the surgery! 

Fortunately, we were introduced to a group of medications that when used around the surgery nearly eliminate the need for narcotics during and after surgery. What we do is prescribe anti-inflammatory drugs to be taken two hours before the surgery. Then, when we go to the operating room, we add other medicines to the cocktail to continually suppress inflammation. After surgery we continue the anti-inflammatories and add ice to put the final lid on the inflammatory process.

What we found is that for some surgeries like tummy tucks, our narcotic use afterwards is cut tenfold.  The same is true for mommy makeovers and breast implants. For less uncomfortable surgeries like breast lifts, breast reduction, eyelid surgery, facelift, or even liposuction, narcotics are eliminated almost entirely.

Taking the prospect of pain out of the equation for a cosmetic surgery procedure is huge.  It's something that surgeons have strived for since the beginning of surgical time.  While there is some discomfort associated with almost any procedure, I rarely hear the word "pain" used anymore. The introduction of our non-narcotic protocol to the surgery here at Austin-Weston, The Center for Cosmetic Surgery, has made an already pleasant experience one that is truly exceptional.

- Robert Sigal, MD


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