Innovative Technique Decreases Pain in Surgery Patients by 50 to 70 Percent

Hundreds of Chicago-area patients are benefiting from a new technique designed to dramatically reduce pain following cosmetic surgery, including cancer-related breast reconstruction and abdominal skin removal following extensive weight loss.

Breast lift, breast augmentation and tummy tuck are among the most common procedures in plastic surgery, and also among the most painful. But patients at the Hinsdale Center for Plastic Surgery are benefiting from a new approach to lowering pain after these procedures: a constant, two- to three-day infusion of powerful local anesthetic after surgery. When this procedure is used with other advanced anesthesia protocols, patients report a 50 to 70 percent reduction in the intensity of their post-operative pain, compared to the level of pain they have experienced after past surgeries for either cosmetic or traditional medical purposes.

The new technique could make it possible for thousands of people to go forward with reconstructive or cosmetic surgery that they may have been too fearful to try before.

“It can be daunting to face breast reconstruction after a mastectomy, or to face an extensive removal of excess abdominal skin after a dramatic weight loss,” says Tal  Raine, MD, FACS, of Hinsdale. “Even more subtle cosmetic changes to the breast and abdomen can be intimidating. By blunting the immediate post-operative pain, the patient’s entire experience of undergoing plastic surgery is radically improved.”

The pain-reducing procedure includes delivering a powerful anesthetic drug directly to the surgical site over several days with the use of a catheter/pump device called the ON-Q Post-Op Pain Relief system. Dr. Raine and his partner, Ric Izquierdo, MD, FACS, have used the technique on more than 585 patients at the Hinsdale Center for Plastic Surgery, with excellent results.

With the new technique, doctors insert a small catheter (about one to two millimeters wide) directly at the surgical site before closing—for example, underneath a breast implant or beneath the abdominal muscles. The catheter is connected to a small reservoir and pump that deliver low, but constant, levels of long-lasting anesthetic, soaking the surgical site in strong pain-killing medication. In two to three days, the device is removed, and the patient continues on normal pain relief medication if needed.

In combination with other advanced anesthesia protocols used in surgery—a strong regional block as well as careful selection of anesthesia drugs to reduce nausea and vomiting after the operation—the On-Q system helps dramatically ease the discomfort following surgery. It even shortens the patient’s stay at the clinic. In the past, patients receiving a breast lift, breast augmentation or tummy tuck usually spent at least two hours in recovery, and many went home in significant pain. Some even went to the hospital afterward for pain treatment and observation. The new technique has made it possible for patients to go home as little as one hour after surgery.

“When they wake up, and in the course of the next two to three days, the majority of patients say they are almost astounded at how little pain they feel compared to the pain they had after other surgeries,” says Dr. Izquierdo. “On a scale of 1 to 10, where 1 represents ‘no pain,’ they rate their post-operative pain at a 3 or 4.” In the past, patients who have undergone breast augmentation, breast lift or tummy tuck surgeries with traditional pain-killing treatments rated their post-operative pain at 9 or 10, on average.

Doctors developed this new post-operative pain control technique several years ago for traditional surgeries, such as knee scope procedures, to get their patients up and around more quickly. The Hinsdale Center for Plastic Surgery is among just a handful of clinics nationwide that use the technique for cosmetic surgery patients. The IFlow Corporation, which developed the ON-Q Post-Op Pain Relief technology, has selected Dr. Izquierdo and Dr. Raine from among thousands of plastic surgeons nationwide to teach the new pain protocol to doctors from around the country. The training will take place in the sophisticated surgical suites of the Hinsdale Center for Plastic Surgery.

“Reducing pain associated with these procedures makes recovery a totally different experience for these patients,” says Dr. Izquierdo. “Patients who undergo their surgeries under the pain reducing protocol seem to bypass the ‘why did I ever do this?’ phase of recovery entirely, and are better able to enjoy the results of their decision.”

The Hinsdale Center for Plastic Surgery is a state-of-the-art private cosmetic plastic surgery facility with two fully-accredited operating room suites and recovery areas. Both Drs. Raine and Izquierdo are fully trained in all aspects of plastic surgery and are Board Certified by the American Board of Plastic Surgery. Together, they have more than 40 years of combined experience.