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Improving Pain Management in Surgical Facial Rejuvenation
Bryson G. Richards, MD (*)
William F. Schleicher, MD (*)
James E. Zins, MD, FACS
* - Authors listed alphabetically, two primary authors
Cleveland Clinic
2014-03-14
Presenter: Bryson G. Richards, MD
Affidavit:
Majority of the above work represents the original work of the fellows participating in this study.
Director Name: James E. Zins, MD
Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics
Introduction:
Post-operative pain is a major concern for patients undergoing facial aesthetic surgery. Aggressive efforts to reduce post-operative pain while avoiding adverse sequelae such as nausea and vomiting will result in an improved patient experience. Newer pharmaceuticals, medical devices and longer acting local anesthetics offer the potential to reduce pain and enhance patient satisfaction. The purpose of this report is to review these options and then apply them to three specific facial aesthetic procedures: facelift, brow lift, and blepharoplasty.
Methods:
Our review of the literature investigates methods used for pain control in the surgical facial rejuvenation patient. We highlight those techniques which have documented efficacy. We share specific methods of pain management for the more common surgical facial rejuvenation procedures that we perform.
Results:
In an effort to maximize patient comfort, we review the effectiveness of various devices, technologies, and treatment modalities available for pain control after surgical facial rejuvenation. These include: local anesthetics, topical creams, IV Acetaminophen, local anesthetic wound catheter delivery systems, liposomal bupivacaine, tarsorraphy/frost sutures, postoperative pharmacologic therapeutics, prophylactic steroids, as well as tricks to eliminate pain with suture removal. Additionally, we summarize the primary investigator's preferred method of pain management for common surgical facial rejuvenation procedures performed.
Conclusion:
Recent advances in post-operative pain control can significantly improve the patient's surgical experience. This multimodal therapy includes new pharmaceuticals, longer acting local anesthetics, and devices designed to minimize post-operative pain. Adoption of these techniques will also reduce the need for narcotics and prevent post-operative adverse sequelae.
