Express Exparel® Recovery

What Is the Best Painkiller for Post-Surgery?

Most post-surgical pain is managed with oral medications, including opioids. While effective, these strong medications can cause side effects like nausea, drowsiness, or constipation, and many patients prefer to avoid them because of the possibility of dependence. Alternatives that target the surgical site directly are becoming more widely used. These options can reduce reliance on oral drugs while still helping you stay comfortable.

What Is EXPAREL?

EXPAREL is a long-acting local anesthetic used to control pain after surgery. It is applied directly to the surgical area while you’re still in the operating room. The goal is to numb the area for several days to reduce or avoid the use of prescription pain pills. EXPAREL injections are used during the surgery itself, not after, so you will wake up with the area already comfortable.

What Is EXPAREL Made From?

EXPAREL contains bupivacaine suspended in a liposomal delivery system. Liposomes are tiny fat-based particles that release the medication slowly. The anesthetic remains active for much longer than standard formulations, and the ingredients are processed to target pain at the site without affecting the rest of the body.

How EXPAREL Works in the Body

Once injected into the surgical site, the liposomes in EXPAREL gradually release bupivacaine into the surrounding tissue. The medication blocks nerve signals that send pain messages to the brain. As the body metabolizes the medication, sensation gradually returns.

Plastic Surgery Procedures That May Include EXPAREL

We often use EXPAREL during surgeries where discomfort tends to be more noticeable in the early days of recovery. It can be a helpful part of post-surgery pain relief for the following:

• Breast augmentation
• Tummy tuck
• Facelift
• Mommy makeover
• Arm and thigh lift
• Rhinoplasty
• Gynecomastia surgery
• And more!

Benefits of EXPAREL

Non-Habit Forming

Opioid medications carry a risk of dependence, especially when used for longer than a few days. EXPAREL provides pain control without affecting the brain or central nervous system. Because it works locally, there is no potential for addiction. Patients looking to avoid habit-forming medications often prefer this type of targeted approach.

Reduces the Need for Other Pain Medications

Many patients use fewer oral pain medications when EXPAREL injections are included during surgery. By controlling pain at the source, EXPAREL limits how much medication your body needs to feel comfortable. Patients can recover using only over-the-counter medications once the effect of EXPAREL wears off.

Reduces Gastrointestinal Side Effects After Surgery

Oral pain medications often cause issues like constipation, nausea, and bloating, especially when taken over several days. When pain is managed directly at the surgical site, there is less need to rely on medications that affect your digestive system. Avoiding common gastrointestinal side effects also helps many patients return to eating and drinking normally sooner.

Improved Mobility and Comfort During Recovery

Pain that is well controlled can make it easier to get out of bed, move around, and follow post-surgical instructions. You will feel more comfortable during the first few days when discomfort is typically strongest. Better mobility during this time can support circulation, help with swelling, and promote healing. A smoother recovery experience may also help reduce the risk of complications related to limited movement.

Who Is EXPAREL Right For?

Patients who want to limit their use of oral pain medications during recovery are good candidates for EXPAREL. It can be especially helpful for those who are sensitive to opioids or have experienced unwanted side effects from them in the past. Patients undergoing surgeries with moderate to higher levels of post-operative discomfort may benefit from the added comfort EXPAREL provides in the first few days. It’s also a good option for patients who want to feel more mobile and alert in the early stages of recovery.

How Does EXPAREL Differ From Traditional Numbing Agents? 

Traditional numbing agents like lidocaine or standard bupivacaine are effective but wear off within a few hours. EXPAREL uses a liposomal delivery system that allows the medication to be released gradually to provide longer-lasting results. While lidocaine is commonly used for shorter treatments like dermal fillers or minor in-office procedures, it isn’t designed for extended relief after surgery. EXPAREL is formulated specifically for surgical use, where longer-lasting effects are needed to support early recovery.

How EXPAREL Is Administered During Surgery

We administer EXPAREL local anesthetic directly into the tissues around the surgical site before we complete the procedure. The timing is important because it allows the medication to begin working as soon as the anesthesia wears off. Using an injection needle, we place the medication into layers of tissue where inflammation and pain are expected. It is not injected into the bloodstream but remains in the local area. The specific placement depends on the procedure, and we take care to target areas where discomfort is typically most noticeable during recovery.

What to Expect With EXPAREL Recovery

Day One: Numbness and Immediate Pain Control

You’ll likely feel numb around the surgical area for most of the first day. This is an expected part of the EXPAREL recovery experience. It means the EXPAREL shots are active and blocking pain signals at the source. Many patients report needing little or no additional medication during this time. Movement may feel limited due to swelling or surgical dressings, but pain is typically well-managed in these early hours.

Day Two -Three: Continued Pain Control

Pain control usually continues into the second and third days as the medication keeps releasing slowly into the tissues. The numbness begins to fade, but discomfort often remains mild or manageable without prescription painkillers. You may feel more mobile and begin resuming light activities as directed. Patients often report improved comfort compared to recoveries where EXPAREL non-opioid pain relief wasn’t used.

Day Three: Transition to Over-the-Counter Medications

By the end of the third day, most of the effect has worn off, and it may be time to start using over-the-counter pain relievers if needed. Discomfort levels tend to be lower by this point, especially if swelling has started to decrease. We’ll give you specific instructions on which medications to take and how often.

Additional Considerations of EXPAREL

FDA Approval and Clinical Testing

EXPAREL has been FDA-approved for use in surgical settings since 2011. It was developed as part of a growing effort to expand non-opioid options in pain management and has undergone multiple clinical trials to evaluate its safety and effectiveness. These studies support its use in a range of soft tissue and orthopedic procedures.

Common Side Effects

Most patients tolerate EXPAREL after surgery well, but some may experience mild side effects near the injection site. These can include swelling, bruising, or a feeling of firmness where the medication was placed. Rarely, patients report a sensation of tingling or sensitivity as the numbing effect wears off. These effects usually resolve as your body recovers from surgery.

Contraindications

Express EXPAREL recovery is not recommended for patients with known allergies to bupivacaine or similar anesthetics. It also should not be mixed with other local anesthetics since combining agents interferes with its extended-release design. Patients with certain heart rhythm conditions may require additional screening before using EXPAREL. We’ll review your medical history carefully before determining your candidacy.

Suitability for Certain Injection Sites

An EXPAREL shot is only effective in soft tissues and should not be injected into joints, blood vessels, or areas with limited circulation. It is not designed for intra-articular or intravenous use and is limited to infiltration around surgical sites. In plastic surgery, we use it in areas like the chest, abdomen, face, or extremities.