Out-patient plastic surgery-pain not addressed- in agony for alomst 2 days

Everyone can expect different pain responses, but I have found that the plastic surgeons, and perhaps many patients, tend to retrospectively under-report pain, thinking that in a few months who will remember that they had 48 hours of uncontrolled pain.  (This is the answer I got when I returned after 24 hours and begged for different pain meds.)   If you have the surgery at an out patient clinic, the anethesthiolgst will tell you that he will give you pain meds to get you home (BIG FAT LIE).  Make sure the person who is taking you home will not let them shuffle you into their car if you are already/still in pain. If you leave in pain, it may be out of control by the time you get home and can get more pain meds.   I left groggy and already in PAIN. And told them - the %$^&** nurse said that was the brow lift, but did not do anything.  I was too groggy to demand they give me something.   After 2 hours of NJ rush hour traffic when I finally got home, I WAS IN AGONY.  My whole face felt like it was on fire, my head felt like it had a 6"stake in it, my jaw felt like it was broken in 10 places, my eyes felt like they had glass in them, just as a start.  The percosets did little (nothing for 12 hours then 2 hours of some relief then 2 hours of pain until I could take the next dose of percoset.)  It took 2 days to get any real relief.  

Thankfullly, the surgeon did call me shortly after I arrived home and told me to take 2 percasets (instead of just one), however, by that time, 2 percasets did not even dent the pain.  And it was 2 more days until the meds caught up to the pain. 

I would suggest at least trying the liquid percoset, which is the LEAST the doctor should have offered when I was still in great pain when I returned after 24 hours. And perhaps 2 different strengths of percosets - a few stronger ones for he first 24-48 hours post=surgery and the 'normal' dose for later.

At this point - 10 days post-op, I cannot say that I would have gotten the surgery if I understood the pain, complications, and length of time to real recovery - 6 weeks until I will look pretty normal.  (I think I will have good cosemetic results, but nothing elective and cosemetic should have hurt that much).  I hope I feel better about the pain/reward as time goes on).  Unlike much of the info I got, many people are not able to go out in public in 2 weeks after the surgery and look anything normal.  I have improved from looking like an Alien to Mrs. Potatohead, but I am weeks away from being able to be seen in public without people staring at me and wondering who beat me up.  For at least four weeks, I am wearing an ace bandage around my head -without it my faces swells and I get the Alien look again.  I cannot chew and am glad that I has lots of prot shakes on hand. 

I compare the pain management for this 6 hour gen anesth plastic surgery to a short 30 min shoulder surgery I had 3 weeks ago.  When I got the short shoulder surgery - I had local with sedation - not even general. That local block stopped all feeling from the shoulder for 16 hours and I got a 3-day Pain Ball that injected pain med right into the surgical site for 3 more days and I got the percosets for any remaining pain.  For this 6 hour operation, all I got was the percosets and was sent home already in pain.  The surgeon knew what he did and I cannot image that he did not know the level of pain I would experience. His pain management plan was the same as the other doctors I consulted with.    

I appreciate the post-op pictures people have posted.   They give you an idea -  when large scars are still raw after 3 months, you know they were really bad at the beginning.

ONE MONTH UPDATE

I still need to wear the ace bandage to keep the swelling down, but I keep it off for a few hours when I leave the house.  Good thing I am currently retired.  Most of my scars are healing nicely, although I have a few small 'bubbles' that the surgeon assured will go away.(Consistent with my research on internet - raised scars fade, depressed scars do not, keloids grow.)

Making sure I keep the protein up at 8o gms a day and taking vits.

What surgery did you have, and who performed it?

I'm assuming that you had a facelift from your description.  I will say that I had one too.  I did not get the brow lift but got the eyelid both upper and lower and the smas procedure.  I also had a full face laser treatment at the same time.  I have also had a double mastectomy with reconstruction from my abdomen - 90% of a tummy tuck, an arm lift, a thigh lift and an assortment of lipo and an abdominal hernia repair over a period of 5 years.  While I will warn that plastic surgery is not for the faint of heart, I will say that my pain experience was nothing like you describe.  For all of the procedures, my trip home was relatively pain free - although getting in and out of the car had its challenges.  I was prescribed percocet for each of my procedures and found them more than adequate to control my pain.  I would generally take a half of a pill every four hours for the first day or two and then only take them to sleep  for the first few nights.  After that, I was usually good to go. 

I had my facelift on a Monday morning and by the following Monday, I was willing to go outside without worrying what I looked like.  Since I had the laser treatment, my face looked sun burnt but other than a few tiny black and blue spots which were easily covered with makeup, I looked fine.  I returned to work exactly two weeks after my procedure.  I did continue to wear the chin strap at night for the first month I believe. 

The mastectomy was really the only procedure that kept me in the house for two weeks - 1 week in the hospital actually and another at home.  That was really due to the  drains in multiple parts of my body and the tightness of the muscles in my abdomen. 

It is a shame that you had to go through this experience.  Perhaps your pain tolerance is lower than most folks?  But be wary if you are going to move forward with more work.

Thank for your info.  I am glad you had a much better experience than me - I wonder if I got defective percoset.  From what other people say, 2 percosets is enough to put out an elephant - it just took the edge off at the beginning.  After 2 days it got better.  I was wondering if I should have used the liquid percoset - but your RNY did not seem to impair your absorption of the meds, so the liquid might not have helped. 

I did everything you did on your face plus the browlift and necklift, except I only had the laser on my under eyes, not my whole face.  I think it's the muscle work that hurts and those are painful muscle procedures.  I was surprised that the lasered areas did not really hurt alot - they looked so raw but they were not painful, even when cleaning them.

I agree with you - I'm totally waiting on the decision to do anymore - I'm hoping the pain of the first few days fades in light of the final results.   (I hope it does, because the thought of never having the arm lift is almost as bad as the pain, but now I prob would only consider the arm-lift, not the entire UBL - Plus there is no muscle work on the arm-lift.)

The smas work that I had done is the neck lift.  My incisions started on the front of my hairline band by my cheeks and followed the hair line then around the bottom of my ear and up behind it and following my hair line a couple of inches behind the ear - drains were placed in the back for overnight drainage.

My biggest issue with this was the fact that my jaw was so tight.  It made eating anything solid for the first day impossible.  So I resorted to protein shakes for the first few days to keep up my strength.  I slowly moved to more solid food at a faster pace than after the rny. 

I have had no malabsorption issues with pain medications through any of my procedures.  I believe I have only taken a full Percocet once during all of this and I would guess that was the mastectomy since I was cut in a couple of places.  A half a pill does it for me - I have a high pain tolerance, I hate the loopy feeling, but most of all I hate the constipation that those things cause.

The laser treatment looked nasty for the first few days and was uncomfortable but did not really hurt.  Seeing was an issue as I could not use my contacts and my glasses kept sliding down my face from all of the moisturizer that I had to use those first few days.  But that is all a distant memory now and I love the results.  Hopefully you will too.

Today,  I sort of look like me.  Today, I go back for my 2 week check--up and to get my eye stitches out (b'c of the brow lift, the dr had to leave the stitches in for 2 weeks because of the additional tension.)  I can tell I will be happy with the eye part.  I can actually see my eye - not the saggy flaps of skin that covered them for ages.   But my lower jaw and ears are still swollen.  Maybe I just had a lot of sagging muscles to shore up - I will be 59 in 3 weeks (although I sure as hell with not look it).

I also had to go back to prot shakes - my mouth did not open the whole way and I didn't want to pop any of the stithces too soon - more around the back of my ears will come out today (I hope).  It was days before I could put my glasses on.  I can mostly chew OK now.  Lost 7 pounds, but expect to put the back on once I can do weight training again. (I haven't seen 133 since, like the 1980s).  I've been off of a the pain meds for a few days now- none even at night, so the swelling is the remaining big issue.  It comes back at night - even though I sleep in a lazy boy and get up every few hours and walk around for a few minutes.  Did you have any tricks to get rid of it?

Unfortunately no tricks for the swelling - its something you just have to live through.  I slept sitting up for the first week I believe - until the big skin peel from the laser treatment.  After that, I was back in bed and I like to sleep pretty flat.  But the doc was ok with that and I didn't see any significant change with the swelling because of that.  I was 57 when I had my face lift.  Love the changes that it made without making me look like a different person.  I am actually having a minor tweek on my eyes tomorrow due to some muscle laxity.  It really is amazing how tight they can pull those neck and jaw muscles.  I could barley get a straw in my mouth the first day.  Luckily I still keep protein drinks around the house so I was good to go.  The glasses was the worst as I could not read or do any computer work to occupy my time.  I did eventually have my eyesight fixed and in retrospect, I probably should have done those two procedures in reverse order.  Now my new eyes are not even hidden by glasses other than sun glasses.  I just love that there are surgeons who do this kind of work to finish off the project that I started with the bariactric surgery all those years ago.

I finally solved the pain mystery - it was the brow lift.  Holes were drilled in my skull and my forehead muscles pulled up and anchored with clips placed in the holes that were drilled in my skull. (The holes only go half way through the skull - not all the way to your brain).  Why I didn't get a long acting local or better pain meds I DO NOT KNOW.  But now I know where the pain came from.

Something just wasn't right, because ever since I played intercollegiate ice-hockey, and dealt with that level of pain, I have had a fairly high pain tolerance and could not understand people saying that the face lift was no big deal versus the searing white hot unrelenting agony I had to endure.  Mystery solved. 

Wow - is that the normal procedure for a brow lift?  Glad that I didn't get it then.  I will have to ask my PS if that is how he does it.  I guess they have to anchor the muscles somehow but I never would have thought they drilled holes in your head.

I had it done and somehow missed how it is done.  This is the way.  Here it is by the dr. on BOTCHED!  Many people complain of the headache but I think doctors dismiss the pain because THEY ARE NOT EXPERIENCING IT.  I think that maybe other docs have more local, but I don't know what exactly caused the ungodly headache. 

https://www.youtube.com/watch?v=ZfEJgdA7BsQ

 How this came about is that I was discussing pain mgt and told my arm lift surgeon that I prob could have worked through the facial pain if it weren;t for the headache.  That's when he said "They drilled holes in your head" As in, What do you expect?  So that level of pain is somewhat expected, although as the daughter of a nurse, I now that it is not right for a doctor to refuse to do anything about it and send the person home to cry in a darkened room for another day or two.

So, I am having the arm lift in an actual hospital main operating room. It may be overkill but if I have the same pain problem I will ruin the facial work more than the pain already did.

Interesting to see what your doc says.