Summer Coming to an End!

Yesterday was granddaughter, Kinley’s birthday, and today she returns to school, marking the unofficial end of summer. Our Santa Barbara son and family took the train down from Santa Barbara and visited this past weekend as well – as usual, the grandchildren spent a lot of time in the pool – and return to school this week. This time of year is a bittersweet transition, not just for children but for adults too. Summer, our favorite season, is a time of long days, joy, adventure, and connection. It is when we travel to visit relatives, reconnect with our roots, and spend time outdoors. Whether we are swimming, gardening, picking berries, eating outdoors or enjoying a barbecue, summer invites us to live fully, soaking in the warmth and sunshine.

As the days shorten and the air cools, we find ourselves reluctantly acknowledging the inevitable arrival of autumn. The return of rain in California, snow in Massachusetts, and the slow creep of colder days are reminders that winter is just around the corner. We seem to endure the long months of winter and spring as mere preludes to the glorious days of summer. Now, with the school year beginning, the leaves hinting at change, and the days shortening, we prepare to bid farewell to summer, holding onto the memories we have made and looking forward to the next season’s joys.

Grandson and granddaughter enjoying the summer.

Grandkids doing what they do best.

Mama Bunkis and brother-in-law Doug with their summer ritual.

So summer! Dana Point Harbor with daughter, Jessica.

As plastic surgeons, managing post-operative pain is a critical aspect of care for our patients. Many procedures, especially those that do not involve major muscles, cause minimal discomfort and can be effectively managed with Tylenol and icing. Examples include blepharoplasty, minor neck liposuction, and ear pinning. However, when major muscles are disturbed, the pain can be significant. This is particularly true for procedures like tummy tucks, where the rectus abdominis muscles are sutured together, or breast augmentation, where the pectoral muscles are elevated of the underlying ribs.

Traditionally, the gold standard for pain management in such cases has been the use of oral narcotics. While effective in managing pain, narcotics come with a host of potential problems. Narcotics can lead to addiction, constipation, and nausea. The scope of this issue is concerning: 10.2% of patients undergoing rotator cuff surgery, 17.6% after colectomy, 7.5% following hysterectomy, 9.9% after total hip surgery, and 16.7% following total knee surgery continue using opioids beyond the prescribed period. Shockingly, 1 in 15 surgical patients who are prescribed an opioid go on to long-term abuse, and 92% of patients have unused opioids after surgery. Furthermore, 4 out of 5 heroin users started by misusing opioid pain relievers.

In light of this, reversing a decades long trend, there now is a strong emphasis on limiting opioid prescriptions. Alternatives such as pain pumps or long-lasting local anesthetics like Exparel are becoming more popular. At our practice, we have used pain pumps for over 20 years, significantly reducing the need for narcotics during that time.
Exparel, a long-lasting local anesthetic, offers a promising solution.

While it is expensive—costing around $500 per procedure—many patients are willing to pay for long-term relief without the dangers of narcotic addiction. We routinely offer Exparel for procedures involving major muscle stimulation, such as breast augmentations, tummy tucks, and buttocks implants. Our goal is to provide effective pain management while minimizing the risks associated with narcotics, ensuring our patients have a safe and comfortable recovery. Below are examples of cased that can be managed with Exparel and narcotic avoided.

40 year old female, before and after an abdominoplasty and a liposuction – with a strategically placed tattoo after surgery to hide her abdominoplasty scar. Surgery performed by Dr. John Compoginis.

35 year old female, shown before and after a Mommy Makeover (breast augmentation plus a tummy tuck). Surgery performed by Dr. Deborah Ekstrom

60 year old female, shown here before and after a buttocks implant procedure, performed by Dr. Juris Bunkis

For CA, please call 949-888-9700 or visit www.orangecountyplasticsurgery.com
Or for MA location, call 508-755-4825 or visit www.salisburyps.com