Using TAP Blocks for a Better Tummy Tuck Experience (Ep 29)

The Trillium Show with Dr. Jason Hall

Highlights:

• What is the tummy tuck procedure and why is it so painful? (00:40)
• What is a TAP block and why is it done? (02:20)
• Benefits of receiving a TAP block with abdominal surgery (03:25)
• When patients receive a TAP block (05:47)

Links:

Dr. Jason Hall, MD

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Transcript

Dr. Hall: Welcome to The Trillium Show, where we help you make the changes you want to see in your body, in your mind, and in your life. I’m your host, Dr. Jason Hall.

Abdominoplasty surgery is typically one of the most painful plastic surgery procedures that a woman can undergo, but there is a procedure that can help significantly reduce the discomfort a woman feels after an abdominoplasty. We’re going to talk about what that procedure is and how I’ve added it to every body contouring case that I do and made the recovery so much better. Typically, abdominoplasty surgery involves something called rectus muscle plication, which is where we take the loosened rectus muscles, which are your six-pack muscles, and we sew those muscles back together in the middle to kind of recreate the six-pack that is stretched out with pregnancy or significant weight changes. Now, any surgery involving muscle—and you know this if you’ve ever had any orthopedic procedures done before—any surgery involving muscle hurts. Now, there is a procedure that we can do that we can significantly decrease the amount of discomfort that a woman feels after an abdominoplasty surgery; that procedure is something called a TAP block.

Now, this procedure is an anesthetic procedure. It is a—it is not a surgical procedure, it is an anesthesia procedure where we use an ultrasound and actually put numbing medicine around the nerves in your sides that kind of come out of your spinal cord from your back around to your rectus muscles and give those muscles and the skin over them sensation. And by injecting some local anesthetic before your surgery even starts, we can significantly minimize the amount of discomfort that you feel during surgery, and by doing that, essentially tricking your body into thinking that you haven’t had surgery, or at least haven’t had the kind of procedure that you’ve had, we can significantly reduce the amount of postoperative pain and discomfort that you have.

So, what is a TAP block and how is it done? I started doing TAP blocks and using these in my abdominoplasty surgeries about a year-and-a-half ago—it’s like mid-2022 right now as we’re recording this—and the beginning of 2021, I started using TAP blocks with every abdominoplasty surgery that I performed. I have an ultrasound that I used here in the office and in surgery. And using that ultrasound, I can locate the area where these nerves come out of your back and travel around the side to the front of your abdomen, and specifically inject some local anesthesia, watching it the whole time, around those nerves. And what that does is it deadens the muscles and skin in the front of your abdomen. By doing that, we block painful feelings from going back into your spine.

How this is effective is that it minimizes the amount of pain that you experience during surgery. Our anesthesia colleagues noticed that after I started doing these, that the amount of narcotic, the pain medicine that patients normally get during surgery was significantly reduced from what they had gotten beforehand. And this is beneficial for a number of reasons. First of all, it decreases the incidence of postoperative nausea and vomiting. That by itself is awesome.

Secondly, it decreases the amount of narcotics that patients require after surgery. Again, a great benefit. Third, by doing this, they can get up and get moving the day of surgery. You’re a little sore, but much less sore than you were beforehand. Being able to get up means lower incidence of clots in your legs, which can be a fatal complication of any plastic surgery procedure but it’s higher in tummy tuck and body lift surgery, and if you work out, you know that the quicker that you get back to activity after a hard workout—and you can look at a tummy tuck as being a really hard core workout—the quicker you get back to normal activity, the less sore that you are and the easier that recovery is as opposed to laying around and not moving and not doing anything for a few days, getting back to full activity can be really painful and really time-consuming, so for these reasons, the addition of a TAP block to abdominoplasty surgery, body lift surgery, really any body contouring procedure where we’re going to be manipulating the rectus muscles, a TAP block is a fantastic addition and significantly improves recovery from these procedures.

The TAP block has been such a great addition to our surgery that I’m afraid I’ve painted myself into a corner because our recovery room nurses have told me that they are not going to let me quit doing them because the patients wake up so much more comfortable, they’re able to get up and leave the surgery center so much easier than they did before I started doing the TAP blocks, I’m kind of committed to doing them forever now, or at least until something better comes along. The TAP block is something that is done before surgery but after you’re asleep. This is something that I do, you know, as we’re getting a patient ready for surgery, they’re already asleep, and then I’ll come in and do our TAP blocks before we, kind of, get everything sterilized and actually begin the surgery. The TAP block is done before anything even happens. And so, you’re asleep, but the block has already started to work.

I hope you found this informative and useful. If you haven’t, go back and listen to the abdominoplasty show. I talk about the addition of the TAP block during that show as well. This gives you a little bit more detail, and you can see exactly what’s going on when we do a TAP block, but do check out that other episode. As always, if there are any topics that you would like to see discussed, hit us up on Instagram, leave a comment below, or send us an email [e-mail] and we’ll see you soon.

Dr. Hall: Thanks for listening to The Trillium Show. You can keep up with the latest on the podcast at jhallmd.com. Be sure to follow us on Spotify, Apple Podcasts, or wherever you listen to podcasts. If you want to connect with us on social media, you can find us at @jhallmd on Instagram and Twitter and @DrHallPlasticSurgery on Facebook. Remember, be the change you wish to see in the world.