Robert Whitfield MDAmerica's Breast Implant Illness Expert™

Stop Pain Signals BEFORE Surgery! Doctor Explains #shorts

16 Jun 2026 · 1 min

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1:13

In this short video Dr. Robert Whitfield MD explains his approach to minimizing the body’s stress and pain response before and during surgery. He frames the problem as a cortisol surge triggered by surgical stress, which he humorously claims he himself generates as a surgeon. To blunt this response, he starts the night before with “brain programming” – emphasizing sleep hygiene, proper nutrition, targeted supplementation, and pre‑operative preparation through ERAS protocols and an ultrasound‑guided nerve block. During the operation, particularly for explant procedures, he injects a long‑acting liposomal bupivacaine formulation (Exparel) into the tissue after clearing a quadrant, allowing the drug to set for 2‑3 hours and provide analgesia lasting up to a week. The overall goal is to keep the cortisol surge as small as possible, thereby reducing postoperative pain and accelerating recovery.

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Because programming to your brain starts from the moment surgery starts. So what we try to do is stop the signal to the brain before it starts, right? So I started something the night before, right? To calm down the nervous system, right? We're trying to prevent, so that everybody understands, the big cortisol surge. Mm-hmm. 'Cause the number one maker of cortisol on this conversation in the world right now is me, Dr. Rob. I make cortisol. It's what I do for a living. So I want to shut that down. So sleep hygiene, proper nutrition, proper supplementation, proper preparation before surgery. You come here, ERAS the night before, marked pre-op, pre-op ultrasound-guided nerve block. So there, you've done all these things to calm down what's going to be a little bit of a cortisol surge, right? In my practice. In some practices, it's like a nuclear bomb went off. Yeah. So what we're trying to do is make it as small as possible. So in the operating room, we'll say I'm doing an explant. Think of like a pie chart. As soon as I get a quadrant of the pie chart cleared on the inside, I'll numb it up with a long-acting lip line aesthetic called Exparel, which is just liposomal bupivacaine. Once it sets up, it takes 2 to 3 hours to set up. It lasts for a week.