Pain Management Birmingham, AL | JOURNAVX & Pro-Nox

A More Thoughtful Approach to Comfort

Pain management at Core Plastic Surgery begins before a procedure takes place. We consider what the treatment involves, the expected level of discomfort, the patient’s medical history, and what will make recovery easier. The goal is straightforward: control pain responsibly without giving every patient the same medication plan.

Core Plastic Surgery offers several pain-management options for appropriate patients, including JOURNAVX® for acute pain and Pro-Nox™ for discomfort and anxiety during selected procedures. These tools may be used alongside local anesthesia and other established methods as part of an individualized plan.

JOURNAVX is a prescription, non-opioid medication for adults with moderate-to-severe acute pain, including pain following surgery. Pro-Nox is a patient-controlled inhaled mixture used during treatment. Because they work differently, one may be appropriate without the other, or they may play separate roles in the same overall plan.

Why Pain Management Matters

Discomfort is not an insignificant part of an aesthetic procedure. It can affect whether a patient feels prepared, remains comfortable during treatment, follows postoperative instructions, or is willing to complete a recommended series.

This is particularly relevant with treatments such as laser skin resurfacing. A second laser session may provide additional improvement for certain skin concerns, but patients who had a difficult first experience may understandably hesitate to return. Improving comfort can make an effective treatment plan easier to complete.

The same principle applies to surgery. Pain cannot always be eliminated, but it can be anticipated. Planning ahead allows Dr. Core and his team to explain what patients are likely to feel, prescribe appropriate medications, and adjust the plan when a patient has medical or practical concerns.

Pain Control Before, During, and After Treatment

Pain management does not refer to a single medication. It may include several measures used at different points in the treatment process.

Before a procedure, the team reviews the patient’s health history, current prescriptions, previous responses to anesthesia and pain medication, allergies, and the treatment being performed. Patients should disclose every prescription, over-the-counter medication, vitamin, and supplement they use.

During treatment, local anesthesia or another form of anesthesia may be used when appropriate. Pro-Nox may help selected patients manage procedural discomfort and anxiety while remaining conscious and responsive.

Following a surgical or qualifying nonsurgical procedure, the recovery plan may include JOURNAVX or other medications based on the expected degree of acute pain. Instructions are specific to the patient and procedure.

What Is JOURNAVX?

JOURNAVX, also known by its generic name suzetrigine, is an FDA-approved, non-opioid prescription medication for moderate-to-severe acute pain in adults. Acute pain is short-term pain associated with tissue injury, including postoperative pain.

JOURNAVX belongs to a new class of pain medications. It targets the NaV1.8 sodium channel in the peripheral nervous system, where pain signals begin. By reducing the transmission of those signals before they reach the brain, the medication offers another way to manage acute pain without using an opioid.

JOURNAVX is not an anesthetic. It does not numb the treatment area or replace local or general anesthesia when anesthesia is required. It also does not guarantee the complete absence of pain. Its role is to reduce acute pain as part of a carefully selected treatment plan.

JOURNAVX for Laser Skin Resurfacing

Laser skin resurfacing can produce substantial improvement in sun damage, uneven texture, wrinkles, pigmentation, and certain scars. The treatment works by creating controlled injury in the skin, which means discomfort can be part of the process.

Historically, that discomfort has made some patients reluctant to undergo a deeper treatment or return for another session when additional correction would be useful. Adding JOURNAVX to the pain-management plan has helped selected Core Plastic Surgery patients undergo laser resurfacing with significantly less discomfort. Some have reported little or no pain during the experience.

Results vary, and the medication is not necessary or appropriate for every laser patient. The type and depth of laser treatment, expected discomfort, medical history, medications, and individual sensitivity all influence the plan. Topical anesthetic, local anesthesia, cooling, or Pro-Nox may also be used when indicated.

The purpose is not to make a stronger treatment sound effortless. It is to remove avoidable discomfort when we have a responsible way to do so.

JOURNAVX After Plastic Surgery

Postoperative pain is one of the most common concerns patients raise before plastic surgery. The degree and duration of discomfort depend on the operation, the amount of tissue involved, whether procedures are combined, and the individual patient’s response.

JOURNAVX may be prescribed to appropriate adult patients for moderate-to-severe acute pain following surgery. Its non-opioid mechanism gives Dr. Core another option when developing a postoperative medication plan.

A non-opioid medication is not automatically appropriate for every person, and “non-opioid” does not mean risk-free. Dr. Core considers the full medical history and current medication list before prescribing it. Some patients may also require other medications or additional pain-control measures. Patients should take only the medications included in their postoperative instructions and contact the office if pain is not adequately controlled.

JOURNAVX should be used for the shortest duration consistent with the patient’s treatment needs. Its use for acute pain has not been studied beyond 14 days.

What Is Pro-Nox?

Pro-Nox is a patient-controlled inhaled analgesia system used to ease pain and anxiety during selected medical and aesthetic procedures. It delivers a fixed mixture of 50% oxygen and 50% nitrous oxide through a mouthpiece or mask.

The patient controls when the mixture is delivered by breathing through the device. It takes effect within several breaths, and the patient remains conscious, responsive, and able to communicate with the treatment team.

This control is important. The system delivers gas only when the patient inhales through it. The mixture cannot be adjusted by either the patient or the medical team.

The effects generally diminish quickly after inhalation stops, but every patient is assessed before leaving the office. Pro-Nox is administered only after the team has reviewed the patient’s health and confirmed that inhaled nitrous oxide is appropriate.

When May Pro-Nox Be Used?

Pro-Nox may be considered for procedures that cause temporary discomfort or anxiety but do not require the patient to be fully asleep. Depending on the patient and treatment, it may be used during laser procedures, injections, energy-based treatments, and other selected in-office services.

It can be especially useful for patients who feel anxious about a procedure or have difficulty tolerating brief periods of discomfort. Pro-Nox does not replace local anesthesia when numbing medication is required, and it is not intended to make an unsuitable procedure tolerable at any cost. Patient feedback remains important throughout treatment.

Not every patient can use nitrous oxide safely. Certain medical conditions involving trapped air within the body, impaired consciousness, some ear or sinus problems, and an inability to hold and use the delivery device may make Pro-Nox inappropriate. The Core Plastic Surgery team screens each patient before treatment.

JOURNAVX vs. Pro-Nox

JOURNAVX and Pro-Nox are different forms of pain management.

JOURNAVX is an oral prescription medication. It is used for moderate-to-severe acute pain in adults and may be incorporated into the plan for qualifying surgical or nonsurgical procedures.

Pro-Nox is inhaled during a procedure. It works quickly to reduce temporary discomfort and anxiety while the patient remains awake. Its effects begin to fade after the patient stops inhaling the mixture.

One option is not inherently better than the other. The appropriate choice depends on when pain is expected, how long it may last, the procedure being performed, and the patient’s health.

Who May Be a Candidate for JOURNAVX?

JOURNAVX may be considered for an adult expected to experience moderate-to-severe acute pain after an appropriate procedure. Before prescribing it, Dr. Core reviews the patient’s liver health, prescriptions, supplements, contraceptive medications, and other relevant medical information.

JOURNAVX can interact with medications processed through the CYP3A pathway. It cannot be used with strong CYP3A inhibitors, and its dosage may require adjustment when certain moderate CYP3A inhibitors are taken. Strong or moderate CYP3A-inducing medications may also make JOURNAVX inappropriate.

Patients must avoid grapefruit and products containing grapefruit while taking JOURNAVX. Those using certain hormonal contraceptives may need an additional nonhormonal contraceptive method during treatment and for 28 days after the medication is discontinued. Patients who are pregnant, breastfeeding, planning a pregnancy, or who have liver disease should discuss this directly with Dr. Core.

Common adverse reactions reported in clinical studies included itching, muscle spasms, rash, and an increased blood level of creatine phosphokinase. Patients should contact the office if they develop a concerning reaction or if their pain remains uncontrolled.

What to Expect From Your Pain-Management Plan

The process begins with an honest discussion of the expected discomfort. A light laser treatment and an extensive surgical procedure do not require the same plan. Individual pain tolerance, anxiety, previous experiences, and medical history also matter.

Before treatment, patients receive clear instructions covering:

Which medications to take and when
Which medications, foods, or supplements to avoid
Whether local anesthesia or Pro-Nox will be available
What level of discomfort is typical
How pain should change during recovery
When to contact the office
Which symptoms require prompt medical attention

Patients should never take additional prescription medication, change a dose, or combine pain medications unless instructed to do so. If the plan is not controlling the pain adequately, the correct next step is to contact the office.

Why Choose Core Plastic Surgery for Pain Management?

Dr. Grady Core has spent his career refining procedures to reduce unnecessary trauma, conceal incisions whenever possible, and make recovery more manageable. Pain management follows that same practical approach.

New medication or technology is useful only when it improves care. Core Plastic Surgery uses JOURNAVX and Pro-Nox selectively, with attention to the procedure, the evidence, and the patient’s health. The team explains what each option can reasonably accomplish and where its limitations lie.

The result is a pain-management plan built around the actual treatment and the person undergoing it.

Schedule a Consultation in Birmingham

Pain concerns should be addressed before treatment, not after discomfort becomes a problem. During your consultation, Dr. Core and the Core Plastic Surgery team will explain the procedure, anticipated recovery, anesthesia options, and whether JOURNAVX or Pro-Nox may be appropriate.

Contact Core Plastic Surgery in Birmingham, Alabama, to schedule a consultation and receive an individualized treatment and pain-management plan.

Pain Management Frequently Asked Questions

Is JOURNAVX an opioid or narcotic?

No. JOURNAVX is a non-opioid prescription medication. It works by targeting a sodium channel involved in transmitting pain signals through the peripheral nervous system. It does not work through opioid receptors.

Will JOURNAVX make my procedure pain-free?

No medication can guarantee a pain-free procedure or recovery. JOURNAVX can reduce moderate-to-severe acute pain in appropriate adults. Core Plastic Surgery has seen selected laser resurfacing patients experience substantially less discomfort, including some who reported little or no pain, but individual responses vary.

Can JOURNAVX be used for pain after plastic surgery?

Yes, JOURNAVX is FDA-approved for moderate-to-severe acute pain in adults, including postoperative pain. Dr. Core determines whether it is appropriate based on the procedure, expected discomfort, health history, and current medications.

Is JOURNAVX intended for long-term pain?

No. JOURNAVX is intended for acute pain and should be used for the shortest appropriate duration. Use beyond 14 days has not been studied.

What does Pro-Nox feel like?

Pro-Nox can create a temporary relaxed or light sensation while reducing pain and anxiety. The patient remains conscious and controls delivery by breathing through a mouthpiece or mask. The effects begin to diminish after inhalation stops.

Does Pro-Nox put me to sleep?

No. Pro-Nox is used by conscious, spontaneously breathing patients. You remain awake, responsive, and able to communicate during treatment.

Can everyone use JOURNAVX or Pro-Nox?

No. Each option has medical considerations and contraindications. The team reviews your health history and medication list before determining which pain-management methods are appropriate.

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3595 Grandview Parkway, #150, Birmingham, AL 35243

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