What to expect after your abdominoplasty (tummy tuck)

Expect

• Moderate to severe discomfort requiring 5-14 days of prescription pain medication
• Abdominal skin numbness for 6 months or greater
• "Dog ears" Little skin poufs at the end of the incisions which will improve over time. In some cases they can be revised in the office
• Some swelling especially right above the incision of which the majority will resolve in one month
• Do not take aspirin or ibuprofen for 2 weeks before and after surgery as this may cause bleeding and the need for emergency surgery.

Bandages

Leave on until seen in clinic in 3-6 days. Sponge bathe (do not get drains wet) until that time. Wear your abdominal binder at all times. It is important to provide compression of the skin and fat to the underlying muscle, and reduce the chance of a fluid collection (seroma). If you need a break, you may take it off for short 20 minute periods, but you should be immobile during this period. The garment should ride low on the hips and cover the tape overlying the incision. After you are permitted to shower, avoid bathing or soaking in a hot tub or swimming pool for 4-6 weeks.

Stitches

Any black or blue stitches at the umbilicus are removed at the first clinic visit. You may not have these stitches. The large incision has stitches which are dissolvable and all under the skin to improve patient comfort and cosmesis. You will have steristrips (surgical tape) reinforcing the incisions. They will gradually come off by themselves in the shower (usually in 2 weeks)

Drains

Will be placed at the time of surgery to prevent postoperative fluid collections called seromas. They will be removed in 1-3 weeks following surgery depending on fluid output. Record the output morning and night and also note the 24 hour total. Activation of the drain is important to keep constant suction in the tubing. The drain should be squeezed and look like Figure A (see drain sheet), NOT expanded as in Figure B. The blood will tend to clot in the tubing, even if the drainage turns to a yellow color (normal serum color). You will have to remove the clots by stripping the tubing (see Figure C). This is done by pinching the tube near the skin at point 1 and while holding tightly at point 1, strip the tubing towards the collection reservoir with your other hand (index and thumb). Now while pinching at point 2, release at point 1. You may see small clots in the tubing. Repeat this until all clots are in the reservoir. If you have leakage around the tubing where it exits the skin, this means there are clots blocking the flow and you must clear the tubing. It is important to keep the drain sites dry to reduce the possibility of infection into the deeper spaces. You may clean the exit sites with hydrogen peroxide or alcohol and apply antibiotic ointment. You will be on antibiotics while the drains are in. Continue these until they are gone.

Return to Work

In 7-14 days as long as there is no lifting or manual labor. No lifting >10 pounds, exercising, or elevation of heart rate or blood pressure is allowed for 6 weeks. We can provide a note from our office requesting light duty.

Driving

May resume when off narcotic pain medication and if you are comfortable enough to act quickly in the event of an emergency.

Exercise

TAKE IT EASY!  Find a comfortable chair or bed, a recliner is ideal as this allows you to keep your hips somewhat flexed.  Lying on your side with the knees drawn up may be more comfortable than lying flat on your back or stomach.  Weight lifting and cardio may resume in 6 weeks.  In order to reduce the chance of lung complications or blood clots, you are strongly advised to walk as soon as possible after surgery, no later than the day after surgery.  Get up slowly, and have assistance if you feel lightheaded or dizzy.  Walking slightly bent over initially may be more comfortable for the first week.  Gradually stand up straight over the next week.  It is important that you take deep breaths throughout the postoperative course or you may develop a fever.

Diet

There may be nausea associated with the pain medication or residual anesthetic gas.  Avoid carbonated beverages and extremes in temperature as well as spicy foods, in addition to any other foods that normally cause you bloating.