Tummy Tuck Preparation & Recovery

1/9 | http://www.docshop.com/education/cosmetic/body/tummy-tuck/recovery
BY
Constance M. Barone, MD
SENIOR SECTIONAL EDITOR
updated March 12, 2015
Source: http://www.docshop.com/education/cosmetic/body/tummy-
tuck/recovery
Abdominoplasty, or tummy tuck, is a cosmetic surgery procedure that
provides both aesthetic and practical benefits. Tummy tuck patients
have usually achieved significant weight loss, or have given birth to one
or more children, and wish to restore a lean, toned midsection.
Patients must understand that in order to ensure a successful
procedure, extensive preoperative planning is essential. Meanwhile,
recovery will involve very specific instructions from your surgeon that
should be followed closely.
Tummy Tuck Preparation & Recovery

A tummy tuck almost always involves the removal of excess skin, fat,
and other tissue, along with the tightening of the underlying abdominal
muscles. It requires both internal and external healing. Therefore, it is
especially important for your surgeon to make certain that any risk of
excessive bleeding and other complications during surgery is
minimized.
During a pre-op consultation, you should be prepared to discuss your
medication and supplement regimen in great detail. You should also be
prepared to talk about your own medical history. Both of these aspects
have to be reviewed in order to assess your risk of developing
potentially dangerous blood clots and bleeding excessively during
surgery. If you use tobacco, you must also understand that you will be
expected to stop nicotine intake of all kinds at least three months prior
to surgery, and continue to abstain during recovery.
Depending on the extent of your surgery, you can expect to spend
anywhere from three days to a week or more limiting yourself to
minimal physical activity. You certainly will not be bed ridden during
this time, but you will be expected to avoid activity that is more
strenuous than walking very short distances. You will also have to take
very special care to avoid placing any strain on your incisions.
Gaining an understanding of the entire abdominoplasty process from
pre-operative planning to full recovery can play an important role in the
success of the surgery. This knowledge can help you feel confident in
your decision to undergo body contouring, and help you play an active
role in achieving the best possible results and the longest-term
satisfaction with your refined midsection.
The Pre-op Assessment
During the pre-op assessment, you can expect your surgeon to conduct
a close evaluation of your risk of thrombosis, or the formation of blood
clots inside blood vessels. Blood clotting is a natural process that is
essential in healing. For example, when you experience a minor cut on
your skin, the scab that forms is a result of blood clotting. In most
cases, blood clots dissolve on their own. However, when a blood clot

inside a blood vessel fails to dissolve, it can obstruct proper blood flow
to the lungs, brain, and other areas, which can cause serious health
complications.
In order to minimize your risk of developing blood clots, you will be
asked to stop taking birth control at least two weeks before surgery. You
will also have to stop taking any hormones or supplements such as fish
oil, and aspirin. The American Society of Plastic Surgeons requires that
you sign a consent form confirming the cessation of all supplement
intake. In addition to reducing your risk of developing blood clots,
stopping your intake of supplements and other medications also helps to
minimize bleeding during surgery.
Your risk of developing a dangerous blood clot may be higher if you
have previously had deep vein thrombosis, or the formation of a blood
clot in your leg. If you have had cancer, or if you have a family history
of cancer, this must also be considered. Another part of assessing your
risk of thrombosis involves a test called the Caprini Risk Assessment
Model. It takes note of factors such as your age and any recent injuries
or surgeries. A point system indicates whether it is safe to proceed
with abdominoplasty, or if any special measures should be taken to
ensure your safety during surgery.
Umbilical and Ventral Hernia
Umbilical and ventral hernias are conditions that must be addressed
prior to undergoing abdominoplasty. An umbilical hernia occurs when a
portion of the small intestine protrudes through a natural opening
between the abdominal muscles. Though the condition is fairly common
and usually does not create any painful or debilitating symptoms, it can
complicate abdominoplasty.
A ventral hernia occurs when part of the intestines push through a tear
in the abdominal wall. These tears are sometimes the result of an
incision made during a prior surgery. Either of these conditions can
inhibit blood flow, which can in turn complicate the healing process.
During a patient's initial consultation, I conduct my own physical
analysis of the patient and a review of his or her medical history to
determine if either of these conditions are present.

Your Ideal Body Weight
Patients frequently pursue abdominoplasty surgery because they have
experienced significant weight loss, leaving them with stretched skin
and separated abdominal muscles. These conditions can be quite
uncomfortable, resulting in rashes and irritation. Meanwhile, they can
obscure the results of the patient's weight loss achievement.
Once patients have undergone a tummy tuck, it becomes very important
to avoid dramatic weight fluctuation in the future. That is why I always
spend time during the initial consultation to help the patient determine
their ideal weight, and evaluate whether he or she is currently within a
reasonable proximity of that weight.
If, for example, the patient wishes to achieve further weight loss, we
must consider whether the results of abdominoplasty might be more
flattering once the patient's goal has been met. On the other hand, we
must consider the likelihood that the patient will be able to maintain
their ideal weight. By discussing the patient's lifestyle and goals in
great detail, we can determine whether the planned extent of surgery
will provide results that will be compatible with the patient's lifestyle for
the long run.
Abdominoplasty and Pregnancy
Many abdominoplasty patients are mothers who wish to refine their
midsection following childbirth. Carrying a child can cause the
abdominal muscles to separate, and stretch the abdominal skin. In
addition to considering ideal body weight, female patients must
contemplate the likelihood of wanting more children in the future. Often,
the best time for a mother to have abdominoplasty is when she is
certain she does not wish to have more children.
Extent of Treatment and Extent of

Extent of Treatment and Extent of
Recovery
The extent of your treatment is the greatest determining factor in the
amount of downtime needed following surgery. There are three primary
classifications of abdominoplasty surgery: mini, standard, and extensive.
A mini tummy tuck focuses on
the area below the navel. It
typically involves an incision
placed between the hip bones,
some tightening of the abdominal
wall, and the removal of excess
fat and tissue. It usually only
requires about a week of
minimized physical activity before
patients can resume more
rigorous activity.
A standard tummy tuck is similar to a mini tummy tuck, but can include
treatment above the navel. An extensive treatment usually involves
liposuction and other treatment extending to the flanks, or love handles.
Both of these tummy tuck procedures can require weeks of minimized
activity following surgery.
Both standard and extended abdominoplasty often require that I place
drainage tubes that help prevent the buildup of blood and fluid at the
incision site. I will usually remove the first of these tubes after about
three days, and the remainder are removed a few days later. I always
provide a special support garment that can further prevent the buildup
of fluid.
Meanwhile, patients should understand that they will not be expected to
be immobilized during recovery - nor should they be. By getting up and
walking around the house to carry out simple day to day tasks, patients
can further reduce the risk of developing harmful blood clots. In other
words, while a patient who had surgery days ago should not lift a heavy
bag of groceries onto the counter, they are encouraged to stand up and
walk to the kitchen for a glass of water. During recovery for any extent
of abdominoplasty, it is very important for patients not to do anything
that could place strain on their incisions. Incisions are usually fully
The extent of your
treatment is the greatest
determining factor in the
amount of downtime
needed following surgery

healed after two weeks.
Each patient's case is different, but generally speaking, those who have
sedentary jobs that mainly require sitting at a desk can return to work
about a week after abdominoplasty. Those with more physical jobs will
probably require at least two to three weeks before returning to work.
Follow-up Appointments
You should expect to visit your surgeon the day after surgery to fully
assess your condition. During this appointment, I usually fit the patient
with their support garment, which will help to prevent the formation of
blood clots. After the first follow-up, I schedule weekly visits. These
continue depending upon the patient's extent of treatment, as well as
his or her risk factors in developing blood clots and other complications.
Nicotine Compromises the Ability of the
Body to Heal
It's no secret that tobacco use is a potentially deadly habit that can have
many adverse affects on your health. However, many patients do not
realize that nicotine can severely compromise the body's ability to heal.
Considering the extent of treatment abdominoplasty can require -
incisions, liposuction, excess skin removal, and tightening of the
abdominal muscles - a patient who smokes must make a commitment to
detoxifying themselves at least three months prior to surgery, and
continue to abstain from cigarettes as they heal. This also involves
taking measures to avoid second-hand smoke. Ideally, they will cease
smoking altogether once healing is complete.
Smoking specifically hinders two very important functions: the ability of
cells to divide and grow, and the ability of white blood cells to eliminate
bacteria that can lead to infections.
Nicotine causes blood vessels to become more narrow, making it
difficult for red blood cells to deliver oxygen to the skin cells at the
incision site. When the delivery of oxygen is inhibited, it can delay

healing considerably. Meanwhile, if the function of white blood cells is
compromised, a patient has a much greater likelihood of developing an
infection, which can result in serious health complications and take a
toll on the aesthetic results. If you are a smoker who is considering
undergoing abdominoplasty, it is not too early to begin exploring
strategies to eliminate nicotine from your life for good.
Medication and Pain Management after
Surgery
Obviously, you can expect some pain and tenderness following surgery,
but your surgeon will provide you with a recommendation for pain
management. I personally administer EXPAREL®, an injectable
painkiller that provides three to four days of relief, and eliminates the
need to take oral medication in order to maintain comfort. It is important
to keep your bowels moving after abdominoplasty, so I always
recommend that patients take laxatives during recovery. I also prescribe
antibiotics to further reduce the risk of infection.
Alcohol and pain medication absolutely do not mix, but once a patient is
finished taking pain meds, I usually allow him or her to have a glass of
wine when they choose, which can be a nice way to relax.
Patient Profile: Jeanette
My patient Jeanette underwent abdominoplasty about four months ago.
She said the level of comfort and mobility she experienced during the
first week of recovery was surprising.
"That same day after my surgery was completed, I was able to walk by
That same day after my surgery was
completed, I was able to walk by myself
and get dressed

myself and get dressed," Jeanette said. "The pain wasn't there at all. It
felt tight, but I was moving around just fine. As Dr. Barone instructed, I
just took it easy. Wearing my support garment helped a lot, and I went
on with doing what I needed to do with no issues. My friends and family
were like, ‘Wow, we cannot believe you just had surgery.'
"I had drains placed. I think having them hanging felt a little awkward
and uncomfortable, but that was only for about a week. I didn't
accumulate a lot of fluid because I wore my garment all the time. When
it was finally time for them to come out, it was painless."
Jeanette was able to start working out after about six weeks. After 8
weeks, she was able to incorporate abdominal exercises into her
routine. She says anyone planning to undergo abdominoplasty surgery
should be prepared to follow the doctor's orders closely, and be patient
as swelling subsides.
"Personally, I think people need to mentally prepare themselves," she
said. "You just had surgery, so of course your body will swell. You will
be thinking, ‘Okay, I'm going to get a tummy tuck, and then I'm going to
look amazing.' But that takes time. It's a process, and you need to be
aware of that. You won't see an amazing new tummy after one or two
days. It will be flat, but the swelling takes up to a year to finally
subside."
Prepare for Success
Thorough preparation and a proper, well-monitored recovery spent
carefully following your surgeon's instructions can result in a beautiful,
natural-looking enhancement that provides you with many years of
comfort, satisfaction, and boosted self-esteem. Patience is a virtue in
every stage of your treatment. Be ready to discuss your medical history
in great detail during your pre-op evaluation, and understand that you
will be dramatically reducing your physical activity immediately
following surgery.
If you find a surgeon who is willing to take a thorough and patient
approach to preparation and recovery, and if you are willing to take

•
•
•
every measure to cooperate with your surgeon's recommendations,
abdominoplasty can provide you with a flattering new body tone and an
improved quality of life.
References & Resources
Source:
http://www.docshop.com/education/cosmetic/body/tummy-
tuck/recovery
Author: Constance M. Barone, MD
Publisher: DocShop

Tummy Tuck Preparation & Recovery

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