12 Things I want Patients to Know Before Tummy Tuck Surgery
Byon 23 Dec 2010
I am an active participant in the RealSelf doctor community and have seen the great interest in Kimmers posting about 12 Things I Wish I Knew Before a Tummy Tuck. In the spirit of sharing my opinion, I prepared this guide to tummy tuck from the perspective of a board certified plastic surgeon. While I may not be able to respond to comments, you deserve to be armed with good information in advance.
To start out, healing well and getting the best result from a tummy tuck depends on a partnership developed between me as the surgeon and you as the patient. What I do in the operating room is only part of the ultimate outcome. You have to heal. Healing requires a lot of attention to taking care of yourself, probably more than most women are in the habit of doing. For a majority of my women patients, this requires a fair amount of planning. So if there are twelve things I want a patient to know before surgery to plan for a smooth recovery it is these:
1. Plan enough time off
This is not simply time off work. You must also make arrangements for care of your children, for care of your home, for care of other family members for whom you may be responsible (husbands, elderly parents, etc.) Two weeks is the minimum before returning to a desk job. Working only ½ days the first week back to work is even better. You will not be able to do heavy physical work, work that involves travel or alot of standing for three weeks.
2. Make sure you have enough help lined up.
This probably means full time help with young children AND an adult to help you get in and out of bed, prepare food for you, help you dress for the first few days after the surgery. One additional adult in the house (you don’t count) is only adequate in those first several days if your children are at an age where they can be left unsupervised at the drop of a hat for 5 minutes or so when the adult needs to be with you. By around the third day after surgery, you will be able to do more for yourself so that one adult (in addition to you) in the house is usually enough.
3. You should do little or nothing besides caring for yourself in the first 2 weeks.
Even if you think you feel well enough to “do some work” you are not to try. This means no cooking, no answering emails (work related or personal), no child care, no laundry, no housework, no cleaning out that closet you have been dying to organize. It is entirely too easy for many of my patients to focus on a task and not be aware of their body’s needs. In the first week after surgery you need to pay careful attention to yourself so that you lie down as soon as you are tired and eat as soon as you are hungry. If you give yourself the space to answer your body’s signals, you will find yourself suddenly overcome by the need to sleep or the need to eat and you should do just that.
By the second week, you will be feeling better, but certainly not back to yourself. You will probably be able to stand up straight and move around the house for several hours at a time. You will be able to spend time with your kids, but should not plan to be their full time care giver. You will still feel suddenly exhausted or hungry and should have enough other help that you can excuse yourself and go lie down as soon as you feel the need.
I am aware as I give these instructions to my patients in the office that a glassy look often comes into their eyes as they think “Oh, she has no idea how tough I am. I know that her other patients are all softies, but I delivered a baby and went right back to the rice paddies.” Trust me on this, surgery is a big deal and your body is going to take what it needs. You CAN fight it and not plan adequately for it. Doing this is likely to prolong your feeling lousy and wiped out and possibly increase your risk of complications. You will recover better and faster if you accept you body’s need for attention and rest, and plan adequately for it.
4. Expect to feel wiped out for six weeks.
By the time you go back to a desk job at two weeks, you will feel OK focusing on your job. Any pain you still have should be managed by Ibuprofen. Expect though that when you get home from work you will be wiped out. You may find yourself needing to go to bed at 7:30 PM. Most of my patients are used to being active for several hours after everyone else in the house is asleep. For six weeks, you will not be able to do this. It is very common to have patients in for a postoperative visit around three weeks after the surgery, stressed out that they can’t do what they are used to doing and they don’t feel like themselves. I remind them that they probably don’t remember they have just had surgery because they are not in a lot of pain, but that they have three weeks more to go for this intense healing period. When you heal you need more sleep. Most patients are pretty consistent at telling me that the first day of week seven, their stamina is back and they feel like themselves. It can take longer if you don’t allow yourself those six weeks sleeping more and accomplishing less than you are used to.
5. Nutrition is very important
In my area, a fair number of my smart, professional women patients don’t sit down to eat regular meals. Many of us also diet constantly. Nutritional habits that may work to maintain you when you are healthy can become a huge stress when you have a surgical wound to heal. You have to eat well. You should have protein with every meal, at least two eggs or four egg whites, two pieces of citrus fruit per day (whole fruit, not juice) and then whatever else you want. It is not healthy to try to lose weight during this time. You must eat well to heal well.
6. Full healing takes up to a year.
A majority of swelling, pain and postoperative fatigue resolves in the first six weeks. The healing process goes on for months after that. The scar which will initially be dark or red and bumpy under the skin will soften, flatten and fade. The skin on the belly will initially be numb. Sensation will return in fits and starts. Your abdominal wall will initially feel stiff and swollen, particularly the area below the belly button. This swelling will usually be worse in the evening and better in the morning, but the fluctuations will improve slowly over months. While improvement in your shape and appearance will be obvious within days after surgery, things will continue to change and improve over that first year.