What's the evidence based rationale for a compression garment after a TT? My PS isn't having one for my B/L breast lift (anchor incision); just TT, yet I'd think the disruption of flesh to underlying tissues would be the same for both sxs. I've read the comp. may reduce circulation, and possibly cause "flap death", and is uncomfortable. Yet, I hear the comp. reduces swelling (wouldn't that just be for a few days though?), and helps lymph system re-establish. Thanks so much!
Is a Compression Garment Essential, Why, and for How Long After Tummy Tuck?
Doctor Answers (10)
Compression garment after tummy tuck
Do you absolutely have to wear a compression garment after your tummy tuck? No, you do not. Why do most plastic surgeons suggest it? Because it helps the skin and fat that are lifted up during the tummy tuck procedure stick down faster which decreases swelling and also decreases the potential for fluid pockets to develop. What will happen of you don't wear it? Most likely nothing but it does increase your risk of developing fluid pockets (called seromas). Why do you not need one for the breast lift? This has to do with the manner in which the operations are performed. During a tummy tuck a large amount of skin and fat are lifted up creating a potential space for fluid to accumulate and complications to occur. There is not nearly this large space created with a breast lift, and so usually a compression garment is not necessary. Hope these answers help. Good luck with your surgery.
Questions about wearing a compressive garment for a tummy tuck and breast lift
Your question and rationale for your opinions are very interesting and show much thought. The natures of the tummy tuck and breast lift including the extent are far different so using a binder for one but not the other is not irrational.
Most plastic surgeons do use a binder for a tummy tuck for a variety of reasons, particularly discomfort control, support, security and even help in reduction of swelling - and it is based on intuitive thinking as well as experience. However, there is no large evidence based study for either procedure to definitively support one approach. I personally use binders for tummy tucks and supportive bras for breast lifts. These latter do supply slight compression but it is to a lesser degree than that for a tummy tuck. One doesn't want too much pressure for either garment as this can be detrimental regarding blood perfusion.
To add another caveat: Plastic surgeons usually have their own preferences for doing certain things - and that does not necessarily mean that their way is right or wrong. It is what works for them and their patients.
Compression Garments after Tummy Tuck
Compression can cause pressure necrosis, but I have never observed this after hundreds of tummy tucks. Obviously technical factors during surgery play into this, and every surgeon is different. Compression is thought to reduce fluid collections and is the primary indication. Unrecognized fluid collections can cause contour deformities that can prove difficult to fully correct.
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Compression after tummy tuck
Most of my patients feel better with a compression garment after tummy tuck as it provides support. I don't however require it. I am not aware of any studies. I will say if that if there is compromise of the abdominal flap noted in the operating room then compression is not a good idea. Trust what your PS recommends.
Is a Compression Garment Essential
Best of my knowledge, there are no valid comparison studies. I like them because most patients find them comfortable, and many wear them beyond the time that I recommend. They also allow for holding in place gauze dressings without the use of tape which often is changed a number of times. Most of us feel that compression reduces the chance of seroma formation. (Seroma is much less common after breast surgery.)
That said, when a patient finds them uncomfortable, I am quick to abandon the use of compression garments.
Thanks for your question, best wishes.
Compression after a tummy tuck to prevent seroma
The compression garment after a tummy tuck is part of the equation to prevent seromas - the undermining in a tummy tuck is more involved than a breast lift.
Compression Garments Are A Mixed Bag
Thank you for your insightful questions. All of what you have read about compression garments is to some extent true. They help to temporarily reduce swelling, may provide comfort and support, can reduce seroma fluid accumulation, but do not change the final outcome of a tummy tuck, breast or face procedure. There are some risks which you mentioned due to illfitting or tight garments. These risks include permanent contour irregularities, skin flap death or blistering, and discomfort. They are also very costly. Cheaper subsitutes like Spanx can be a compromise. The use of garments is a choice by both the surgeon and the patient. They are not absolutely necessary for a tummy tuck or breast procedure. I would recommend discussing the pros and cons further with your surgeon and making an informed decision. Good luck!
Compression after a Tummy Tuck
Every doctor has their opinion on how long a patient should wear their compression garment. For abdominal surgery I recommend at least 6 weeks, sometimes longer is they still have some swelling. For breast surgery I have my patients wear a sports bra without any underwire for 6 weeks as well. Compression garments help reduce swelling faster as it can take 3 months to a year for all swelling to subside. Garments also lower the risk of seromas that can develop and lead to infections. I recommend consulting with a plastic surgeon for examination and to go over all of your post-operative concerns.
Compression garments in tummy tuck vs. breast lift?
Hello and thank you for your question.
As you may guess, different plastic surgeons have different ideas over when and why to you compression. I use compression in many of my surgeries, but it is mild compression. In a TT, there is a very large area of tissue elevation over the entire abdominal wall muscles. In the breast there is less so. Also, the breasts tend to be somewhat heavy and push the tissue toward the body while the abdomen is less so. In addition, when you twist your abdoment, there are shear forces between your fat layer and muscle layer as you rotate that doesn't happen in the breasts. Seromas or fluid collections are much more likely to happen in a tummy tuck rather than a breast lift, and thus, surgeons are more apt to use compression to help avoid this.
Pablo Prichard, MD
Garments Essential after Tummy Tuck?
Thank you for the intelligent question.
As far as I know, there is no “evidence-based rationale” for the use of compression garments after plastic surgical procedures. You will find that every plastic surgeon will have his/her own thoughts about their use. Therefore, your plastic surgeon' preferences will be the most relevant in your case. I can tell you, however that their use is not “essential”.
In my practice, I do use a relatively loose fitting surgical bra and abdominal wall binder after the procedures that you are about to undergo. In no way, are these garments meant to apply pressure to the surgical areas. They do serve to keep dressings in place (neater and drainage collecting)...
I hope this helps.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.