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Am I Supposed to Wear my Binder over my Incision or Just a Little Bit Above It?

I had my TT last week 07/18/2012 and I am very swollen, my incision is very low but I was wondering if I'm supposed to wear my binder covering my incision or above it? Also is it normal to be this swollen....I look like I'm pregnant?

Doctor Answers (7)

Am I supposed to wear my binder over my incision or just a little above it?

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Hello! Thank you for your question!. The tummy tuck procedure is an excellent method for contouring of your abdomen, often removing the excess skin as well as tightening the abdominal wall. After nearly all surgical procedures, a potential space is created from where the surgical procedure/dissection was performed. This is especially true for the tummy tuck, in where the abdominal flap is raised off of the abdominal wall and then redraped atop the area to contour the abdomen. The procedure alone promotes swelling and inflammation, which typically lasts for 6-12 weeks. This may even last longer if liposuction has been performed in addition. During this time, a few things may be done to allow adherence of the abdominal skin/soft tissue to readhere to the abdominal wall and close that space. Many surgeons use drains to evacuate the expected serous fluid from building up. Stagnant fluid as such may be a nidus for infection as well as does not allow the tissue to adhere back to its normal anatomic position. Drains usually are removed once output is <30cc/day - usually removed within 3-4 weeks on average, sometimes longer. When this occurs, a seroma may develop - which may require aspiration or surgical evacuation to rid this in order to optimize your result.

This is not an uncommon reason for persistent swelling and/or bulging in a certain area of your belly. Of course, thwarting the development of a pseudobursa, or seroma capsule, is always best, to provide the best result as well as avoid any future procedures for this. This may be a troubling consequence and often compromises your overall result. Thus avoiding this complication, in whatever manner, is the objective. "Drainless" tummy tucks are becoming more popular - basically, the overlying tissue is physically sutured to the abdominal wall to close the potential space. In addition, most surgeons typically restrict vigorous activity/strenuous exercise as well as lifting restrictions of usually <20#, especially the core, for 6-8 weeks to allow healing to continue. Most also often recommend an abdominal compression-type binder or garment, which will serve to provide compression as well as assist to decrease swelling and eliminate the dead-space of the area for at least 6 weeks as well.  Your binder should be worn snug to cover the incision, be worn low on the hips, and adequately give compression to areas with the swelling.  After the initial binder, many patients like the Spanx garments. Most patients are able to return to most activities within a couple of weeks, provided they adhere to the restrictions.

Overall, this is a procedure with a high satisfaction rate. Discuss the procedure and postoperative instructions/restrictions with your surgeon, as these will vary among surgeons. Hope that this helps! Best wishes!


Scottsdale Plastic Surgeon
5.0 out of 5 stars 12 reviews

Should cover the incision

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The garment should be covering the incision at all times, so if it slips off, then simply pull it over the incision  again by holding on to the sides of the garment. Swelling can be quite prominent after surgery and can take a few months to fully subside. Wearing the garment and following your surgeon's post-care instructions will help with the swelling. Best of luck. 

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 74 reviews

Hello

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Your compression garment is supposed to be covering your incision, you should have padding on your incision and your garment right along the incision nothing should be touching you incision but the padding. It is very normal to be swollen after surgery it takes 6-9 month for the swelling to start subsiding.

 

Stuart B. Kincaid, MD, FACS
San Diego Plastic Surgeon
4.5 out of 5 stars 8 reviews

Binder and Tummy Tuck

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I recommend for my patients to wear the binder over their incision. If liposuction is performed with the tummy tuck, then my patients wear a compression girdle which is different. Every plastic surgeon has their own recommendations on what type of garment they use and how they want the patient to wear it. Check with your plastic surgeon. I would also follow up with your doctor about the swelling to make sure that you do not have a seroma in the midsection.

Leo Lapuerta, MD
Houston Plastic Surgeon
4.5 out of 5 stars 26 reviews

Binder after surgery

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Thanks for your question, this question is best answered by your surgeon who is watching your progress and incisions, but in my practice i have patient's wear their binder over the incision.  I reccomend this  so that swelling does not form between the botton the binder and the top of the incision. 

Vishnu Rumalla, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 87 reviews

Where To Wear Binder After Tummy Tuck

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Check with your surgeon. I tell my patients to wear the binder lower, over their lower tummy / hips. The binder can have a tendency to ride up higher beneath the breasts. This is not good since it tends to restrict your rib cage and makes it more difficult to take a deep breath.

Ronald Schuster, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 30 reviews

Binder should be worn to provide gentle compression to the abdominal skin flap.

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It is now 10 days after your surgery, so you should certainly have been seen by your surgeon by now (I see my TT patients the morning after surgery, and again at one week for umbilical suture removal and usually drain removal). Your binder should have been adjusted daily and your incisions inspected, cleansed if needed, drain care done (if used), and pads/dressings changed. I certainly hope your abdomen has not remained unexamined for this period of time.

Your low incision sounds well-placed, and your binder can actually cover the incision, but should not irritate or abrade it. The intent of the binder is to provide gentle pressure to the lifted abdominal skin flap and underlying abdominal wall tissues to aid in adherence and healing. This (and drain, if used) help to allow your tissues to adhere completely and smoothly without collections of blood or serum (seroma) that can sometime be troublesome and in some cases require re-operation. Thus, this is not a trivial issue.

Please ask your surgeon, and if you have not scheduled a recheck appointment, do so immediately! This is part of your surgery. Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 146 reviews

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.