4 Weeks Post-op - Should I Still Be Wearing Padding Between my Binder and Scar?

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. 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!

Hello,

Thank you for the question.  Most patients do not wear padding under the abdominal binder at 3-4 weeks after their tummy tuck but each patient and each surgeon has his/her own specific ways of doing things.  If it feels good you can continue to do so.  Some patients will cut the top off of a T-shirt and have that as a lining between the skin and the binder.  The swelling or fullness that you are swelling can should be evaluated by your plastic surgeon to verify if its swelling, seroma, abdominal wall, or fat.

All the best,

Dr. Remus Repta

Thank you for the question and pictures.

Your plastic surgeon will have specific suggestions for you. It's best to follow his/her advice given that he/she is responsible for your care.

Generally, I suggest the use of pads between the incision and binder to prevent irritation of the suture line. Around this time,  patients may switch from binder to compressive garment ( which is generally softer but still useful for a edema  control).

Best wishes.

 

Your board certified plastic surgeon has  a list of pre and post-operative instructions that should be followed. Please consult with you surgeon for help in determining what products you should be using. Best wishes!