Abdominoplasty Recovery

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Tummy Tuck Recovery

Introduction
TT is one of the most life-changing, beautiful, and powerful cosmetic operations I do. But restoring contour to the abdomen, flanks and waist comes with a couple trade-offs:
1. The Recovery
2. The Scar

In terms of recovery, it’s also one of the longer and more painful cosmetic surgeries to recover from. The scar itself can be long in some patients, but well-placed. It follows the natural contour of the pelvic/hip bones, and is hidden in clothing and bathing suits. I offer Embrace scar therapy, which gives the best TT scars possible. Some patients choose to use it, some don't.

3 Phases of Recovery
I think it’s best to think of recovery in 3 major phases:
1. Initial surgical recovery (Week 1-2)
2. Ramp-up to normalcy (Week 2-6)
3. Return to normalcy (Week 6-8)

Initial Recovery: Phase 1
The initial recovery involves pain and limited mobility (this lasts 1-2 weeks and improves throughout that timeframe). Pain is mostly from the muscle repair itself. It’s as if you did 1000 sit ups so there is a lot of "tight" feeling. You’ll walk slowly, get to the bathroom, feel like you need to stay bent over a bit, and recognize how much you actually use your abdominal muscles for daily activities.

You’ll need help in the first 5 days or so. Your help will need to get you items, help you with your drains, and just be an emotional support and company for you. You’ll want to plan for books and movies to keep you occupied on the couch or recliner. Most people sleep on the sofa or recliner for the first 5-7 days since it allows them to sleep in a flexed position with pillows. It also allows them closer access to the kitchen and bathroom!

In terms of pain, I do 4 things, which I think helps my patients recovery better than most:
1. I perform nerve blocks in the operation, which I find greatly reduces the initial 8 hours of pain.
2. I use Toradol, which is a prescription non-steroidal anti-inflammatory (NSAID) drug that many surgeons of the past have been afraid of because of a concern for bleeding. Study after study has proven it does not cause post-operative bleeding and I find my patients benefit a great deal from this
3. I use muscle relaxers to relax the abdominal muscles that have been repaired
4. Narcotics (i.e., oxycodone, etc.)

Muscle tightness, pain, and slow moving will be around for the first 2 weeks, but get better throughout that time. It’s also normal to experience mood swings, which most people don't talk about. In the initial recovery many patients ask, “why did I do this?” Some patients feel so excited that they over-do it. So, it’s important to be aware of these thoughts and have a good support system of friends or family that will be around you during the initial recovery.

I generally use 1 or 2 drains. One comes out at week 1 and the second usually at week 2, sometimes week 3.

Ramp-up to Normalcy: Phase 2

  • You’ll wear a compression garment around your tummy for 4 weeks, then I have patients go to a store-bought garment like Spanks, which feels more comfortable
  • I’ll limit your lifting to about 20 pounds for the first 3 weeks, so if you have toddlers around, this may be an issue and you’ll need help
  • People with desk jobs often feel like going back to work after 2 weeks. Others with more physically demanding jobs will need to wait 3-4 weeks
  • I call this the ramp-up to normalcy because you are getting closer to normal each week, but will have limited activity. Most people are back to “normal” activity by 2 weeks, but things don’t quite feel normal in your abdomen, your energy is still down a bit as your body is devoting itself to scarring/healing.
  • You’ll experience twinges of pain here and there but you should be off all pain medicine after week 2 except for occasional Tylenol or ibuprofen
  • After 4 weeks I allow aerobic exercises like treadmill, elliptical, jogging, but no weights or abdominal exercises
    • It takes at least 6 weeks to build up enough scar tissue so that you are no longer relying on the stitches in the muscle to hold things together

Return to Normalcy: Phase 3

  • You’re hardly ever, if at all, feeling any of those twinges in the abdomen
  • You’re exercising and are ramping up your weight lifting
  • After 8 weeks, I allow full abdominal exercises if you feel up to it. LISTEN TO YOUR BODY!
  • Your swelling is gone down and you will start to feel quit elated at your results
  • Your scar is still not full mature. It will be red still and obvious. But if you do Embrace scar therapy, it will be almost finished and your scar will look great in 6-9 months
  • You can get rid of those compression garments at 8 weeks

Overall things to keep in mind

  • Be patient with the healing process
    • Understand that this is going to take 6-8 weeks to feel normal again
  • The end result will be worth it
  • Make sure you are aware of the emotional roller-coaster that can occur during recovery
  • Make sure you have help in the first 5-7 days and a support system
    • Get help with your young kids
  • Expect less of yourself; don’t go back to work too soon and let your support system help you!
  • Most of all, keep in close communication with your surgeon and do not hesitate to ask questions or communicate concerns

Michael Carlisle, MD

Article by
Des Moines Plastic Surgeon