Tips to optimize your tummy tuck recovery
Recovering safely and quickly from surgery is no small task. This is particularly true of an abdominoplasty. People falsely assume that a “tummy tuck” is a Mickey Mouse, elective procedure. Nothing could be further from the truth. Like many excisional, plastic surgery procedures, a tummy tuck poses several challenges to the body that drains the bodies healing reserves, including a large, internal, raw space, tissues put together under tension, and increased abdominal wall tension from fixing the six pack muscles. Despite these inherent challenges, I have noticed great variability in how patients recover. Some patients zoom along untouched and others labor. I wanted to share some of my personal observations as to why this is so.
- Exercise: Patients who are physically active and work out on a regular basis typically recover very quickly! So, if you are considering a tummy tuck, get in shape and get as close to your ideal weight as possible. For some people this is difficult. Even still, it helps to get that ball rolling and commence with an exercise routine prior to surgery and to continue afterwards once you have healed.
- Diet: Similar to fitness, patients who live cleanly and eat well do well. Processed carbs and sugars are the enemy of healing. They release a plethora of oxygen free radicals in addition to raising blood sugar and gumming up blood vessels long term. Try to eat more raw foods and things that spring up from the ground. Also, protein loading prior to and after surgery is a good idea. The protein and caloric requirements for post-surgical healing are significant and thus tanking up in advance and during your recovery will get you back on your feet sooner.
- Positive thinking: Patients who are positive do better and have fewer complications. This may sound crazy, but I first noticed this during my training in Minnesota and it is still today. Being filled with fear and tension releases chemicals that are toxic to our bodies. This reality has been borne out by wound healing studies. There is also a spiritual dimension to this reality, which trumps simple physiology. Stay positive and do what you need to do to get in a good space.
- Decompress the six pack muscles in advance: Most women have their tummy muscles (rectus abdominis) stretched out and displaced laterally by the pregnancy process. This gives the abdomen and rounded appearance. In some women, the “diastasis” can be sever making them permanently pregnant. One simple trick to ease the stress of the repair is wear an abdominal binder prior to the procedure to simulate their repair make the actual closure easier and more tension free.
- Early mobilization: Getting your butt moving early paradoxically speeds recovery. Couch potatoes typically have a prolonged recovery. A vast majority of my patients are done on an outpatient basis and go home the day of surgery. I get them moving right away. Early mobilization helps with DVT and pulmonary embolus prevention. It also gets your GI tract going sooner thus avoiding post-operative constipation. This paradigm goes against what I learned during training where many cosmetic patients stayed in the hospital overnight with an IV in place and blobbed out in a hospital bed. Orthopedics and other specialties have learned the value of early mobilization speeding recovery.
- Non-narcotic pain control: Despite being the mainstay of post-surgical pain management, they SLOW DOWN recovery and early mobilization. Patients who are gorked out on the couch are more prone to complications particularly the dreaded embolic phenomenon such as a PE. I try to limit use of narcotics post-operatively and use a multi-modal approach that addresses the pain axis from multiple angles. I make liberal use of local anesthetic (in the form of tumescent solution) and this helps break the cycle of post-op pain significantly. In addition, non-sedating, non-opioid forms of pain control such as Celebrex (or Mobic). These medications ease pain and inflammation much like Ibuprofen or Aspirin but without the bleeding risks. Finally, muscle spasm due to plication of the rectus abdominis muscles causes a lot of pain and using a good muscle relaxer helps tremendously. I am now using Zanaflex that also acts centrally to inhibit pain receptors.
- Swelling control: Swelling complicates and lengthens recovery. I attack this in two ways. A good compression garment fights swelling. I start with a traditional abdominal binder and then transition to gentle Spanks compression and at a later date a body shaper to fine tune things. In addition, I use Bromelain (pineapple extract), which is a natural anti-inflammatory that reduces swelling. Several years ago, I did a tummy tuck on a nurse who had had ankle fusion years earlier. She had chronic swelling in that ankle, and it disappeared while taking the Bromelain. She ended up taking it as a regular supplement. Finally, Arnica is another natural supplement that eases bruising and reduces swelling. All my patients receive it as well.
Surgery is an imperfect science and not two patients recover the same way. That being said, following the principles above will help you maximize your healing potential and eventual outcome.