Consequences of Not Wearing the Binder After Tummy Tuck?

Question

I'm 9 days post op Tummy Tuck. I was asked to wear a binder for 6-8 weeks if not my stomach would get bigger. It it is very uncomfortable and caused my cut to bleed.  Is this normal? And if I don't wear the binder will my stomach really get bigger?

Richard J. Bruneteau, MD · Answer

Compression garments and abdominal binders are frequently
used following abdominoplasty for several reasons. These devices provide
compression which reduces swelling, increases comfort and minimizes the
potential for seroma formation.I
generally tell my patients to use a binder for three weeks following surgery.
When drains are used, we continue the use of the binder for longer periods of
time. It’s interesting to note that when we discontinue the binder, many
patients continue to wear it. They feel that the extra support makes them feel
more comfortable with activity. Failure
to wear a compression garment in the immediate post-operative period can have
significant consequences following abdominoplasty. This can result in the
development of seromas, infection and possibly wound breakdown. For these
reasons, it important to wear a compression device for at least three weeks
following abdominoplasty.

J. Timothy Katzen, MD, FACS · Answer

Hello HappyGal,
Thank you for your questions regarding wearing a compression garment after an abdominoplasty or tummy tuck. This is a very important question to ask your individual plastic surgeon. In my past 20 years of plastic surgery experience, I cannot think of a single patient who has not worn their binder. I believe compression garments are very important after a tummy tuck. Compression garments do multiple things. After a tummy tuck,compression garments compress the abdomen and minimize swelling. By minimizing swelling of the abdomen, the binder accelerates healing and decreases your overall recovery time. Also, the compression binder protects the incision from opening by providing external support. In addition, the compression garment provides back support after a tummy tuck. After a tummy tuck, you are flexed at the waist and bent forward. The back muscles or erector spinae muscles work overtime to help support your torso. The compression garments aid in back support. If you are experiencing bleeding underneath your binder, perhaps you should wear thicker padding over the incision. Unfortunately, the binder is usually not comfortable. However, most patients wear it nonetheless. If you do not wear your binder or compression garment after a tummy tuck, your abdomen will not return to its original state as it was before the tummy tuck. However, in general, the compression garment minimizes swelling and prevents your tummy from getting bigger. I would suggest you consult with your plastic surgeon and perhaps obtain a different compression garment or even a pair of tight Spandex. Thank you for your questions regarding wearing an abdominal binder after a tummy tuck. If you have any more questions regarding the tummy tuck or the postoperative care after an abdominoplasty, please contact my office.
Sincerely, Dr. Katzen.

Jed H. Horowitz, MD, FACS · Answer

Thank you for your question.After #tummytuck surgery, most patients will be placed in an #abdominal binder,
which they will wear the first week. There is usually a fair amount of swelling
and the binder should be opened  several times a day so that there are no
pressure points. After the first 7 to 10 days the patient is placed in an
elastic #garment for compression over the next six weeks.However, since it is so uncomfortable, you need to contact your #BoardCertified #PlasticSurgeon who may be able to offer you another garment or other advice.

Lewis Albert Andres, MD · Answer

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.  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!

Jerome Edelstein, MD · Answer

Please ask your surgeon regarding your compression garment. It may not be fitted properly if it's causing problems with your recovery. A compression garment is designed to help ease swelling and facilitate your recovery. It also helps your body conform to its new sleeker contours.

Armando Soto, MD, FACS · Answer

Hi there-
There are tummy tucks, and then there are tummy tucks... What I mean to say is that the importance of the binder to your particular outcome is going to depend on the details of your surgery.
Because this is the case, really the only person who could give you a responsible answer to your question is going to be your surgeon.
I would give him/her a call and ask if the binder is vital to the achievement of your goals, and if there is anything they can recommend to make the binder less uncomfortable to wear. I'm sure they will have the answers you need.
Congratulations on your new body!

Otto Joseph Placik, MD · Answer

You should contact your surgeon in regards to the limitations and recommendations after your tummy tuck surgery. Only he or she will have the best idea if compression is essential to maintaining your result.
If you have had an aggressive diastasis repair use of external compression may be supportive in the same way a cast is useful after repairing a fracture. This may provide rnecessary reinforcement when you cough, sneeze, etc.
If however, the diastasis was minimal, you could easily forego the use of the binder.

Jeffrey Zwiren, MD · Answer

If your lower abdomen was flat at first and now it is swollen this is normal.  As you get more active the fluid between the cells, called interstitial fluid tends to accumulate above the scar.  The scar works as a dam.  It takes about 3 months for the lymphatic vessels to re-form and properly drain this dependent edema.  Give it a chance and it will get better.  If in doubt discuss this with your plastic surgeon.

John J. Edney, MD · Answer

For most patients wearing the binder not only helps improve contouring but provides additional comfort.  Many patients prefer to wear the garment beyond the time recommended by the surgeon.  This however acquires that the garment fit properly.  It may be helpful for you to discuss obtaining different garment with your surgeon.  There are many types of impression garments on the market.  It is likely you will find a suitable replacement.  Good luck

Michael Law, MD · Answer

Not all compression garments are created equal. As with surgeons and surgery centers, you tend to get what you pay for. In my practice we provide the compression garments for abdominoplasty patients (there is no added fee for compression garments), and we have tried out almost every major company’s garments. We have been happiest with Marena’s compression garments as the fabric is very soft, elastic and comfortable yet durable. They are also the most aesthetically pleasing garments we have used. If modified with scissors the fabric does not ‘run’ or split. 
If the garments are not pleasant to wear then patients will inevitably discontinue their use earlier than would be ideal. Some practices ask patients to purchase their own garments (I’ve even heard of patients being sent to Wal-Mart for this), which is leaving an important part of the postop care regimen in inexperienced hands. If a practice advises you to purchase your own compression garment, they are probably more interested in controlling costs than your postoperative comfort.I am not dogmatic about compression garment use. If a patient states that they would prefer not to wear it, or would prefer to discontinue its use early, we allow the patient to do so. That being said, the vast majority of our patients wear their garments for the full four-week protocol, and some use them for longer than four weeks on their own volition. Garment fit and comfort is everything. If the fit is right and the patient is comfortable, then patients feel better, have a more pleasant recovery, experience less edema and more rapidly return to normal activity.

Consequences of Not Wearing the Binder After Tummy Tuck?

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