Is It Possible to Diminish Tummy Tuck Results by Pushing to Hard to Have a BM After?

Most patients who have abdominoplasties require some narcotic pain meds for a day or so.  A side effect is constipation and difficult bowel movements afflict many patients.  Although uncomfortable, they will not jeopardize the surgery.

On rare occasion it is possible to disrupt the muscle repair. For this reason, it is wise to consider the use of stool softeners during the post-operative period when narcotic analgesics can make your more prone to constipation.

Chances are that you will not create enough force or pressure from a bowel movement to cause any harm to your tummy tuck.  That being said, I would definitely recommend avoiding heavy lifting after surgery for at least three weeks to allow the site to heal. 

Most plastic surgeons use very strong sutures and so the risk for them breaking is very low.  What can happen is that your own tissue tears and, while the sutures actually remain intact, the tissue separates.  This can occur if you place too much force on your abdominal wall tissues during the early healing period.

Most surgeons use very strong sutures to create the plication during an abdominoplasty or tummy tuck. Although unlikely, it is possible to have the sutures "rip" from the tissues. This is the reason most surgeons advocate that patients not lift heavy objects (more than 15 lbs) for six weeks, much like in a hernia repair. Drink plenty of fluids, stool softeners, and walk as much as possible. The garment or abdominal binder will provide extra protection. Your surgeon would be able to tell by examining you if any stitches have ripped.

You want to avoid heavy lifting or strenuous activity.  This includes bearing down or pushing hard for a bowel movement.  It is common to experience a slowing of your bowels or even constipation after surgery.  This is due to the medications from your anesthesia and your pain meds. To avoid straining (which could damage your tummy tuck), most plastic surgeons can recommend some over the counter stool softeners such as colace. Talk to your plastic surgeon to learn what she/he recommends.

Having a bowel movement jsut after a tummy tuck may be difficult. You may want to consider stool softeners to make it a bit easier.

Regarding: "Is It Possible to Diminish Tummy Tuck Results by Pushing to Hard to Have a BM After?
I was wondering if it was possible to diminish the results of a tummy tuck by pushing to hard to have a BM? I was told by my ps to either push against my stomach when pushing or use a pillow. How would I know if I ripped a stitch?"

The ONLY way a tummy can be flattened after one or more babies is by bringing the separated and stretched tummy muscles (rectus abdominis) together (this is referred to as "muscle repair"). There is no one way to put the muscles together and different surgeons use different techniques and different stitches. Frankly, some repairs are better and more apt to resist separation than others. As important, some people have thin and poor tissues which do not hold stitches well, making them more apt to suffer repair failure. Obviously, a poor repair technique done in a woman with thinned tissues is much more apt to fail.

In the early post-operative period the repair is only as good as the ability of the stitches to hold the straining muscles together. As time goes on, scar tissue is put down which literally bonds the tummy skin to the underlying muscles making any muscle strain spread across a wider area of support than the initial stitches. For this reason, we ask women NOT to engage in strenuous abdominal activities for 4 weeks or so to allow the scarring to form and brace the repair.

So, HOW careful should you be? Should you abstain from going to the bathroom? from sneezing or coughing? Obviously this is preposterous and reaches full blown paranoia.

How this answer your question?

None of us were there during your surgery and assessed the thickness of your tissues nor do we know how the muscle repair was done. Therefore, I would refer you to your surgeon who was there and knows both.

In MY opinion, in MY patients,I trust my muscle repair and  I have never had to caution women about straining with bowl movement. 

Good luck.

Dr. Peter Aldea

It will be difficult to "rip" the sutures; however, too much intrabdominal pressure could cause the sutures to cause a tear in your tissues.  So I would recommend holding a pillow on your tummy in especially difficult BM!  Try stool softeners.