An abdominoplasty causes many effects on the body, especially in relation to bowel motility. The surgery itself can cause decreased motility due to surgical manipulation in and around the abdominal contents causing ileus, or sleepy bowels.The midline of the abdomen is often tightened with corseting stitches, an this can cause pain inhibition when straining at stool. The intraoperative drugs and narcotic medicines after surgery will have a significant effect on the bowel motility. Patients can also become dehydrated during surgery, causing a harder stool.
The answer to the question is to be proactive and begin a bowel regimen preop. I tell my patients to pre-hydrate and take an enema the night before surgery. Over the counter stool softeners, propellants, and a high fiber diet can be started preop as well. With proper preparation, your experience will be smooth sailing.