Can You Wear a Binder on Top of Spanx After a Tummy Tuck? (photo)

Question

I'm 5 weeks post op with significant swelling. A week ago I was fine,but have recently returned to work where I'm on my feet for 8hrs. I found since I returned to work and switched to spanx, my tummy had gotten bigger. I don't have reason to think I've compromised the muscle repair. The last couple days I switched back to my binder and its slowly getting better, but still not quite like before. Could it help wearing the binder over the spanx for maximum compression?

Tom J. Pousti, MD · Answer

Congratulations on having undergone the tummy tuck procedure. The use of an abdominal wall binder over a “spanks” garment should not be a problem.

	In regards to abdominal wall “swelling”, it is best to be seen in person ( by your plastic surgeon) for precise diagnosis and treatment.
	 

	Generally speaking, abdominal wall "swelling" after tummy tuck may be related to:
	1. Swelling in the soft tissues.  This may take several months to resolve and may worsen with increased activity  or at the end of the day.   Patience  is required to allow for resolution of the swelling. The swelling occurs because of the interruption of venous and lymphatic channels that occurs during the tummy tuck operation.
	2. Fluid accumulation in the space between the skin and the abdominal wall muscle.  this may consist of blood ( hematoma)  or serum (seroma).  This fluid accumulation can generally be diagnosed by physical examination ( occasionally ultrasound  may be helpful).  Treatment consists of aspiration;  several episodes of aspiration may be necessary. 
	3. Separation of the abdominal wall muscle repair may lead to a swelling/bulge appearance. This may be diagnosed on physical examination  with your surgeon examining you in different bodily positions. One of the steps of a tummy tuck procedure involves reapproximation (plication)  of the rectus muscles.  These muscles have spread apart during pregnancy and/or weight gain. Bringing them together again in the midline helps to “tighten” the abdominal wall as well as to narrow the waistline.
	4. Residual adipose tissue may be confused for swelling. Again this is most easily diagnosed by physical examination. Additional liposuction surgery maybe necessary to improve the results of surgery.
	Generally, it takes many months for swelling to resolve after tummy tuck surgery and it may take up to one year  (or greater)  a complete skin redraping  to occur.

	I hope this helps.

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!

Vincent N. Zubowicz, MD · Answer

There's no danger to wearing a binder over another compressive garment but I doubt it will do any good.

Pablo Prichard, MD · Answer

Dear chrmik,

	Thank you for your post. Yes, you can absolutely wear your binder outside your spanx.  In fact, I recommend to my patients that they wear a spandex like shirt on their skin with the binder on top from the get go.  As far as the swelling is concerned, you should be assessed by your surgeon to see if you have free fluid, or just swelling fluid.  If free fluid, then this should be drained.

	Best Wishes,

	Pablo Prichard, MD

Can You Wear a Binder on Top of Spanx After a Tummy Tuck? (photo)

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Can You Wear a Binder on Top of Spanx After a Tummy Tuck? (photo)

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