How long after a Tummy Tuck do you need to wear compression stockings?

Congratulations on your tummy tuck surgery! I'm sure your plastic surgeon's office would be happy to answer your question, and of course, they are responsible for your care and well-being, as is obvious from your having been supplied with compression stockings. But instead of giving you a random answer (read the other answers--they all differ, so I understand your and many patients' confusion) let's reason this out and give you the RIGHT answer. Let's first assume you are at no increased risk of blood clots, unlike women with Factor V Leiden, MTHFR gene mutation, or Factor 2 mutation. Patients with these have increased risk of blood clots, especially after tummy tuck surgery where the patient wears compression binders around their abdomen and has had sutures in the area where the leg blood vessels enter the abdomen. Even women on oral contraceptives have increased risk of blood clots, and many of our tummy tuck patients are taking BC pills. Women without these clotting disorders (thrombophilia), have a "standard" risk of about 1 in 1000 per year.So that's the WHY of compression stockings. The funny thing is, many women with Factor V Leiden ask questions about their increased risk of blood clots, but virtually no woman on oral contraceptives either knows or cares about their increased risks. Must be because FVL is rare and many people (and doctors) aren't versed about this, whereas we all know many many women on BC pills.So let's go into a bit more detail so you can understand not only why, but how long you should wear compression stockings. Let's start with a little more about the "rare."
Factor V Leiden is a genetically-inherited clotting disorder seen in
about 5-6% of US and European Caucasians who are heterozygous (one copy
of the abnormal gene), or 1 in 5000 (0.02%) of persons who are
homozygous (two copies of the abnormal gene, one from each parent).
People with one copy of this abnormal gene can form blood clots 4-8
times more commonly than the normal population, and people with two
copies of this gene are 80 times more likely to form a clot than the
general population.
Since the overall risk of developing clots is about 1 in 1000 per year,
heterozygous Factor V Leiden patients have increased risk ranging from 1
in 250 to 1 in 125. Homozygous FVL patients' risk increases to 1 in 12.
By way of comparison, healthy, normal women taking oral contraceptives
have a 3-4X increased risk of developing a blood clot compared to women not taking oral contraceptives. Women with FVL on oral contraceptives see their risks increase by 35X.Thus, as long as FVL patients are under the care of a hematologist or internal
medicine specialist who can consult with their plastic surgeon about
minimizing the 4-8X risk of clotting (which is nearly identical to
women taking oral contraceptives), elective cosmetic surgery is not only
possible, but just about as safe as operating on women who take oral
contraceptives (3-4X), which we do all the time (with "standard" precautions)!Part of those "standard precautions" are active pneumatic boots or leggings during surgery. These inflate and deflate several times per minute, actively pumping or moving the blood in your (immobile) legs during surgery. This can be considered comparable to taking a brisk walk while you are asleep on the operating table, reducing the risk of blood clots!But what happens after surgery? You go home (or maybe to an overnight facility or rarely, hospital) where you pretty much go to bed and take some pain pills and muscle relaxants. So even if you are safe in the operating room, clots can begin to form in the sluggish or pooled blood in your leg veins while you are relatively immobilized post-op. (This is one reason I don't like hospitals with bed side rails and nurse call buttons. At home you have to get up and go to the bathroom, get your meals, and move about the house. At the hospital, less so.)So compression stockings are designed to give those dilated, sluggish-flowing leg veins a bit of elastic support, boosting flow and decreasing the risk of clots forming in the first place. BTW, elastic compression stockings with tight bands at the top. or those that are rolled down a bit, form a nice tourniquet which can INCREASE the risk of clots. So wear them properly!But now that we know why, how can we properly answer "How long are they really needed?"The answer, of course, is intimately tied to how long your activities are less than usual, with you moving about in diminished lengths of time and frequency. Along with this is a related issue, which is how long your body remains actively clotting vessels in the operative site and how long your clotting factors remain on "Heightened Duty Status" rather than "Standard Operating Parameters--i.e., back to "normal" clotting rather than hyper-coagulable.This latter time is actually significantly longer than "24-48 hours" or "at least one week." Since every patient's healing, activity levels, and clotting abilities are different, I have summarize this length of time to return to "normal" risk of clotting as similar to the return to "normal activities."In other words, once you are up and moving around pretty much as you did before surgery (not exercising or doing sit-ups, mind you), but moving around in usual lengths and durations of activity, then the compression stockings are safe to remove. Prior to that time patients may want to exchange their white TED hose for more stylish nude or other-color compressions varieties, but the key is to leave them on until the risk of blood clots has passed. This is more like a couple of weeks, which may sound like overkill. However, as you probably know, blood clots can kill you, so this was not a trivial exercise in over-answering. Best wishes! Dr. Tholen

Congratulations on having undergone the tummy tuck surgery. Always best to run these type of postoperative care instruction questions by your plastic surgeon who knows your history and is ultimately responsible for your care. Best wishes for an outcome that you will be very pleased with.

It is my pleasure to answer your question. I recommend my patients to use compression stockings for 24-48 hours post op and walking for blood circulation.