Primary Reason for Hospital Stay After a Tummy Tuck?

Most patients across the country go home after tummy tuck surgery. I do most of my surgery out of a hospital setting where my patients have the option to stay or go home. Over 90% of my patients choose to stay overnight. Granted it is a special program which only costs an additional $300 but they find real value in it. Why? It's nice not to have to home directly after the surgery and anesthetic. They can be treated for any pain or nausea. I think the biggest benefit is the fact that they can continue to receive IV fluids, which not only decreases nausea but also keeps you well hydrated and reduces blood clots (DVT). Also compression stockings (SCDs) are continued throughout the night which also decreases DVT. The nurses also help you deal with the drains and getting in and out of bed. In summary, while hospital stays after tummy tuck are not necessary, there is great value in using them if they are readily available.

In the United States, most tummy tucks are done on an outpatient basis with patients going home the day of surgery. The two main reasons why a patient might need admission are 1) excessive post-operative pain and 2)inadquate oral intake because of nausea/vomiting.  When patients are admitted after surgey these two problems can be better treated in that patients can be given pain medicine and fluids by an iv. Currently, anesthesia providers are experts at preventing and treating nausea and vomiting.  Also, pain is usually well controlled with oral pain meds.  Some patients will also benefit from the use of pain pumps.   Fortunately, it is extremely rare for patients to require admission after a tummy tuck. 

we did this for years and have stopped this in the last ten years.   it is not necessary.. pain can be controlled with proper care.  it is safe and reasonable to go home

In my practice whether an abdominoplasty patient stays overnight depends on if there are combined procedures that may require further monitoring of hydration status, blood pressure and/or pain control. During the consultation the determination is made if overnight stay would be necessary.  Different surgeons will have their own criteria for overnight admission.  You will have to determine your comfort level with the surgeon of your choosing reasons "To or Not To" admit you overnight.

Dr. ES

Tummy tuck is a significant amount of surgery.  Often is may be accompanied with liposuction and sometimes breast surgery.  If it is a long case 6 or more hours i offer a 23 hour stay for comfort and monitoring.  The patients health plays a significant decision on every aspect of this type case.  If you are in good health and a 4 or 5 hour case and good support at home, then it sounds reasonable.

I always use a pain pump for comfort.

If your overall medical status is such that you are not a safe and appropriate candidate for outpatient tummy tuck surgery, then by all means, hospital care is reasonable. That being said, I operate in my own fully-accredited in-office surgical facility (and have done so for 24 years), and do dozens of outpatient tummy tucks each and every year. Safely, and comfortably for the patient, as well as less expensive for better care.

How can my office surgical facility be better than the hospital? Well, first of all, my office does not expose you to sick patients or nasty bacteria--only healthy, elective surgery patients in my operating rooms! Second, our anesthesia is better than the (safe, routine, cheap) inhalation anesthetic you receive at the hospital. For more information on this, read my article (click the About tab on my profile page) on this site titled: "Is TIVA (Total IV Anesthesia) or General Anesthesia Safer?"

Assuming the plastic surgeon you choose to perform your surgery operates at an accredited surgical facility (either his or her own, a stand-alone outpatient facility, or a hospital-affiliated surgicenter), you will get identical monitoring as you would at a hospital, including availability of "crash cart" medications, defibrillator, malignant hyperthermia medications, etc. What you won't have is the higher cost, increased overhead (to pay for all the patients who receive hospital or ER care without having insurance), and things you don't need like MRI and CT scanners, angiography suites, and lots of doctors of specialties not involved in your care.

Also, any outpatient who goes home has the same prescription pain medications as the hospital, just not a nurse to inject them into your bottom! In the recovery room at an outpatient facility you will still receive the same intravenous pain medications used at the hospital, and perhaps even more thoughtful ways your surgeon has learned to control incisional pain, muscle spasm, nausea, and swelling/inflammation.

So if you are the typical young, healthy patient that usually asks for tummy tuck surgery, you have no reason to go to a hospital (unless that is the only place your surgeon operates, or if the anesthesia practices have such a high PONV--post-operative nausea and vomiting--rate that patients that could have gone home with better anesthesia are "green and barfing" and must stay to get that under control!)

See several ABPS-certified plastic surgeons who have busy enough practices that they operate their own AAAASF-accredited surgical facility; you will get not only safe and better anesthesia, but likely a more experienced surgeon and superior cosmetic result. Best wishes!

Hello,

There are a handful of reasons why some patients stay overnight after a tummy tuck including:

1) Patient/surgeon preference

2) Treatment/prevention of nausea/vomiting

3) IV pain medication

4) Expert care (no one at home to take care of patient)

5) Fluid management (IV fluids)

 

All the best,

Dr Repta

The reason for a hospital stay after a tummy tuck may have to do with your overall medical condition, ability to control pain and the facilities and recovery area available. Many healthy patients can have a tummy tuck and go home the same day if the surgical team (including the anesthesiologist) are able to provide an outpatient experience for the patient. You should discuss the reasons more with your surgeon.

Thank you for the question.

The vast majority of my patients who undergo tummy tuck surgery recover at home. It is the unusual patient,  with some type of medical concern,  who I suggest stay in a facility for overnight observation/care. Most patients however feel much more comfortable at home under the care of their family, friends, and/ or nursing care.

I hope this helps.

Interesting question. This shows how the "standard of care' over the last thirty years has changed. In my PS training from 1978 to 1980, we would NEVER think to do a TT as an out patient. Usually, they were 2 days of in patient care. Starting practice in late 1980, I followed that dictum of in patient Only TTs. The costs were reasonable and the patient's mind set was to receive personalized care. I would say starting in the very late '80's or early '90's, there was a beginning change in perception of the need of hospitalization for TT's. This was due to a few reasons. The costs that the hospitals were charging raised significantly, well over 30 to 40%. Non PSs, the gray zone docs, were starting to do in office general anesthesia, to save the patients $'s. A few PSs started office surgery with very good results. I, personally, was NOT one of them. I believed at that time the best care was in hospital no matter the costs. I visited many colleagues office surgery suites over the next few years, in the mid '90's, and much to my surprise the attitudes of the patients were changing as to a more private setting was better than an in hospital stay. One thing of note were the boarded PSs office surgery suites in general were much better equipped than the non boarded PSs. In late '90's to early 2000, I built an office surgery suite, copying my hospital operating room. The best equipment, supplies, and medications. In fact my liposuction unit was much better than the hospitals. I did fine the costs savings to the patient was significant. But I also found "patient selection" was a HUGE KEY. If the patient had any medical issues or was over weight I deferred to in hospital setting based upon medical safety for the patient. So all in all, office TT surgery can/is done regularly, but I feel a "state of the art" OR is needed and excellent patient selection is paramount. Hope this helped.