Is tummy tuck very much painful? How many days major pain will be there after post op? Considering to do it in Pune (Photo)

Hello and thank you for your question.

Based on your photos, you appear to be a great candidate for a tummy tuck with liposuction. This can be done through a low and short incision, all completely below the bikini line. The belly button can be designed to look natural with minimal scarring on the exterior. Your muscles can also be plicated resulting in a flatter and firmer abdominal contour and profile.

Pain and discomfort are usually the most pronounced during the first week, and continue to subside as each week passes by. I typically recommend for patients to take 2 weeks off for recovery.

I would recommend to obtain an in person consultation with a Board-Certified Plastic Surgeon to further discuss your options and expectations.

I hope this helps.
Best, Dr. Karanetz

Dr. Irena Karanetz
Fellowship-Trained
Board Certified Plastic Surgeon

Thank you for your question. I can't comment on pain medications administered in India, and in any case the exact pain regimen would likely vary depending on the surgeon. In my own practice I use a combination of a muscle block with a long-acting local anesthetic, plus different medications so each patient can customize their treatment. The most common combination is acetaminophen, celecoxib, and hydromorphone, but other medications can be helpful such as muscle relaxants or drugs that specifically target pain due to nerve irritation. As for your question about pain after tummy tuck surgery, this is unique to each patient. Some find the pain to be very minimal and hardly use any medications, and others will be more sore for the first week or so. The surgeon(s) you are consulting will be able to discuss their pain control regimen and what you should expect after surgery.

hello,
Thank you for your question. You should expect to have post op pain for the first week following surgery. This can be greatly managed with the use of an Exparel block (given at the time of surgery) which will numb the area for up to 3 days. In my practice, we also prescribe narcotics for pain . Since they both work in different ways, you can do both at the same time. Lastly, most patients will take a short course of steroids which will help with the swelling, and likewise reduce pain.

Once you have your drains removed and take a shower at one week, you should feel almost like yourself! However, patients do continue to take motrin for the remaining 2-3 weeks for any discomfort they still have. With time, it all heals, and your pain should go away completely.

cheers,
Ricardo L Rodriguez MD
Board Certified Plastic Surgeon
Baltimore, Maryland

Dear Vivid509576,
pain levels can be significantly reduced with proper preoperative and postoperative planning. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Thank you for your question and pictures. The pain varies a lot from patient to patient, in my practice, we manage the pain with pills for 7-10 days and offer patients a pain pump. Thankfully it's usually bearable and Doctors follow up closely with their patients to adjust the dose if necessary.

I do suggest losing weight before surgery, that will ensure getting better results and safer surgery.

If you're willing to travel, Surgeons in the Dominican Republic have experience and very high standard of excellence when it comes to plastic surgery. I'm positive you can get what you're looking for.

Thank you for your query! You seem to have a significant diastasis of your muscles, and a good repair is required. Pain relief in the postoperative period is essential. There are several methods thay I use in my practice. For most individuals I use a TAP block with a long acting local anaesthetic agent, which I administer before closure of the skin. Another method, for people with a low pain threshold, is an epidural catheter local anaesthetic infusion that can be used for the first day or two. The skin around the incision can also be infiltrated with a long acting anaesthetic agent for additional pain relief. Post operatively a PCA pump can be used as also multiple other medications that are available. Please discuss the methods of pain relief that your surgeon employs. I am sure he/she can keep you comfortable. All the best!

I’m looking at your abdomen you need a diastasis repair in order to flatten out your abdomen and prevent the projection or “sticking out.” This is the corset part of the abdominoplasty, where we tighten the muscles, this can cause moderate discomfort. However, if you use Exparel (which is liposomal, bupivacaine) during the surgery, you should have 72 hours of minimal discomfort. We do use a muscle relaxer, which helps with the discomfort/ muscle spasm after surgery. I’ve got a.

A tummy tuck is surgery and involves the whole anterior abdomen. Yes, you will have pain, but you will also have pain medication. If you are too worried, then do not have surgery.

Patients typically rely on narcotic based pain medication for the first 5-7 days after surgery for pain management. If the Exparel injection is used during surgery the pain seems to be more manageable. By two weeks post op patients usually no longer require pain medication or if it is still needed, over the counter medications suffice.

While your question was focused, primarily on recovery from the procedure, I would like to take a moment and talk about your candidacy for the procedure in the first place.
Can make an assessment of someone’s abdomen for aesthetic purposes. We generally look at four different tissue variables. If somebody doesn’t like the way there abdomen looks it is always because of one or more of four different tissue variables. Understanding the contribution of each of these tissue variables is the key to making an accurate assessment, and this will intern create a clear understanding. What the right procedure is, and what each procedure can, and cannot accomplish..
The four tissue variables that determine what they have the bed looks like or as follows. 1) Abdominal skin laxity typically due to previous pregnancies or significant weight loss.2) Excess subcutaneous fat. 3) muscle separation from previous pregnancies a.k.a. Diastasis rectii. 4) excess visceral or intra-abdominal fat.
In your case, your picture shows moderate skin, laxity, thin layers of subcutaneous, fat, significant muscle separation, and most likely significant excess visceral fat.
Excess visceral, fat and muscle separation both cause bulging of the abdominal wall. The appearance can sometimes look fairly similar, and sometimes both variables are contributing.
A full tummy tuck primarily treats, abdominal skin, laxity, and muscle separation. No operation that can reduce excess visceral fat. It’s very important to understand if visceral fat is contributing in any significant way because of visceral fat when present will significantly lower someone’s potential for having a quality outcome. In other words, individuals who have significant amounts of excess visceral, fat are not good candidate for a tummy tuck.
Your picture shows what to me looks like excessive visceral fat, combined with muscle separation.
It’s very important to differentiate how much of the bulging is due to muscle seperation versus visceral fat because this will determine if you’re going to get a flat abdomen or not from a full tummy tuck.
The easiest way to differentiate between visceral, fat and muscle separation is to simply lay on your back and have someone take pictures of your body and see if your abdomen goes flat. If the problem is purely related to muscle separation, then your abdomen should go completely flat. On the other hand, if the problem is related to excess visceral fat, then your abdomen will still bulge while laying on your back.
Another way to determine if visceral fat is creating a significant issue is to see how much pressure it takes to press your abdomen flat. A flat abdomen should be when your abdominal wall is lined up with a potential straight line between your pubic bone and your sternum.
If you can, press your abdomen flat, so that your abdominal wall lines up perfectly with your sternum and pubic bone, and you can do that using your nondominant hand then visceral fat may not be as much of an issue. If it takes a great deal of pressure and you feel like your abdomen is excessively full when pressing your abdomen flat and visceral fat is most likely a significant component. Some people describe the sensation as being difficult to take a deep breath when their abdomen is pressed in all the way.
Individuals who have access, visceral fat, can potentially be disappointed with the outcome of a tummy tuck. You can leave them feeling like their abdomen is chronically tight and potentially uncomfortable. Visceral fat can only be reduced through weight loss. The percentage of visceral fat is determined genetically. Individuals may have a genetically predisposed fat distribution, leaving them with excess visceral fat even when they’re not significantly obese. Individuals who have excess visceral fat usually have had a bulging abdomen before having pregnancy related changes.
Understanding your candidacy for a full tummy tuck is very important because it tells you if the operation is going to give you quality results or not.
There’s no point in even considering having the operation if you’re not a good candidate for it in the first place.
While most plastic surgeons should be able to easily differentiate between the four tissue variables, especially assessing if somebody has a visceral fat problem before prescribing operations this gets missed all the time.
I suggest having multiple in person, consultations with local board-certified plastic surgeons in your community. During each consultation, ask each provider to differentiate between the tissue variables, explicitly, asking them to assess how much visceral fat is contributing and how this is going to impact the outcome of having a tummy tuck.
Based on your picture, I question if you’re ready for a tummy tuck at this point. It looks to me like visceral fat is a significan component in this may leave you with a sub, optimal, loud, unless you get your visceral fat, reduced with weight loss before considering surgery. It’s not possible to give you an accurate assessment without an examination, so I am making certain assumptions. I’m doing so because the potential consequence of having this operation on an individual who is not an ideal candidate is significant enough that I believe a warning is due.
You may in fact be a far better candidate for a tummy tuck than I believe, and other plastic surgeons may have very different opinions.
The recovery from a full tummy tuck, including muscle tightening is intense. It is probably the most difficult recovery of any plastic surgery operation We perform in regards to cosmetic surgery.
Most patients will need around the clock, pain control with narcotic pain medication and be more or less immobilized for the first three days. On the third day patients generally get a bit of relief and begin recognizing that from now on each day will become a little easier. by the fifth day patients should be able to get out of bed on their own and potentially go to the bathroom without assistance. The pain will become more tolerable, and patients can usually use narcotic pain medication, intermittently, sometimes getting by with ibuprofen alone. most plastic surgeons will place surgical drains with this procedure. Around the same time, the drains become more irritating and uncomfortable. by the seventh or eighth day, the pain becomes easier day by day and at this time patient should only be using narcotic pain medication intermittently. At the same time as the drains become more irritating, and patients are generally wishing the drains can be removed as soon as possible. From my experience drains typically stay in for 9 to 11 days, but this can vary substantially from patient to patient and provider to provider.
The day that the drains are removed is typically a nice relief for the patient, and at that point, they can usually get back to lower impact daily activities, including possibly driving a car, walking stairs, or going out, and potentially resuming low impact work. Most patients need to take two weeks off work and should not be expected to have physical obligations regarding home or work during that time. Patient should expect to have someone by their side helping them around the clock for the first 3 to 5 days.
Things we take for granted like going to the bathroom can be a major challenge the first few days after the procedure.
The most difficult time is the first three days after surgery. The recovery continues weeks to months after, but the most difficult part is always the first three days.
With sufficient pain medication the pain after this procedure can be controlled. Excessive use of strong narcotic pain medication can make people severely constipated and this is a common problem after this operation.
I think in your case, the most important variable is having a clear understanding of your candidacy for the procedure, which is not clear based on your post.
Before considering scheduling surgery, you need to make Absolutely sure you have a clear understanding of your candidacy for the operation because this has a big impact on if you should have the procedure in the first place.
Best,
Mats Hagstrom, MD