Sleeping Upright Causing Severe Back Pain Post-Op

I had a mini tuck combined with a breast augmentation 5 days ago, and have been sleeping upright with legs elevated every night. I was told to sleep this way for at least the first 10 days, but now am experiencing some serious lower back and upper buttocks pain. I cannot bend over, and sitting hurts my butt. Seems like I cannot get comfortable in any position. I tried a heating pad today with little relief. Any suggestions?

Doctor Answers 4

Back pain after tummy tuck

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The Tummy tuck patient or abdominoplasty patient is asked to sleep in a flexed position to decrease stress on the abdominal incision. The skin is pulled down very tight and tension is reduced by bending the hips and not standing straight up. As your skin and muscles stretch after surgery, you can slowly resume a normal upright position one week after surgery. It is normal to have back pain because you are in a prolonged awkward position after surgery. Conservative measures to help the pain may be a heating pad, Tylenol. More severe back pain may require Valium or narcotics(ie Vicodin). Ask your doctor at your next visit.

Houston Plastic Surgeon
4.3 out of 5 stars 48 reviews

Position after tummy tuck

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While I do not require my patients to sleep upright following a breast augmentation I do ask them to maintain a partially flexed waist position after a tummy tuck.  You can accomplish this in any number of ways.  Experiment with different combinations of legs up vs sleeing upright.  Obviously you are currently placing too much of your weight on your lower back and buttocks.  Talk it over with your plastic surgeon as the position requirements at 5 days or so should be ok to be relaxed.

All the best,

Dr Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 reviews

Breast augmentation/tummy Tuck recovery

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Unfortunately, what you are experiencing is very common after these procedures. Communicate your discomfort with your surgeon; hopefully, you will be able to be able to get out of the “upright” position soon and move into a more reclined position. This may help alleviate some of the discomfort you're having in the lower back and buttocks areas.

You may also find that walking and relieving pressure off of the back and buttocks will help. Massage may be useful. Hopefully, in the near future, your surgeon will okay sleeping on the side (for example flexed  in the fetal position).

Regardless, while you are recovering, make sure you are shifting frequently to relieve pressure off of any given area. As I am sure you have found out, rather severe emotional swings are common after the procedure you have undergone. Hopefully by keeping in mind the positive end results  you will be able to stay as positive as possible. Best wishes.


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Sleeping upright is certainly an advantage in the early post-op breast augmentation patient.  What's more important is that you are in a flexed (bent) position to take strain off your muscle repair (which I assume you had as part of your mini-tummy tuck.)  At this point I think you're likely OK lying flat with something under your knees to keep your hips a bit bent but I would check with your doctor first as I don't know the specifics of your surgery.

Scott E. Newman, MD, FACS
New York Plastic Surgeon
4.9 out of 5 stars 42 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.