Am I Supposed to Wear my Binder over my Incision or Just a Little Bit Above It?

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.  Your binder should be worn snug to cover the incision, be worn low on the hips, and adequately give compression to areas with the swelling.  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!

The garment should be covering the incision at all times, so if it slips off, then simply pull it over the incision  again by holding on to the sides of the garment. Swelling can be quite prominent after surgery and can take a few months to fully subside. Wearing the garment and following your surgeon's post-care instructions will help with the swelling. Best of luck. 

I recommend for my patients to wear the binder over their incision. If liposuction is performed with the tummy tuck, then my patients wear a compression girdle which is different. Every plastic surgeon has their own recommendations on what type of garment they use and how they want the patient to wear it. Check with your plastic surgeon. I would also follow up with your doctor about the swelling to make sure that you do not have a seroma in the midsection.