Tightness and Difficulty Standing Up Post-Tummy Tuck

I had an abdominoplasty and umbilical hernia repair 2 1/2 weeks ago (to repair the recti diastisis and umbilical hernia after having my twins four years ago), and I am getting really concerned that after a little more than two weeks, I still can't stand up straight. The tightness is still so intense, that I am still flexed at the hips slightly. My background is in fitness and dance, and I expected to bounce back more quickly because of my fitness level, however this has been much tougher than I expected. Is it normal at this point to still not be able to stand up fully straight, and feel such intense tightness at the incision site?

Doctor Answers 58

Don't be alarmed, this is not unusual after an abdominoplasty

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I do a lot of "mommy makeovers," and I tell my patients that the abdominoplasty part is the toughest! After having quads, your abdominal wall was way over stretched, and you lived like that for four years. Now it is very tight and you are not used to the feeling.

Start straightening up slowly (you might find that the abdominal wall feels tightest in the morning and it gets better as you move around), do not push yourself. Allow your body to heal. I do not allow my patients to do any strenuous activity up to 6-8 weeks postop. Only then can they start doing sit ups or push ups.

You waited four years to have this done, give your body time to heal. It might take up to six months or longer before you get back to "normal."

Best regards.

Sounds normal

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It is not unusual to have tightness and difficulty standing up after a tummy tuck. You should ask yourself if things are getting better.

Is it more easy to stand up straight today, than it was a week ago? Does it feel less uncomfortable than it did a week ago? If the answer to these question is "yes," then you should expect that things will continue to improve and you will feel better soon.

If the answer is "no," then I would check with your plastic surgeon.

Hope you feel better soon.

Daniel Sherick, MD
Ann Arbor Plastic Surgeon
4.5 out of 5 stars 14 reviews

It's not unusual to still feel tightness, but you should straighten up by this point.

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There are essentially 2 areas of tightness after a tummy tuck. Most commonly, women can feel tightness over the length of the abdominal wall from the upper abdomen to the pubic region. This is normal because of the internal stitching that tightens and flattens the abdominal wall. This sensation can last for weeks and months, but you should still straighten your back and walk erect by one week after surgery (the strain on your lower back can result in a great deal of lower back pain). The other area of tightness is at the skin closure across the lower abdomen. At the time of surgery, plastic surgeons generally flex the patient at the hips on the OR table in order to maximize the amount of loose skin that can be safely removed. Protecting that skin closure by walking hunched over for about a week is adequate, but at this point you should be able to straighten up safely. Even with your background in fitness and dance, this is a major operation affecting your core muscles and your body will need time to heal. Don't be discouraged. I am sure your surgeon would be happy to see you if you have any concerns and give you reassurance that you are progressing well.

Behzad Parva, MD
Washington DC Plastic Surgeon

Stay calm and work toward standing straight soon

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The more muscle laxity you start with, the more tightening you require to get a flat tight abdomen. Some surgeons take a bit more skin out and this can lock a patient in to a bent position longer than necessary. Anxiety will also cause you to feel tighter so try to relax and take some warm showers and gently work to get to a full standing position. It may hurt a little, but it won't hurt your result at all.

Tight feeling after tummy tuck is common

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All patients after tummy tuck will experience a degree of tightness which can last for several week after the procedure. Most, however, stand up right away and we encourage walking at home the day after and discourage any bed rest. The tightness may be caused by muscle stiffness, or tightness in the skin as well. Also, tightness and heaviness can be caused by a fluid collection called a seroma.

After two weeks, you may want to continue to wear an abdominal binder or transition to a Spanx or similar garment. They make one called the "Higher Power" which our patients like. If your incision is healing well you should try to stand up confidently and take short walks.

As with any muscle pull or strain the abdminal muscle will begin to relax, and as the skin heals and swelling resolves the skin will relax as well. The process will take longer than you hoped it will. However, with time you should do well. After six weeks try yoga.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 43 reviews

You should get better day by day.

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SheriBrock, Usually after abdominoplasty it takes about 1 to 2 weeks before you can stand up straight. So, you soon should be getting better. I have found that some patients are afraid to stand up straight, so they really have to push themselves to do it. At this point, you are not going to hurt yourself by standing up. Make sure you follow-up closely with your surgeon to make sure there are not any other issues. Good luck. David Shafer, MD New York City

Not unusual after tummy tuck

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Hi there-

While most patients would be further along in their recovery than you seem to be at this point in time, I would not by any means want you to think that what you are experiencing is unusual or necessarily indicative of a postoperative complication.

Muscular plication as is performed in most types of tummy tucks, causes significant discomfort, tightness, and cramping in many patients and this can last several weeks. Most patients are able to cautiously stand upright after one week or so, but it is not uncommon for this to take a bit longer.

I really don't think you have a problem, but the best thing to do is to visit your surgeon- he or she will know, based on the details of the technique and your exam, whether you are experiencing a problem or just the anticipated postop discomfort.

Congratulations on your new shape!

Give it a full 8 weeks

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Tightening of a diastasis and an umbilical hernia repair at the same time as abdominoplasty undoubtedly will lead to more tightness and inability to fully stretch. Unfortunately, being fit and having a dance background does not mean you will heal more quickly.

Many general surgeons warn their patients who are having hernia repairs to allow 2 months for healing. I would guess you also fall in this category.

Most of our abdominoplasty patients can stretch pretty well by a month after surgery, but we ask them to wait a full 6 weeks before returning to heavy exercise and 8 weeks if they do heavy lifting or do serious abdominal exercises.

It sounds ike your recovery is going well, but your expectations are ahead of schedule. Have a discussion with your doctor, hang in there and you will reap the benefits.

Francisco Canales, MD
Santa Rosa Plastic Surgeon
5.0 out of 5 stars 35 reviews

When to stand straight after a tummy tuck

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As you can see from the differing answers, every surgeon has their own opinion on what is "right" as far as when you should be able to stand straight. In my mind, the goal of the operation is to restore a tight / flat abdomen that will last you the rest of your life (as long as your weight is stable and you don't have future pregnancies). As such, I'm fairly aggressive in how much skin I remove, and I request that my patients say fully bent over for the first week, and then allow them to start standing straighter over the next week. From week 2 to 4 they have noticeable "bad" posture (slouching), and are standing fairly straight after a month. When you really look closely (side view before and after photos) at how straight they are standing, it takes about 6 months to stand at military attention (shoulders back and straight back). If you want to stand straight right after surgery, your surgeon can take out less skin, but then your result will become lax fairly soon after that.

A simple way to think about the procedure is to consider a bow and arrow. Your back (spine) is the wooden part of the bow, and your stomach skin is the string. As you straighten the bow (stand straight), the string (your stomach) becomes taught. More aggressive tummy tucks yield better results, so be happy and not so anxious.

Fit patients often have the toughest tummy tuck recovery

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As a fitness instructor, you have the most toned muscles. The larger the muscle and the more toned the muscle, the less lax it will be when it is pulled and tightened.

Although 2 and a half weeks is longer than most, it is not unheard of for fit people like yourself to take longer than the weaker patient. Relax- it will get better!

Robert M. Freund, MD
New York Plastic Surgeon
4.8 out of 5 stars 34 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.