Out of Town Tummy Tuck: How Many Follow-up Appointments?

I do surgery for out-of-town patients regularly, but only when follow-up is possible according to my recommendations. I see all tummy tuck patients the next morning to check for bleeding, suture line intactness, and circulation to the umbilicus and lower abdominal flap. If something needs to be done, right away is always better than a week later!

Most of my tummy tuck patients (especially those with liposuction as well) will have 1 or 2 drains. I leave them in for 1 week, or until drainage is less than an ounce per drain per day. Since the only removable sutures are 6 tiny ones around the belly button, they are taken out at 1 week, usually with drain removal. I like to check my patient a few days after the final drain is removed to make sure there is no accumulation of seroma or blood; if this is missed, a pseudobursa can form, requiring re-operation.

After that, patient follow-up can be via Skype, Google+ video chat, or digital photo and email or phone. If a patient is local, massage therapy and ultrasound treatments (6 included with no charge) are started as the patient's schedule permits. Late(r) rechecks are at 3-6 months, and 6-12 months, or as needed.

My patient care coordinator has all out-of-town patients scheduled in advance for anticipated rechecks, and I am always happy to add rechecks over the weekend or evenings if job or other requirements need a special schedule.

Please note this is different from surgical tourism, where out-of-country surgery is paid-for, done, and the patient returns home, hoping there is no complication, bleeding, infection, wound breakdown, or need for any follow-up. Otherwise, the hapless patient ends up asking a local plastic surgeon to fix someone else's problems, when the patient should have been close enough to the operating surgeon for proper care and post-op visits (which are part of the surgical fee paid)!

My best advice would be for you to ask your surgeon's patient coordinator or nurse to set up a detailed recheck schedule as much in advance as possible. If this seems too difficult to manage, consider that they may not be comfortable or used to dealing with patients who come from a distance. Then, find an ABPS-certified plastic surgeon who IS! Best wishes! Dr. Tholen

     If you are 2.5 hours drive away, I would recommend staying at the surgeon's location at least for the first day or so (more days is always better).   Then you will likely need to return at least one more time for drain removal and assessment for fluid collections.  Most doctors would want to see you more than that, but patients from a distance usually only return if there is a problem.

I regularly have patients that fly into see us or that drive many hours away.  It certainly can be done.  I would recommend that you stay in town at least one night before returning home.  A lot of follow up questions can be answered using pictures that you email.  I always try to minimize the number of times that a patient traveling from distance has to come to the office.  You will have to return for your drain removals unless you have a local doctor who can collaborate with me.  Most importantly, you must have a plan to get back into town if there is a problem.   Good luck.

It's safer for you to be as close as possible to your surgeon. If your recovery is normal and you don't experience any complications, you may only need to see your surgeon 5-8 times in the first year after your surgery, with higher frequency in the days and weeks right after. If you have a complication, you'll need to see your surgeon several more times and it will be better and safer to be closer. Your surgeon is ideally the most suitable person to address any complications you experience. In addition, sitting for a long time right after surgery increases the risk of complications, so you'll need to stay at least overnight nearby.

We want all out of town patients to stay in our facility with overnight care with at least two nurses providing round the clock care, You will be seen before being released the next morning and again in about 3 days, unless you have concerns and will need be seen sooner, 

I like to see my patients a couple of days immediately after surgery to make sure everything is OK. I then see them weekly or as often as they need or want to be seen. The visits can be less frequent if everything is proceeding normally

Out of town patients should stay at least 3 days or so following the procedure. Immediate concerns such as pain, drain outputs, assistance with walking and getting around are of primary importance. By the end of the first week, patients are typically mobile and able to do most daily activities. Follow up visits are usually weekly for 2 weeks, then a return at 1 month. Of course, any complications (wound healing, seroma, etc.) may require more frequent visits. Using the internet may seem logical, but there are concerns with HIPAA and privacy. Also, a key component of your visit - the examination - is missing. There is no substitute for a hands-on exam.

A full tommy tuck is an involved procedure, especially when muscles need to be plicated. Our patients stay in our over-night facility for one night, and I recommend staying is the Savannah or Coastal Empire area for another 3-4 days, according to your age, speed of recovery, and the extent of the procedure. Many patients want and need a fair amount of liposuction of the sides and back as well. 

Once I know the patient is having a smooth recovery, she/he can return in one month and then every 3 months for a year, if the location makes such travel practical. Patients usually have questions for me as well regarding recovery, and that usually warrents a visit. Mainly, I just want to know the patient is safe and without complications following surgery.

Good luck with your procedure. Tummy tucks can be very gratifying.

I personnaly see my patients frequently after surgery.At 3 to 5 days post op , one week, one month, 3 monthes 6 monthes, and one year.

One of the biggest concerns after abdominoplasty is clots in the legs and pulmonary emboli. You should be aware of the symptoms and be able to get medical care expeditiously. The chances of having one decreases as the post op days go by. This why it is recomended you stay close to your physician for the first few days.

The number of follow-up appointments varies among physicians as well as with the individual patient. An uncomplicated postoperative course requires fewer visits versus one whereas a patient who has some underlying medical risks, difficulty in dealing with pain, personality issues or untoward postoperative occurrences would require more. Generally, I prefer the patient to remain in the immediate area for at least 48 - 72 hours and would minimize the subsequent visits initially such as weekly for the first 2 weeks then less frequently after that as dictated by progress.

I do see a lot of out of town patients and try to minimize their number of trips. Telephone calls, email, and digital photos can often help resolve issues or questions in the postoperative period - and save a long trip.