I've done a lot of research on Tummy Tuck and about the doctor I have choosen to do the procedure. I'm feeling great and excited about it. I only have one concern; my surgeon says he does not use binders after surgery. He feels they don't do much and that they are over used by other doctors. What exactly is the purpose of a binder after a Tummy Tuck and is what he says true, that they don't really do anything for the Tummy Tuck results as far as for better appearance or comfort?
Purpose of Binder After Tummy Tuck?
Doctor Answers 27
Binders / Compression Garments after Tummy Tuck
Most tummy tuck patients feel better and have an easier time changing positions (laying to sitting, sitting to standing, etc) and ambulating with the feeling of abdominal support that a compression garment provides. My preference is to start patients out with a three-panel, Velcro-fastened abdominal binder that is easily applied and removed. This allows easy access to surgical dressings and easy inspection of the abdominal skin in the early postoperative period.
Patients are placed in a form-fitting but comfortable compression garment at their postop day two appointment after the On-Q catheters (local anesthetic infusion system for postop pain control) are removed. The garment should cover the entire trunk, and ideally should incorporate breast coverage to keep the garment from slipping downward. It should have an open crotch (panties are worn over the garment) so that it does not need to be removed for every trip to the bathroom. Most patients seem to prefer a garment that includes the upper thigh (rather than a 1-piece swimsuit-style coverage at the hips) so that it does not ‘pinch’ in the hip or groin area, although we give patients that choice.
Compression also helps to control the subcutaneous edema that is a normal part of abdominoplasty recovery. The process of elevating the abdominoplasty flap (as well as liposuction of the central subcutaneous portion of the flap which is required in most patients) temporarily impairs normal lymphatic drainage. The lymphatic system is responsible for directing fluid that leaks out at the capillary level from the vascular system back to the venous system. Because lymphatic drainage is impaired, it is quite common for subcutaneous edema (swelling) to develop in the flap – which persists until the remaining lymphatic channels recover and new ones develop. Some patients have very little edema postop, and can discontinue the use of their compression garment earlier.
Often we have patients wear one, two or three panels of the initial binder over their compression garment to provide added comfort and control of edema. The degree and duration of subcutaneous swelling / edema is definitely reduced by the use of compression garments. We direct patients to wear them as close to around-the-clock as possible for the first two weeks postop, and then all day or all night for the second two week period.
Not all compression garments are created equal. As with surgeons and surgery centers, you tend to get what you pay for. In my practice we provide the compression garments for abdominoplasty patients (there is no added fee for compression garments), and we have tried out almost every major company’s garments. We have been happiest with Marena’s compression garments as the fabric is very soft, elastic and comfortable yet durable. They are also the most aesthetically pleasing garments we have used. If modified with scissors the fabric does not ‘run’ or split.
If the garments are not pleasant to wear then patients will inevitably discontinue their use earlier than would be ideal. Some practices ask patients to purchase their own garments (I’ve even heard of patients being sent to Wal-Mart for this), which is leaving an important part of the postop care regimen in inexperienced hands. If a practice advises you to purchase your own compression garment, they are probably more interested in controlling costs than your postoperative comfort.
In responses to questions about compression garments, some surgeons have proposed a number of potential negative consequences related to the use of compression garments in abdominoplasty patients: patient discomfort, abdominoplasty flap ischemia (reduction of blood flow), interference with incision inspection and management, etc. These are all problems related to ill-fitting and/or inelastic compression garments. Patients must be carefully measured for a custom-fit garment preoperatively, and garment fit must be carefully monitored postoperatively. If a one-size larger or smaller garment is needed, we discontinue the current garment and have a new one sent by overnight delivery to the patient’s home.
I am not dogmatic about compression garment use. If a patient states that they would prefer not to wear it, or would prefer to discontinue its use early, we allow the patient to do so. That being said, the vast majority of our patients wear their garments for the full four-week protocol, and some use them for longer than four weeks on their own volition. Garment fit and comfort is everything. If the fit is right and the patient is comfortable, then patients feel better, have a more pleasant recovery, experience less edema and more rapidly return to normal activity.
Another important consideration: there is no convincing evidence that the use of compression garments reduces the rate of hematoma or seroma after abdominoplasty. The most important consideration with respect to avoiding postoperative hematoma and seroma is this: following your surgeon’s activity restrictions to the letter. Excessive early activity and too rapid a return to exercise definitely increases your hematoma and seroma risk, so make sure that your surgeon has carefully outlined a plan for your return to activity.
Our recommendation for abdominoplasty recovery is this:
- Walking only for the first two weeks (casual, non-exercise walking). Walking is highly encouraged and the amount is not restricted, as long as it is casual walking.
- Light, non-impact aerobic exercise in weeks three and four – an elliptical trainer is ideal, and initial use should be brief and low-effort. Effort can gradually increase through the end of week four
- Gradual return to usual exercise regimen in weeks five through eight, with unrestricted activity at the end of week eight.
I always have my patients use a binder
A tummy tuck creates a large open space under the are of your abdomen that is undermined. Therefore, there is a tendency to have fluid accumulate into this space if it is not closed off. A binder, keeps this area under tension and allows healing to occur and lessens the chances of fluid buildup. Surgical drains are often used together with the binder to minimize a fluid build up (sermoma or hematoma). It is possible that your Doctor is using a tissue glue called Tisseal which can minimize the need for a binder in some patients. I still believe that the binder also gives support to the muscle layer that has been tightened at the time of the tummy tuck. For these reasons, in my hands, a binder works well for my patients. If your Doctor is able to obtain great results without fluid build up without the use of a binder, then I commend him/her.
Many opinions on this
When there are several opinions on a subject, it means there is no true answer! Binders can help early on with compressing and keeping the skin adherent to the abdominal wall. It can also assist in early ,light bleeding. Binders will not make the result better or worse if you wear it or do not wear it. Your result will not be different if you choose the surgeon who does not use them . many patients like the "comfort" that the binder affords them, so I use them for a week or two.
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Compression after tummy tuck absolutely helps.
Just as with any other operation, there will be some swelling after your tummy tuck... wearing a compression binder will limit the degree of swelling, and accelerate its resolution.
Additionally, the suture repair of your muscles will be a bit vulnerable for the first few weeks, and wearing a binder helps to support the repair while it heals, lowering the risk of the disrupting the repair.
Finally, the binder will greatly diminish the discomfort that most patients experience after this surgery, as it provides support during healing.
The only potential drawback is that compression may decrease blood flow in the tissues, and some believe this contributes to the risks of delayed healing or to the risk of developing a blood clot in your legs. It is my opinion that good surgical technique will maintain excellent blood flow in the tissues, and that proper attention to details before and after surgery will minimize the risk of blood clots. I do not think that the use of a binder really has much to do with these risks, and that the benefits far outweigh them.
I think that if you are comfortable with your surgeon, and feel he/she has a good understanding of your goals, and that you have a good chance of achieving them in his/her hands, I would trust his/her recommendation and follow their instructions carefully.
Your doctor is right; binders don't do much.
There are no good scientific studies about this, but I can tell you that, in New York City, we use binders on some patients and not on others, and both groups do just fine.
It's all about how the surgery is done. And suction drains for about a week are important.
Binders are always helpful after tummy tuck
I answered this very question yesterday from another individual concerning how long to wear a binder and how should it fit. The binder is very helpful after abdominoplasty, or tummy tuck, and it should fit snug and comfortably without being tight. The binder supports the abdomen as you sit, stand up, deep breathe, or cough as needed, and supports the back as well as the abdomen.
During the tummy tuck procedure, there is often a repair or tightening of the muscle layer in the abdomen to improve the tone and contour. The pull on the muscle is reduced with the support of the binder and will improve your comfort. Also, the area exposed as the skin excess is removed is large and prone to collect fluid called a seroma. The binder will reduce movement and friction in the tummy, and reduce swelling and the potential for fluid to accumulate. In general, you will get up easier, feel better, and possibly heal faster with a binder so I would certainly wear it.
How long for the binder? We have patients wear them for the first two weeks. They will fit nicely under loose clothing, and we always recommend a cotton T under the binder, pulled down past your bottom. The cotton is cleaner and more comfortable on the skin and the newly healing incision, After two weeks, we transition into a Spanx with a high waist (the Higher Power) for about two weeks longer, or until confident without.
Best of luck
Using A Binder After A Tummy Tuck-
There is no science to support the claim of better results after a tummy tuck with using a binder. Yet every abdominoplasty patient that I operated on over the last twenty years has found using the binder post surgically not only beneficial in lessening the pain but routinely describes the binder as "comforting" in the immediate post operative period. Therefore, having learned from my patients, I routinely recommend using an abdominal binder after undergoing a tummy tuck.
Abdominal binders and compression garments help support the abdomen
Need for binder after tummy tuck?
Thank you for your question. I am not aware of any formal scientific studies that have proved the necessity of a compression garment after a tummy tuck. As you can see from the variety of answers there are many opinions on this subject. Reasons to use a binder are primarily for comfort, to help prevent a fluid pocket (seroma), and to help encourage swelling to go away. I generally use a compression garment after a tummy tuck because I frequently combine this procedure with liposuction. I don't feel that a binder is absolutely mandatory, but in my experience, most patients like the tight feeling of the garment. It is comforting and makes them feel good. Some surgeons argue against using a binder or compression garment because they are concerned that blood flow may be impaired. Ask your surgeon about his fluid pocket (seroma) rate. If his results are good and you feel comfortable with his explanations, then move forward with surgery. Good luck!