Tummy tuck pain vs vaginal hysterectomy pain?

Question

Ive recently had a vaginal hysterectomy and am about to have a tummy tuck with muscle repair. I would like to know how the pain compares so I can better prepare myself for after the procedure.

Semih Yildiz, MD, FEPOBRAS · Answer

Pain is personal, but many patients find a tummy tuck with muscle repair more limiting than a vaginal hysterectomy during the first several days. The main difference is the abdominal wall tightening: standing upright, coughing, laughing, getting out of bed, and walking can feel very tight or sore because the repaired muscles are under tension.

The first 3 to 5 days are usually the hardest, then most patients gradually improve over the next 1 to 2 weeks. You may walk slightly bent over at first, need help at home, and feel more pulling than sharp pain. Ask your surgeon about their pain-control plan, whether they use long-acting numbing medication, how to manage constipation, and when to resume activity. Preparing a recliner or pillows, help with meals, and short frequent walks can make recovery much easier.

J. Timothy Katzen, MD, FACS · Answer

Thank you for asking this insightful question about the difference between the pain experienced during a tummy tuck and a vaginal hysterectomy. Both procedures involve the manipulation of different body structures, thus causing different types of discomfort.
During a vaginal hysterectomy, an incision is made within the vagina, and the uterus is removed. This procedure can lead to deep pelvic pain as the body heals and adjusts to the removal of the uterus.
Conversely, a tummy tuck, also known as abdominoplasty, involves making incisions in the abdominal area to remove excess skin and fat and to tighten the abdominal muscles. The recovery period can lead to a unique type of discomfort because the procedure involves both tightening of the abdominal muscles and skin removal.
In my experience, pain following either procedure should be manageable with the appropriate use of prescribed oral pain medication and muscle relaxants. Pain management protocols will vary, and these should be discussed in detail with your surgeon prior to the procedure.
Remember, your comfort during the recovery process is a priority. Hence, communicate openly with your medical team about any concerns or questions you may have about post-operative pain.
Sincerely,
Dr. Katzen

Bram Kaufman, MD · Answer

That is a very interesting question. I do not recall any patients of mine that had both and discussed that with me, nor is there anything I've read in the literature. 
However, I would ask your surgeon about the plan for post op pain. For instance, will they use local anesthetic and if so, where do they apply it? What type of  local anesthetic do they use and how long will it last. Will they perform a TAP block (Transversus Abdominis Plane (TAP) Block).  Is a temporary pain pump an option for a few days? Are muscle relaxants an option? Will they recommend ice packs? Any one or more of these will help considerably and there are many more options for managing pain after abdominoplasty than for hysterectomy.

Hope this helps.

Alan Gonzalez, MD, FACS · Answer

Hello @Deb_rit19, thank you for your question. Every person's experience with pain can be different, and the severity of pain experienced after either procedure can depend on a variety of factors, such as individual pain tolerance, the extent of the surgery, and the use of pain management techniques. It's also important to discuss any concerns about pain management with your doctor before undergoing surgery. Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS),International Federation for Adipose Therapeutics and Science” Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP)

Connie Hiers, MD, FACS · Answer

The tummy tuck may be more painful since a much larger area is being treated. However, most surgeons use injected pain medication, along with poral medication, to help with the first few days of pain.

Mehdi Balakhani, DDS, MD, FACS · Answer

Hysterotomy pain is typically more painful than a tummy tuck. The pain from a hysterectomy feels deeper as opposed to the tummy tuck recovery is more surface level pain. All the best.

Michael S. Wong, MD · Answer

Dear Deb_rit19,
Thank you for your question. Typically it is the muscle tightening component of the tummy tuck that increases the discomfort associated with recovery. Your vaginal hysterectomy does not significantly touch the muscle, so will have less associated surgical discomfort. Thus, most women say the tummy tuck discomfort is greater than the hysterectomy discomfort.
Wishing you well as you proceed.

Saul Lahijani, MD · Answer

A tummy tuck with muscle repair is a surgical procedure that involves removing excess skin and fat from the abdominal area and tightening the muscles. This is typically done to improve the appearance of the abdomen and restore a more youthful, toned appearance.
After the surgery, you can expect to experience some pain, swelling, and discomfort in the abdominal area. The amount of pain you experience can vary depending on factors such as the extent of the surgery, your pain tolerance, and your overall health.
In general, many patients report that the pain after a tummy tuck with muscle repair is significant, especially during the first few days after surgery. However, the pain usually subsides gradually over the course of several weeks. Your surgeon will provide you with pain medication and other instructions to help manage the pain and discomfort.
In comparison, pain after a vaginal hysterectomy may also be significant and can vary depending on the extent of the surgery and the patient's pain tolerance. However, the type and location of the pain can be different from that of a tummy tuck with muscle repair.

It's important to follow your surgeon's instructions closely and take care of yourself during your recovery period. Rest and proper nutrition can help your body heal and reduce the amount of pain you experience. Be sure to communicate with your surgeon about any concerns you have regarding your recovery and pain management.

Camille Cash, MD · Answer

It's difficult to compare two different surgeries.  In many cases patients will report cramp like pain after a hysterectomy.  That is not the same with a tummy tuck.  In the tummy tuck we bring separated muscle tissue together as well as remove excess skin.  Patients typically report the pain is the worst during the first five days and manage pain with narcotic medications.  After that time it gets progressively better and patients that work outside the home are able to return to work after about two weeks.

Douglas Taranow, DO, FACOS · Answer

As I have never experienced the pain level from a vaginal hysterectomy, I cannot compare the potential pain level to an abdominoplasty (tummy tuck).
I can say that I perform 3 abdominoplasty procedures a month and the patients tolerate the pain well.  We inject EXPAREL, a long acting "Novocain" like injection, which is placed into the muscles and skin edges during the procedure.  It lasts 1-2 days and greatly reduces postoperative pain during this period.
Make sure you surgeon offers this option.
Best wishes.
Dr. Taranow

Tummy tuck pain vs vaginal hysterectomy pain?

Answers (11)

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