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.

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

Mats Hagstrom, MD (license on probation) · Answer

I don’t know what it feels like to have a hysterectomy but I do not believe it it is a difficult procedure to recover from if done laparoscopically/Transvaginay.
A tummy tuck is a highly invasive operation that takes two full weeks of recovery time during which time you should have no obligation for any type of physical activitiesI suggest patient spend one night in a medical facility like hospital or recovery suite.
The first two days are the worst which having enough discomfort that most people need to take narcotic pain medication around the clock.
Simply getting up and going to the bathroom will be challenging and something you’ll need assistance with.
It’s very difficult to stand up straight and every movement including breathing will most likely hurt.
On the third day things get better.
Some people can at this point stop using narcotic pain medication and switch over to ibuprofen.
Most patients are still using narcotic pain medication at least intermittently.
By the fifth day the pain is substantially better but it still hurts and the movement is challenging.
When you’re seven days out from surgery you’re able to get up walk around and even get out of the house. if you have the drains in then this is the day the drains start becoming more irritating as the pain from surgery slowly gets better.
In the beginning the pain is so severe patients are not really aware of the drains as much.
From the seventh day until the drains come out which is typically about a week to two weeks the drains become more annoying each day.
By three weeks patients should be able to do most low impact activities including driving a car, going to work and taking care of children.
It’s pretty typical to recommend two full weeks of work to recover from this procedure.
Recovery to the point where I waiting for other things do not change takes months to years.
Most people can do unlimited exercise though certain range of motion may still be uncomfortable and difficult by about six weeks.
Patience should be physically, physiologically, psychologically, financially and socially well prepared before considering a full tummy tuck.
The process often creates an emotional roller coaster with regret, excitement and some upset.
Other than getting yourself well prepared for the procedure the most important variable is choosing the right provider.
I recommend patients do this by having at least five in person consultations with local board-certified plastic surgeons who are known for doing the procedure well.
During each consultation ask each provider to open up their entire portfolio of before and after pictures and look very carefully at the results.
Bring pictures of your own body for comparison during each consultation
There’s no point in seeing the best results of the providers career or the results of patients who are perfect candidate if you are not.
You should therefore ask providers to only show you before and after pictures of previous patients wet similar body characteristics to your own.
Ring pictures of your body to use for reference to make sure they are showing you pictures that accurately represent the same body characteristics that you have.
Ask providers to show you examples of excellent outcomes from average outcomes and outcomes that did not turn out as well as they had hoped.
Surgeons what the revision rate and revision policy is for this procedure.
Ask each surgeon what complications they’ve had with tummy tucks in the past and ask him to explain what that entails for patients.
Being shown a handful of preselected images representing the best results of a providers career is insufficient to get a clear understanding of what average results look like or what results will look like based on your individual candidacy.
Some people are much better candidates for certain operations than others.
The hallmarks of quality tummy tucks surgery include getting a natural appearing belly button on a consistent basis, very low set incision that follows anatomic contours naturally and evenly on both sides and finally the torso should look balanced attractive and proportionate from all angles.
For reference and experience provider should have no difficulty showing you at least 50 set a before and after pictures of commonly performed procedures like a tummy tuck.
Seeing less results than that it’s not sufficient to get a clear understanding of what average results look like or how many of these procedures any one surgeon has actually performed.
Take care from notes regarding both the quantity and quality of before and after pictures shown during each consultation.
Take notes about how thorough the surgeon is with all aspects of the consultation which should definitely include describing preparation for surgery and recovery.
If you had consultations then you should have a good understanding of what the coverage is like from this procedure.
If that was not covered during the consultation then that’s a red flag for that provider.
There’s no correct number of consultations patients should have to find the best provider.
I recommend patients start by having at least five consultations but consider having more if needed.
This operation is very much permanent and irreversible.
I’ve done poorly it’s usually very difficult to improve on the outcome.
Being board-certified in plastic surgery, having a good reputation and years of practice does that mean somebody has mastered any one single procedure.
In the end patient care of the receipt and surgeons skillet I generally the two most important variables and really the only variables that really matter when it comes to getting consistent quality outcome.
You should have a good understanding of your own candidacy for the procedure and feel confident that you have a good understanding of what the average results look like in the hands of each provider especially on previous patients with similar body characteristics to your own.
When in doubt slow down and schedule more consultations.
Personally I do not recommend having virtual consultations if it is at all possible to have an in person consultation.
It’s very difficult to properly vet plastic surgeons without meeting them in person.
Choosing the right provider is paramount and minimizing having this be a negative experience.
A tummy tuck is not for everyone.
Patience should have a good understanding of what you’re signing up for when they sign up to have this procedure.
Best,
Mats Hagstrom MD

Tummy tuck pain vs vaginal hysterectomy pain?

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