4 Weeks Post Op, Tt and Breast Lift, Lipo and I Am Still in Pain, Especially at Night? (photo)

4 weeks post op and I am in a great deal of pain. I am extremely swollen on my tummy, lower and top and also on the side of my breasts. I begin the day pretty normal by noon, I am so swollen my skin hurts, by the end of the day I can barely walk! I feel like an old lady. I am on my third girdle, as the doctor says compression is the only way to minimize the swelling. I feel the girdles crush my ribs and the pain at times is unbearable. But, the doctor says I have to wear it! Is this normal?

Doctor Answers 7

Healing and Discomfort after a Mommy Makeover

Pain varies per person and medication to control #discomfort will be provided. Healing will continue for 2-3 months for the early period. This includes some swelling, bruising, malposition, color differences. Sensation in the breasts may also be abnormal and scars will be evolve. Tingling, burning or shooting pains in the breasts will disappear with time and should not alarm you. It is simply a result of the regeneration of your sensory nerves. If these sensations cause pain, repeated, local self-massage per your surgeon's permission may help.

Healing after a  #tummytuck will require time. Some patients are out of bed and walking the night of surgery and every hour while awake. I allow my patients to return to work at one to two weeks with 14 days preferred.  However, no lifting or straining.  At three weeks, increased level of activity and full with no restrictions, at 6 weeks.
As I advise my patients, if your work keeps you sedentary, you may return whenever you feel up to it. If your work is strenuous, wait until your work activity does not cause any superficial pain. 
Some employers will modify a person’s job duties so they can back sooner, but without physical activity. Our office can provide our patients with a note stating they are not to engage in strenuous activity for a specified period of time. The note will not disclose what procedure they have underwent. Therefore, you may have to request a similar note from your surgeon if you are not independently employed. I recommend avoiding heavy lifting and strenuous #activity for six weeks following your surgery. With that said, it may help you plan your return to work accordingly.

As for heavy lifting and other #strenuous #activities, it should be avoided for until you have clearance from your surgeon. You may, however, do normal activities at any time if they cause no pain or #discomfort. Let your body tell you what you can or cannot do. Aerobic exercise will raise your blood pressure, which could cause late bleeding and harm your result. Once you begin exercising again, start gently and let your body tell you what it can tolerate. Don’t rush!!  If you have concerns about your healing, or pain that you question to be unusual, it is important to call your plastic surgeon to discuss these further asked to be examined.

Orange County Plastic Surgeon
5.0 out of 5 stars 109 reviews

Pain tolerance varies from patient to patient.

It’s not unusual for patients to experience pain following Mommy Makeover surgery.This pain is usually related to elevation of skin flaps and tightening of the abdominal muscles.It’s usually severe in the first 24 to 48 hours following surgery but rapidly diminishes with time.It’s usually easily managed with hydrocodone and Tylenol in the post-operative period.
Although pain tolerance varies from patient to patient following Mommy Makeover surgery, atypical pain such as yours should be thoroughly investigated.
Although it’s difficult to make a specific diagnosis without a physical examination, your pictures and history suggest the presence of a large seroma.This should be investigated and possible aspirated.In some cases, placement of a drain with ultrasonic guidance is appropriate.
It’s important to discuss this issue with your plastic surgeon.Treatment of a large seroma might result in the resolution of the pain that you are experiencing.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 194 reviews

Pain after an abdominoplasty

Sharp pain is not uncommon after an abdominoplasty.  There are many sensory nerves in the area and they get bruised and caught up in post operative swelling.  Sometime you move one direction and just put a little pull on the nerve and it can cause this type of pain. If It becomes persistent then you need to be examined.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

Still in Pain, Especially at Night

Sorry to hear about your post-op course, which is out of the ordinary.

From your photo I wonder if you don't have a fluid collection in the lower abdomen. Your surgeon should be able to tell rather easily, and to withdraw fluid if present, hopefully with some resolution of your discomfort.  I don't see anything unusual in the breast photos.

A couple of suggestions to discuss with your surgeon:

  • switching to an abdominal binder which you can adjust for comfort.
  • Using a longer acting pain med at night-- either alleve if you are off the narcotic pain meds, or an extended release narcotic pain tablet so you can get a night's sleep. 

Once this is all resolved, hopefully you will enjoy your improved appearance and have minimal recollection of this difficult time.Thanks for the question and for the photos. Best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

Follow-up is Essential for Optimal Mommy Makeover Results

A Mommy Makeovers is a truly transformative process. The recovery, though, takes a bit of patience.   It is normal to have intermittent swelling in the operative sites 4 weeks post-operatively. To reduce swelling, I recommend to my patients that they wear the compression garments, limit salt and sodium, and drink plenty of water. If fluid retention persists, a diuretic (water pill) is prescribed. Lymphatic message may help. Localized swelling of the of the lower tummy is common, but your plastic surgeon will want to make sure that it is swelling and not a fluid collection (seroma). Pain of the calves and ankles due to swelling may occur at 4 weeks post-operatively, but should be checked to make sure that it is nothering more serious. Close follow-up with your Plastic Surgeon and his/her nursing staff is essential for the optimal results. I encourage my patients to follow-up with me regularly and frequently for the best results. Best wishes during your recovery.

Dr. Lyos

Houston, TX 



Andrew T. Lyos, MD, FACS
Houston Plastic Surgeon
4.8 out of 5 stars 58 reviews

Tummy tuck

You may have a seroma in the lower abdomen. See your doctor for ordering a sonogram, that will confirm if you have a seroma.

If confirmes then it should be aspirated or drained.

Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews

Experience 4 weeks post breast and tummy surgery

I'm sorry to hear that you are experiencing pain 4 weeks after surgery.  Severe discomfort where you can't walk 4 weeks postop is not normal after your procedures.  I recommend you followup with your PS to communicate your concerns.  Based on what you describe, I think your surgeon is correct: compressive garments will help manage the swelling.  Please make sure you followup with your PS as you do have some fullness in the lower tummy area.  Just make sure you do not have a fluid collection (aka seroma).   In addition, you do have visible irregularities to your areolas and breast shape.  Ask your surgeon about scar management.  Once your swelling resolves, you can better assess your results and evalaute whether a touch up would be warranted.  Wishing you a speedy recovery.

Dr. Basu

Houston, TX

C. Bob Basu, MD, FACS
Houston Plastic Surgeon
4.7 out of 5 stars 210 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.