Tummy Tuck Preparation, Recovery & Aftercare
A tummy tuck (abdominoplasty) can create a flatter, smoother abdomen through the removal of excess fat and skin, and the tightening of abdominal wall muscles that have relaxed.
A tummy tuck is available to both men and women. In men, it is most common in those who have lost a considerable amount of weight. On the other hand, women generally seek a tummy tuck after having children because the abdominal wall, skin, and muscles have stretched and weakened.
The surgery itself lasts about two hours, plus or minus half an hour. It is often, oddly enough, the shortest part of the whole experience.
Instead, how you prepare before, recover, and care for yourself afterwards, is more time-consuming and equally, if not more, important.
Tummy Tuck Preparation
To prepare for a tummy tuck, you can follow our key tips:
- Be healthy: Surgery is not for the faint hearted and not without risk. If you have serious medical conditions, a tummy tuck may not be for you. Be a healthy person and keep any medical conditions in control (e.g. diabetes, high blood pressure, thyroid disease, etc). Stack the deck in your favor.
- Avoid herbal supplements and be careful with medication: Aspirin, Motrin and some herbal supplements, even green tea, can lead to thinning of the blood. When in doubt stick to a healthy diet and a daily vitamin tablet if you like, but if there are any other medicines that you take be sure to let your surgeon know. If you are prescribed any medications for anxiety or depression, make sure that you have a good support system. There is nothing more anxiety provoking than surgery…having a support system is essential.
- Do not eat or drink after midnight the night before: Plus, take only the meds that are recommended the night before. Some meds cannot be continued the morning of surgery. Some medications must be stopped a few days ahead of time. Before you stop drinking be sure that you are hydrated.
- Pick your clothing: Wear loose fitting clothing that’s easy to get on and off both before and after your surgery. Sweatpants and a zipped hoodie are the norm.
- Be at a reasonable weight: This is an important point. It’s very hard for most of us to be in what is called the correct body mass index, but try to be at a reasonable weight. That said, avoid fad diet and weight loss drugs as these often lead to unsustainable changes. Most of my patients will undergo their procedure when they’re about 10 pounds from their target because that’s where most people vary. Don’t think of a tummy tuck as a weight loss operation, think of it as cleaning up problems area after the weight loss is complete. Also, be willing to wait until the pre-operation weight is in your ideal range – if you have a tummy tuck and then you lose another 30 or 40 pounds, you’re going to need another. You really don’t want to do this more than once.
- Quit smoking: If you are a smoker, stop as soon as possible. Tummy tuck changes the blood supply to the abdominal wall. Smoking can markedly diminish that blood supply and cause tissue loss and open wounds. I recommend my patients stop smoking at least six weeks before surgery, if not more, and keep it up for at least 50+ years afterwards.
- Make a post-op plan: Arrange to have someone who will be caring for you bring you to the facility and preferably be the person who will pick you up and take care of you that evening. There are a lot of postoperative instructions that are given the morning of surgery and if your caregiver is there with you less is lost in translation.
- Pick your timing: The time to have your tummy tuck is really when you have the time and support to recover. This is not something that you can do on your own. It’s also not something you will be feeling like you’re over it in just a week or two. Plan on at least two weeks off, although it’s nice to have a third if possible, and then gradually get back into your normal life as your body allows.
Tummy Tuck Recovery
Tummy tucks hurt. There I said it.
It’s just the cold hard truth and you have to know that before you go down this path. People always think it’s because of the scar, but that’s really the least of it. Skin tightening doesn’t hurt that much.
When you get a tummy tuck, I’m pulling the abs back to the middle, the muscle tightening is what causes the discomfort. I am not trying to scare anyone, this is one of the most popular surgeries that I perform, I am just trying to educate you. The more you know the better and, indeed, there are things you can do to make recovery easier.
What will I be able to do post-operation?
After the procedure, it is encouraged to try and walk around. Try and walk three or four times a day for a few minutes each.
Do not expect to be able to walk around as you normally would pre-operation. You will likely not be able to stand up straight and will be forced to stay in a hunched position for several days afterwards. This is completely normal and expected.
In fact, you may be instructed by your plastic surgeon to remain in a bent-over position for up to a week after surgery. Because of this, you may experience some back spasms and discomfort. If so, ask your doctor to prescribe muscle relaxants.
What kind of garment will I need to wear?
An abdominal pressure garment will be issued to you post-procedure. You will need to wear this for several weeks after your procedure without fail. This is vital to ensure that everything keeps in place and heals properly. Without use, your results can heal improperly. The garment also works to maintain pressure and keep swelling down. Some will switch to other more gentle compression garments a week or two into their recovery period.
When sitting, you’ll need to find a resting position that is comfortable and does not strain the abdomen. When sleeping, you’ll likely need to adjust your normal lying position, especially during the first few weeks following your procedure. I recommend sleeping on an incline to reduce tension on the newly tightened abdomen. A recliner is a good chair to have after a tummy tuck.
How long will I be hunched over after tummy tuck surgery?
Many patients will find they walk hunched over after a tummy tuck. It’s due to excess skin removal and muscle tightening during their abdominoplasty surgery, which creates an abdomen that’s tightly pulled together and has less stretch and flexibility.
Therefore, trying to stretch out the abdomen and stand in a normal, straight posture can be painful immediately after surgery, causing patients to hunch instead. You will be provided with pain medications to help ease any discomfort.
But don’t worry, over the course of the following 2-3 weeks, you will gradually transition from hunching over to an upright position as the body regains flexibility in the abdominal muscles. You shouldn’t force the recovery process, the body will adapt slowly but surely, and you’ll need to build up your strength step by step.
When can I return to my normal schedule?
In terms of returning to work, it is typically recommended for patients to rest and heal at home for approximately two weeks following surgery. It’s nice to have the option of a third week off and not need it just in case. Returning to work may be impacted by the kind of job you have.
Many patients are often concerned as to how long it takes until they can return to the gym. Typically, this depends on the healing schedule of the patient. In general, patients can begin incorporating a light workout into their routine (like walking on a treadmill) after 3-4 weeks. I ask many patients to refrain from core exercises until week six.
What kind of scars should I expect?
Often, the most terrifying part of considering a tummy tuck is thinking about the scar. Unfortunately, a tummy tuck procedure will result in scarring. Scars are controlled by genetics and can be unpredictable. In some patients, scarring can be more noticeable than in others.
While the skill of your surgeon and the technique performed can impact your healing, your parents’ genetics may be the most important factor.
I always ask my patients to play what I call the “worst scar in the world” game. If you had a bad scar, would it be worth it? Thankfully, most patients only have normal scars, but it is still safest to play this game so that you can be comfortable regardless. I try to plan my patient’s scars to be hidden under their underwear or swimwear. In fact, I ask them to bring in those garments on the day of surgery for planning the incision placement.
The belly button is another story. It is an unhidden scar and in most cases the only visible sign of a tummy tuck. In my opinion, it can make or break the result. I pretend that all of my tummy tuck patients will want to wear a two-piece bathing suit on the beach one day. My philosophy is about size. I prefer a small belly button and here’s why: Nothing is as natural as a God-given belly button. Therefore, keeping the surgical belly button unobtrusive is my first goal. Smaller draws less attention; larger looks like a tummy tuck belly button. If a belly button is too small it is very easy to make it larger, but it is very difficult to make a large belly button smaller.
There are other subtleties as well. The opening can be vertical or horizontal. Horizontal can allow me to lower the lower abdominal incision, removing more tummy skin. The inside of the belly button can be pulled up or down as need be. It is important to leave a reasonable distance between the belly button and the bathing suit line. I will sometimes shorten the inside, or even reshape it if it has been stretched or flattened by pregnancy. I like to tether it inwards a bit, which can help keep more of the scar on the inside. Paying attention to these details not only makes the best belly button, but the best tummy tucks as well.
What can I expect for results?
A tummy tuck is a process. Swelling goes up before it goes down. The body will stretch to its new normal thereby determining, when you stand up straight, how flat you will stay. For each patient, the recovery and result will be different. How flat the abdomen stays depends on how much weight the patient carries inside the belly. The abdomen is smarter than your doctor and will relax to its new normal. In general, the more slender the patient is, the flatter they will stay. As long as serious weight gain or pregnancy is not experienced post-procedure, then results are usually long-lasting after the healing and stretching phase.
You don’t have to tighten the muscle, and for some patients, that’s an appealing option. It means that the same amount of skin and fat will be removed but the abdominal wall will maintain its original shape. There will be no flattening. Recovery is much easier when only the skin is involved, but the expectations of contour must be modified.
Tummy Tuck Aftercare
I have been in the practice of cosmetic plastic surgery for over two decades. In that time, I have gotten to know countless patients and helped to guide them on the proper path if they are considering cosmetic plastic surgery. Below are what I consider the best tips for aftercare following a tummy tuck.Be Healthy
Want to speed up recovery? Be healthy, I can’t stress that enough. A patient at an appropriate height and weight will not only have a more gratifying result but often a much safer and easier recovery.Plan Ahead
Each year, especially before the summer and school vacation I see many patients who want surgery within a week or two. While I would love to accommodate, our spots before all holidays go before other times, often a few months ahead.
If you are thinking of school breaks or holidays, please plan well ahead. Often people consider surgery just before the warm weather of the Summer. If you want to be ready for Spring or Summer try to plan your surgery 4-6 months ahead of this time, so you can be ready for the warm weather but not be recovering during it.Ignore the Media Hype
So much of what we think about cosmetic surgery is put forth and sensationalized by the media. It has led many patients to fad diets that have failed, exercises that don’t fix muscle separation and bad liposuctions.
I often have to walk my patients back from fictitious “facts” they have gleaned from the internet. It is not uncommon for me to tell patients things they had not considered. It is my hope though that when they leave my consultation, the concepts make intuitive sense.Bring Someone to the Consult and Surgery
The process of a tummy tuck is a shared process. The person taking care of you after surgery will need a lot of information and it is unfair to spring all that on them on the day of your surgery. If the person who takes you to and from surgery, and cares for you after surgery, is involved from the get-go, your experience is often easier, and more importantly, safer.Have Recovery Time
Many patients want to “beat the surgery” and show me how terrific and active they can be early on—don’t do this. Even if you are having an easy and perfect recovery, your body needs the time to heal correctly with common sense activities under my supervision. Patients who give themselves appropriate healing time in the beginning actually recover faster and better in the end. As you consider your surgery, be sure you can take enough time off.Don’t Overspend
Almost every day, I get an email from a patient with a list of lotions and potions, or gizmos and gadgets, asking if they should purchase anything to hasten or improve their recovery. There is no end to post-surgical paraphernalia that some websites want to sell you.
In my opinion, your best items will be pillows, perhaps an old recliner, and a caring significant other. I don’t object to most scar lotions and silicone strips, but it is clear to me that simple scar massage and your genetics are the most important factors in your healing.
If you have a recliner that’s a great chair to recover in because it keeps you bent in the middle. But I don’t recommend spending a fortune to buy or rent one because some pillows under the knees and behind the back while in bed will do the same thing.Be Realistic
This is perhaps the most important point. As a plastic surgeon, I cannot make you thin. Only you can do that through a healthy diet and exercise. I like to tell my patients I can get rid of loose skin and fat, change contour and make them more streamlined. It is an honest and realistic distinction and I hope it makes sense to you as well.Beware The Internet
Blogs, social media, and more will talk about a wide variety of things you must have at home after your surgery to be successful. Too many of these things are just unnecessary. As I have already alluded to, the most important thing is to have a caring and compassionate caregiver for the first few days. Someone who can be there on the morning of surgery, someone who can listen to the instructions and follow them with you as you recover.Bedding
Having sheets on your bed that you don’t care about is a good idea as there may be some oozing. While our staff provides some dressings to take home you may have a few extra gauze pads around just in case. Do not sleep or wear anything you value. Hibernate in an area of your home that’s easy to get around in and near a bathroom. You don’t want to be going up and down the stairs five times on post-op day one.Keep A Log
Keep a record and log of your medications it’s common for people to forget what they’ve taken .This should be your caregivers job as well. If your surgeon places drains he or she will likely want a record of the drainage as well.Food and Beverage
You will want to stay well hydrated after surgery. I’m a big fan of Gatorade as it has lots of electrolytes. It’s OK to have the Gatorade that’s not sugar free. You need the calories to help your body heal. Eat common sense things that are light. Things that are not greasy, things that are not spicy. Think tea and toast and the kind of food your mother would have given you if you had a cold or flu.Constipation
Narcotics can be constipating. Start a stool softener before your surgery and continue it postoperatively. If you’re prone to constipation discuss Exparel with your surgeon. This is a long-acting local anesthetic that I find helpful in diminishing the need for narcotics.
The internet is abound with lotions and potions for scar treatment. Personally, I recommend starting scar treatment at the third week, once the wounds have really had a chance to heal. You don’t want lotions or potions entering fresh incisions.
We recommend things like cocoa butter, vitamin E or bio-oil. I believe that massage is the thing that helps the most to soften scars. Mederma is relatively inexpensive and is available at most drug stores, and it at least has some reasonable science behind it.
The internet promotes silicone strips but the only ones that make sense to me at all are Embrace strips because they actually put some pressure on the incision. Pressure has been shown to help scars remodel more quickly. Ultimately time and genetics will determine your scars.
Exparel Can Make for Effective Tummy Tuck Recovery
Exparel has become a game-changer. For two decades I have used a long-acting local anaesthetic injected into the abdominal muscles to provide post-operative pain relief. What I traditionally used would last for about 12-24 hours.
Exparel is a new formulation of the same anaesthetic but it lasts up to 96 hours. It gets patients through most of their discomfort and vastly diminishes the need for narcotics. It does not take away all the discomfort but the discomfort it helps treat lasts far longer.
Unfortunately, it is expensive on two counts. The drug itself is expensive and it takes additional costly time in the operating room to administer it. Because of this, we offer it to our patients as an option but I strongly recommend it.
Schedule a Tummy Tuck Consultation
Find a knowledgeable plastic surgeon for optimal Tummy Tuck recovery and results. Be sure you like your plastic surgeon and that you know all the details of your surgery. Without question, I have found that the more well-informed the patient is, the more swift, reliable, and safe recovery will be.
Dr. Adam G. Tattelbaum, MDPC, is a Double-Board Certified Plastic Surgeon. He enjoys the process of teaching his patients as much as he loves performing surgeries. If you are considering tummy tuck surgery and would like to know more about the procedure as well as the recovery, contact us online.