As an Orange County mommy makeover surgeon, tummy tuck surgery is one of our most popular procedures. But what happens after the surgery?
Tummy tuck surgery is an out-patient procedure, meaning the patient will go home after the procedure. In rare instances, the patient may be kept in the surgery center over-night.
After surgery, the patient will have 2-3 drains placed under the abdominal skin. The drains will collect any excess fluid which the body produces as the result of surgery. Typically these drains are removed in 7-9 days, depending on their output. The patient’s family or provider will be instructed on how to empty and record the outputs separately on a piece of paper. If the patient has chosen to have a pain pump catheter (which I highly recommend) these catheters will be placed under the abdominal skin as well. These catheters are removed 3 days after surgery. The patient will be instructed on removal, there is no need to return to the office for their removal.
After surgery, it is important for the patient to sleep with their knees or hips bent to avoid any tension on the skin closure. Most of my patients are able to walk fairly straight after the first week of surgery. However, they must sleep in a slightly flexed position for 2-3 more weeks.
The patient will be seen in the office 24-48 hours after the procedure. The dressings will be changed and new ones placed. I instruct the patient and care-giver on how to properly apply and adjust the abdominal binder which was placed at the end of the procedure. The purpose of the binder is to provide support and minimize swelling. It must be worn for 4 weeks. It is important for the binder to fit well and be firm but not too tight. As a general rule, the binder should be as tight as the patient can comfortably tolerate.
The patient will return 7-9 days after surgery. Depending on the drain outputs, the drains may or may not be removed. If the drains are removed too early, the fluid will collect under the skin. This is called a seroma. The patient has to return to the clinic at least once a week to have the seroma “sucked out” with a needle and syringe. This is not fun! It is also critical for the patient to refrain from too much activity for one week after drain removal. It is the movement and rubbing of the abdominal skin against the abdominal wall which produces seroma. If the patient has a “desk job”, they may return to work after the second visit, provided no lifting or bending is permitted.
Minor wound issues, such as small skin sloughs right at the edge of the incision is fairly common after tummy tuck surgery. I would say 30% of patients will have some minor wound break-down which usually heal with antibiotic ointment and daily dressing changes.
The patient returns for a follow-up one month after surgery. Although the swelling has improved, it will take 2-4 more months for the swelling to completely resolve. At this time the patient may chose to remove the binder. Some patients, however, feel more comfortable wearing the abdominal binder. The patient may start light exercises such as walking on a flat surface or light weight lifting. The patient should refrain from sit-ups or abdominal exercises for 6 months. As part of the tummy tuck, the weakness of the abdominal muscles has been corrected with sutures. It takes approximately six months for the repair to be strong enough to allow abdominal exercises.
The patient returns for their 3 month follow-up. At this point, most patients have obtained their final shape. However, in some cases, it may take longer for the swelling to completely resolve. Depending on the patient’s skin color, the incisions may be darker than the surrounding skin. It may take up to one year for the incisions to lighten. Many patients also are concerned about numbness in their skin. It may take one year or longer for the sensation to return to all areas of the abdominal skin.
The last clinic visit is 6 months after surgery. At this time, the patient may resume abdominal exercise as tolerated. The patient should avoid any sun tanning to the abdominal skin for one year after surgery. The skin is very sensitive and even a sun-burn may cause significant damage to the skin.
This is a typical recovery for a patient undergoing abdominoplasty surgery. Not every one will have the same experience and, rarely, complications do occur.
Michael A. Jazayeri, M.D. is a board certified plastic surgeon in Santa Ana with over 10 years of experience. His office is located in Orange County, California. To schedule a consultation, please call (714) 834-0101.