We consider the tummy tuck recovery period as occurring in stages or phases. We have categorized the postoperative tummy tuck recovery into 4 phases in order for you to better understand the recovery experience. The 4 major phases of tummy tuck surgery include:
Tummy Tuck Recovery Phase
Tummy Tuck Renewal Phase
Return to Activity Phase
Q&A with Medical Assistant Dina
How far apart will my Post-Operative Appointments be?
After you are discharged from the overnight recovery facility you will be seen in the office within the first 3-5 days after surgery for pain pump removal. A second visit will be made for 6-8 days post-op for drain removal. A third visit will be made for 10-14 days post-op for DERMABOND™ PRINEO™ tape removal. A fourth visit will be made for 4 weeks post-op for general follow up and a final visit is made for 8-12 weeks post-op for final follow up with the doctor, photos and discharge.
Will I be spending the night after my surgery?
Yes, after your surgery you will be transferred to the recovery center upstairs where you will spend the night under constant supervision from the nursing staff. Greenbaum Overnight Recovery Center offers state-of-the-art, private rooms for our patients to recover in. Each nurse is fully trained in taking care of the special needs a plastic surgery patient requires. A one-night stay is included in the price of your surgery but if you would like to stay more than one night it is your choice to add that on.
What happens if I have any questions or concerns after hours?
Our patients are instructed to call our office at 480-970-2580, at which time a member of our after hours on-call service will decide if the nurse/physician will need to be contacted asap. If the matter is urgent and cannot wait until the following business day the after hours service will contact either the doctor or the nurse and have them call you back within 15 minutes. We have someone on call 24 hours a day.
What should I wear to my post-op appointments after my Tummy Tuck surgery?
We suggest that patients come to their post-op appointments wearing loose fitting clothing such as a sun dress that slips off easily, a gown that buttons or zips down the front, or a house robe similar to a muumuu dress (you can find these at Walmart). At the first three visits we will need to remove everything in order to look at the surgical area and properly treat you. Wearing appropriate clothing will make it easier for you during your appointment.
Phase 1: Tummy Tuck Recovery
Let's get it started.
The first phase begins as soon as surgery is completed and you enter the anesthesia recovery unit. The nursing staff in the recovery unit will make sure you come out of anesthesia gently and have the appropriate level of pain control before going home.The Breast Lift Recovery phase lasts about 2 to 5 days and focuses on post-op comfort. When you arrive at home, you can begin taking prescription medications such as muscle relaxants and oral pain medications. There is a constant amount of pressure in the breast area after breast implants and muscle relaxants work best. The combination of prescribed pain reliever and muscle relaxant is noteworthy for creating the most relief after surgery. Many patients can stop the pain medication after 2 to 3 days and can typically return to some activity, including light-duty work. Five days after breast surgery the vast majority of patients have resumed limited work activity. We do not recommend vigorous exercise which raises your heart rate above 100 beats per minute until 15 days after surgery. This includes no heavy lifting.
Q&A with Medical Assistant Dina
When can I take a shower after my Tummy Tuck Surgery?
We recommend not taking a full shower until after your drain has been removed. Until your drain is removed you can have your caregiver provide you with a partial or complete bed bath.
How long do I need to use ice packs?
Ice therapy is very beneficial if applied for 20 minutes at a time with 20-40 minutes in between each application. It is best when used for the first 72 hours. Using ice decreases post-operative inflammation (swelling) which in turn decreases post-operative pain.
Will I have any drains in place after my Tummy Tuck surgery?
Yes, typically you will come home from the recovery center with one drain depending upon the type of tummy tuck you are having. If you are having a more extensive tummy tuck you may have two drains in place. The type of drain/s used are Jackson-Pratt or JP drains and will remain in place until the output has turned a straw color and is draining below 25-30cc of fluid within a 24-hour period. While the drain/s is in place it is important to follow the post-op instructions given to you by the recovery facility for maintaining the patency (openess) of the drain by milking the drainage tubing at least three times a day. We suggest emptying the drainage bulb at least four times a day and record the date, time and amount each time.
What type of medications will I receive for my surgery and how often should I take them?
For a tummy tuck, you will receive an antibiotic, an anti-nausea, a narcotic pain reducer, a muscle relaxant, and an anti-clotting medication that is injected daily by the caregiver. For efficacy we recommend that patients alternate the pain medication with the muscle relaxer every 4 hours to maintain a consistent level of medication in their system to avoid any pain spikes. We recommend patients stay on a continual dosing schedule through a 24 hour period for the first 3-5 days then eventually wean off of the narcotic pain medication. We also recommend that for patients who have a tendency not to tolerate narcotic pain medications to take the anti-nausea medication 30 minutes prior to their pain medication to decrease the risk of nausea/vomiting.
What is the On-Q Pain Relief System?
The On-Q Pain Relief System is a localized post-operative pain pump system that is placed by the surgeon prior to the end of surgery. This closed, sterile system delivers a constant pain relieving medication to the surgical area that lasts up to 2-3 days post-op. The On-Q Pain Relief System allows for a faster recovery and the medication won't make you drowsy. Another added benefit to the On-Q Pain Relief System is that it comes with its very own carrying pouch, similar to a fanny pack, that is lightweight and can also hold your drain bulb. The pain pump is removed by a member of the Post-Op Team on your first post-op visit.
Phase 2: Tummy Tuck Renewal
Most important phase.
After 5 days, you begin the Breast Lift Renewal phase. This is the most important phase of the recovery process and requires a great degree of patient participation. The breast renewal phase focuses on breast shape and expansion by allowing the implant to settle appropriately. After the implants are placed, regardless of size and tightness, every patient must create additional space to accommodate their breast implants while making the breasts grow. It is important to begin breast massaging to relax the breast tissue and pectoralis muscle, reduce swelling, and allow the breast implants to settle nicely. Breast massaging starts on about day 5 of the breast renewal phase and is performed at least 5 minutes per side twice a day. Initially, massaging is done gently in the first few days, but by the second week a more vigorous massage technique will be encouraged. These breast massage techniques must continue to be performed by the patient in the comfort of their own home for a minimum of 6 weeks. All of these massage techniques are taught after surgery by our postoperative team of nurses. The Breast Lift Renewal phase last until 3 months after surgery and overlaps with the Return to Activity phase of the recovery process.
Q&A with Medical Assistant Dina
What is the best sleeping position after my Tummy Tuck surgery?
The most practical sleeping position after a tummy tuck is in a recliner/Lazy Boy type of chair. This will automatically place you in a 45 degree angle with your back and legs elevated. If you do not have a recliner we suggest placing 2-3 pillows behind your head/shoulders and 2-3 pillows under your knees to keep the body in a soft “V” formation. This will keep any extra tension around the abdominal incision to a minimum. It also helps to reduce swelling in the feet and ankles, which can be common after abdominal surgery.
How long do I have to wear my surgical garment for?
After a tummy tuck surgery you will go home in either a white abdominal binder or a black compression garment depending if you have any liposuction with your surgery. The compression garment will be worn for at least 6 weeks. The purpose of the compression garment is to help reduce swelling as well as to support the abdomen and lower back region.
When do my sutures come out and what is going to be on my incision after surgery?
Sutures are removed along with the DERMABOND™ PRINEO™ tape 10-14 days post-op. DERMABOND™ PRINEO™ incorporates a self-adhering mesh that is applied to the approximated skin edges to provide temporary skin edge alignment until the liquid topical skin adhesive is applied to achieve skin closure. It also aids in the recovery of the incision.
When can I drive after my tummy tuck surgery?
After a tummy tuck it is important not to drive for at least two weeks to prevent any injury to yourself. After two weeks, when you feel you can react in an emergency situation AND do not have any narcotic medication in your system you can drive.
What is Lymphatic Drainage Therapy (LDT) or Lymphatic Massage? How is it beneficial to my recovery and is it required?
LDT is a gentle hands on therapy used to manually move the lymph fluid out of the body speeding up your recovery time. It is a specialized technique provided by a Lymphatic Drainage Specialist. Not only does this speed recovery by reducing toxins in your system and decreasing your swelling, it improves post-operative results. We recommend at least 4-6 treatments after having a Tummy Tuck surgery and if you can, one treatment prior to surgery. This treatment is not required but it is highly beneficial. Check with a Post-Op team member for a list of practitioners we refer to and ask about our patient testimonials about the service.
Phase 3: Return to Activity
Start getting back to a routine.
We allow patients to begin a gentle return to more vigorous activity after 14 days from breast lift surgery. This is when the Return to Activity phase begins. Before this time, we encourage breasts lift massaging and avoidance of vigorous exertion. Once this phase begins patients are allowed to perform limited physical activity like aerobic exercise and limited weights. When performing aerobic exercise, we recommend not to raise your heart rate above 125 beats per minute. In some cases, if a patient wishes to perform a particular strenuous activity it is better to call the office before proceeding.
Q&A with Medical Assistant Dina
What do I need to put on my scars to help them heal better & when can I start this?
embrace® Active Scar Defense is our #1 scar therapy treatment for tummy tuck incisions. Typically, within 2-3 weeks after surgery and when all of the sutures, tape or surgical glue has been removed you can start the embrace® treatment. You can also consider Vitamin E oil, Bio Oil, topical scar creams or liquids, or apply silicone sheets. This will help the tummy tuck scar to appear less pink and decrease in thickness and texture.
What is "Scar Massage?"
Scar massage is taught to each patient during post-op visits by a member of our Post-Op team. Scar tissue forms whenever there is an incision made in the skin. As scar tissue heals, it tends to contract and get thick. We know that the nature of scar tissue as it's healing is to contract but we also know that scar tissue is very malleable and trainable so we teach scar massage to help our patients achieve the best outcome possible with their scars. By placing pressure on scars or by rubbing/massaging them, the fibrous tissue gets broken down and trains the scar tissue to heal more flat. The more frequently it gets massaged, the flatter the scars will heal. This process takes anywhere from several weeks up to 6 months, at which point scar tissue matures and becomes less malleable or permanent.
When can I resume Vitamins and Herbal Supplements after Breast Lift?
Depending upon specific supplements, within two weeks post-op you can resume Vitamins and Herbal Supplements with the exception of weight loss supplements in which case you need to wait at least six weeks to resume.
I need help filling out paperwork for my employer, who can help me with this?
A member of our Post-Op team will assist you with this. Please bring your paperwork in at your pre-op appointment so they will have sufficient time to complete the documents required. If you have specific forms that your employer requires, there is a $25 fee for each form to be completed and will be collected prior to the form being completed please allow 7-10 days for completion. If you only require a letter for your employer there is no fee for that. Generally speaking, Short Term Disability does not cover cosmetic procedures.
When can I workout/exercise after my tummy tuck surgery?
We encourage every post-operative patient to start walking short distances as soon as they arrive home from surgery. Typically we like you to keep your Heart Rate under 100 Beats Per Minute (BPM) within the first two weeks. At week three, you can increase your Heart Rate to 120 BPM, at four weeks you can increase your Heart Rate to 130 BPM and at five weeks you can gradually work back into your normal regimen with the exception of lifting anything over 20 pounds. After six weeks you may return to your regular fitness regimen minus any abdominal exercises. We ask that you refrain from any abdominal exercises for at least 3-6 months post-op.
Phase 4: Clearance
Oh yeah. We're going out tonight.
Patients are considered healed from their breast lift surgery when the breasts have fully expanded to their desired cup size or when their breast implants have fully settled into place and the patient has been fitted for a regular bra. We tell patients they are cleared to live a completely normal lifestyle, when this occurs. This is called the Clearance Phase. The rate of healing with a breast lift is based on each individual's ability to heal and the size of the breast implants placed. For some patients, especially those with elastic breast skin the ability to expand their breast cup size and the settling of the breast implants occurs at a faster pace. Patients without a history of pregnancy who have tighter skin should expect that implant settling and breast expansion will proceed at a slower pace. In addition, with tighter skin and larger breast implants you can expect to have a longer breast renewal phase and have to perform more breast massaging exercises to obtain full cup expansion. After you are healed, we recommend wearing a strong supportive bra for the first year to avoid the risks of skin overexpansion. This is especially pertinent to those women with elastic skin before breast lift surgery.