Recovering from a tummy tuck has to balance two things: the need to get your body up and running as quickly as possible, versus the need to stay calm until your body has had a chance to heal properly.
In the past, patients were told to lie very still for a long time after tummy tucks, but that created its own set of problems, such as blood clots in the legs or problems with the lungs. These days patients are encouraged to get moving early, but that too can have its own problems, such as wound separation, infection or fluid buildup. Like most things in life, the best answer lies in the middle.
The first few days after surgery should be calm. Your body needs to rest and recover. Here are more details on what to do in the first five days after your surgery:
After tummy tuck surgery, you will be in bed with your head elevated and several pillows under your knees (slightly bent). This is important because keeping your torso elevated helps expand your lungs, making lung problems less likely. This position also relaxes the skin on your belly. With relaxed skin you have less tension in the abdominal area, therefore less wound problems and better blood supply for healing.
During these first five days you should not go out. Walking should be guided solely by goals, such as going to the bathroom or the refrigerator. Too much movement can cause the skin layer to slide against the muscle layer so that the two tissues cannot join. This results in a collection of fluid (seroma) or blood (hematoma). Drains can help prevent this, but if too much fluid moves around it will build up despite the drains.
You may resume a normal diet as tolerated, but be sure to drink LOTS of fluids, especially in the first 72 hours after surgery. Liquids should not be diet sodas, but rather liquids like juice or gatorade.
We have our patients wear a compression garment to decrease swelling and prevent fluid buildup. It is extremely important that you do NOT remove your compression garment for the first five days after the operation. Not only does it help you heal faster, but it also influences the final outcome of the surgery.
The compression garment extends to at least mid-thigh and has straps to keep it from bending or shifting while you are resting.
You must wear the garment 24 hours a day, 7 days a week during this initial postoperative period. The garment should NOT be removed during the first 5 days.
Get up to go to the bathroom as many times as you need to, but always have someone with you who can give you support.
You should be able to use the bathroom without removing the compression garment.
For the first five days, DO NOT take a shower. Without removing the compression garment, you can bathe your arms, legs, and face with a sponge. However, you should not get the garment wet and you should not take it off.
After surgery, it is normal to have pain and discomfort. If you are in pain, don’t be afraid to take pain medication.
Pain medicine helps you rest, breathe easier, and get up when you need to with less discomfort.
On the fifth day after the operation, I usually see my tummy tuck patients in my office. Most patients have their drains removed.
With all the tubes and drains removed, you feel freer. During this first postoperative visit, the compression garment is also removed and you are given a new, clean garment. Then we determine the action plan to follow during the next postoperative week.
After the sixth day of surgery, the muscle layer begins to weave against the skin layer. But now I want the patient to start moving. I recommend getting up and walking around the room at least 3 times a day. The purpose is to get your muscles moving again, expand your lungs more, and prevent blood clots in your calves.
But remember, don’t overdo it because it could cause the muscle layer to slide against the skin layer and separate, causing a bruise or seroma. That is why we recommend that you continue to wear the compression garment at all times (24/7) during the second week.
At this point, it’s also important to keep the layer of skin relaxed, so keep the head of the bed elevated and your knees bent while resting in bed. When you walk, stay low. Don’t try to stand up straight yet, as this will pull on the wound.
During this second week after the operation, you may need help getting your compression garment on and off, so it’s a good idea to have family and friends nearby. When you shower, use cold water. Don’t take a hot shower at first because when the garment is removed, the blood vessels relax and the warm water makes them relax even more. If they relax enough, blood can flow from your veins into your lower body and you may pass out. So make sure to use cold water.
As for pain relievers, I usually recommend at this point to start lowering the dose. There are many reasons. First, pain can be a feedback mechanism for your body to tell you if you’re doing too much. And second, sometimes patients feel too good on pain medication and tend to do too much. Finally, pain relievers can cause constipation and straining the stool can damage muscle repair.
At this point we begin the recovery phase. Start by touring the house, but refrain from doing much outdoor activity. You are now beginning to feel your activity level and how much you can tolerate. Let your body guide you.
By week three, you no longer need to wear your compression garment 24/7, but you should still wear it at least half the time. You can take the garment off at night, but if you don’t feel totally comfortable, keep it on. Most patients keep it for the whole month, stating that it makes them feel more secure. This is your body telling you that things are still a little tight or there is still swelling. Listen to your body and don’t push it.
Now you can venture out of the house, but it’s not yet the time to go shopping at the mall or take long trips. Many patients return to work, as long as there are no physical demands.
Start trying to stretch, gently. Don’t try to lift anything that weighs more than 5 pounds. You should not yet wear any tight clothing other than the compression garment.
Even though you are in very good shape, it is up to you that it is not a good idea to drive. During the fourth week after the operation, sudden turns or hits on the brakes can damage the muscle repair.
At this point you may feel a hardness along the wound. Don’t panic, it’s called the healing ridge, and it’s the collagen your body lays down to bind the wound together. It will disappear in the next few weeks. You are still swollen here and there and some areas are numb. All this will improve.
Starting at week 5, you can start to resume your normal activities! I should see you sometime this week for your one-month follow-up appointment. You may still have some swelling, but your new body profile should be obvious. Start enjoying it!
In summary, if you are considering having a tummy tuck, you should plan on 3 weeks off work, without having to drive during the initial recovery period.
Everybody is unique and I hope this detailed explanation of the first five weeks after abdominoplasty will help you prepare for your own tummy tuck recovery time.