Tummy Tuck (abdominoplasty) Recovery: Weeks 1-3 & Beyond

The best way to prepare for your abdominalplasty is to have a plan on how to deal with each step of the process. This includes what to expect during the recovery phase. To do this you need to know what you can expect so you can then plan for dealing with the various issues that occur during recovery from your tummy tuck procedure.

Tummy Tuck Recovery Week 1

By far the most difficult portion of the recovery will be the first week after the surgery. Keep in mind that you have undergone a 2-4 hour major surgery, even though it may not have been in a hospital. More than likely you had a general anesthesia for this procedure with a tube placed into your airway to breath for you during the procedure. You may not remember much about waking up, due to the medications used to put you under and you might be groggy for a while after waking up. Many doctors use long term pain medications so you should really not have much pain when you awaken from the procedure. Medications for nausea may also have been given. If you are nauseated let your doctor know right away. The last thing he or you would want is to start vomiting. What you may experience when you awaken is a pressure or tightness around you abdomen. After the surgery was completed the doctor placed a dressing over the surgical site and likely applied an elastic binder to keep everything tight. Depending on your particular situation you may go home later that day, or possibly stay in a recovery center for a day or two.

Whether you go home that day or a day or two later you will need someone to drive you home. You do not what to choose someone who owns a sports car for the drive home. A larger car that is easier on the bumps that you don’t have to sit down into will be a lot more comfortable. If a sports or very small car is all that is available I would definitely consider taking a cab.

At the time of discharge you will be given discharge instructions that will cover various topics related to your recovery. This includes what type of activities you will be allowed to do. Also included will be instructions for bathing, and possibly instructions for dressing changes. Many doctors will want to see you a few days after the surgery to inspect the surgical site and do the first dressing change in the office. It is extremely important to follow these instructions exactly. If something is not covered in the instructions then contact your doctor before trying anything not covered that may be questionable.

The discharge instructions should also cover when and how to empty the drains that was placed during surgery. During your surgery a tube was placed in the surgical site and attached to a bulb. This bulb is depressed, closed and attached to this tube. What it does is to draw excess fluid from the surgical site. It is important to empty and measure this drainage. This is usually done at least twice a day. When you do this you want to look at the drainage. Make a note of the time the drain was emptied the amount of drainage, and also the consistency of the drainage. Most likely it will be a watery red or blood tinged liquid that is coming from the surgical site. What is important to note is any changes in the amount, color, or consistency of the drainage. Normally over the 2-5 days that the drains are in place you will notice decreasing amounts of this red/blood tinged drainage. If you notice a sudden increase in drainage, or frank blood, notify your doctor right away. This may be an indication of an impending infection or other problem.

Pain Medication During Tummy Tuck Recovery

In addition to discharge instructions at the time of discharge you will be given a prescription for antibiotics and pain medications. Have someone pick these up for you right away. In regards to pain many people wait too long to take medication possibly out of fear of becoming dependent on the medications. It is very important to take the pain medication before the pain becomes severe. The reason for this is that the pain medications are more effective at that point. If you wait too long the medications has to play catch-up to the pain and this needlessly exposes you to more pain than you have to have. Constant pain can increase your recovery time and is totally unnecessary. One thing in regards to pain medications that you have to be aware of is the propensity of these medications to cause constipation. It is important that you do not limit your fluid intake during this part of your recovery. Adequate fluid intake can help prevent constipation.

The other medication you more than likely will be give is antibiotics. It is also important that you take these as directed. These will help prevent infection of the surgical site, one of the more common complications of this type of surgery. It’s also important to take them until they are gone, whether you feel like you need them or not.

You are going to need a good thermometer, it will be important for you to monitor your temperature for the first few weeks. You will want to report any sudden spike in temperature. This can be one of the first signs of infection.

Precautions And Instructions For Minimizing Pain 

During the first week it is going to be important not to put stress on the incision site. During ambulation you will want to walk a little hunched over so as not to put stress in this area. This is not as hard as it sounds as it is kind of natural to walk a little hunched over when you abdominal wall is painful. While you don’t want to over-do it it’s important to get up and move around. This helps prevent the formation of blood clots in the legs, another complication of this type of surgery.

It is important to keep stress off the abdomen even while lying in bed. You don’t want to lie flat on the bed with your legs straight out. There are a couple of things you can do that will eliminate stress on the abdomen. While lying on your back you can use a wedge shaped pillow (pictured left) for the upper half of your body. This not only relieves stress on the abdomen but it makes getting out of bed much easier. To further relieve stress on the abdomen you can roll a blanket or round pillow and place it under the crook of the knees. This keeps the knees bent thereby relieving stress on the abdomen. The wedge shaped pillow is also good if lying on your side. Then you just bend your knees a little and this eliminates stress on the abdomen.

One of the most painful things that can happen during a normal recovery is the inevitable sneeze, cough or laugh. During your recovery you will have someone that makes it their mission to make you laugh. You will soon realize how involved your abdominal muscles are with these actions. There is something you can do to help. Have a small pillow with you, and use it to hold tightly over your abdomen during your coughing, sneezing or laughing episode. This helps to limit movement of the abdominal wall and lessens the pain. You can also use the pillow to assist you in sitting up and getting out of bed. You can use the pillow even when ambulating.

Dealing With Swelling & Bruising 

One of the things you are going to notice during the first week is the swelling and bruising. This is normal so do not be alarmed by this, even if it is extensive. You have undergone major manipulation of skin and muscle beneath the top layer of skin. It is going to take several weeks for all of the swelling to reside, and the bruising to go away. You may notice some numbness to the abdomen this also is normal. During your surgery some nerves were cut, and your skin was pulled down to provide a tight fit. It may take several months for all sensation to return, and some sensation may not return at all.

While some doctors will allow you to shower after the first 3-4 days some will want you to wait a bit longer. Either way it would be best if someone could assist you with this. Planning ahead of time can really help out. I would recommend a couple of inexpensive items that are well worth the cost. One is a shower chair, and a shower wand that allows you to direct water where you want it. It is likely that you may still be unsteady on your feet by this time, due to the nature of the surgery you may not have a lot of energy. Just the act of a shower really zaps your energy level and may leave you exhausted. This also is normal.

By the end of the first week you should not require any narcotic pain medications. You may find over the counter pain medications helpful however.

Tummy Tuck Recovery Week 2

Once you have made it through the first week the hard core pain should be gone. You will still have pain, and swelling along with the bruising, but the major pain should be over. By this time you should have had a follow up appointment with your doctor where the drains have been removed, and the first dressing change has taken place. While you may be feeling a little better it is important to continue to take it easy. You are still healing inside and you don’t want to over-do it.

It is during this period that you will most likely have your sutures removed. While some can be removed as early as five days post surgery most likely it will be one to three weeks after surgery. Don’t be alarmed it your doctor leaves some sutures during your visit. You have a very large surgical incision and it is not going to all heal within the same time frame. At any rate, all the sutures will likely be removed by the end of this second week.

Post Surgical Depression

It is during this period that you may start to experience symptoms of post surgical depression. According to the University of Michigan Depression Center this can occur anywhere from immediately after the surgery to several months later. University Of Michigan Depression Center (2006) These symptoms can range anywhere from mild dysphoria or feelings of sadness to symptoms of major depression. (University Of Michigan Depression Center, 2006) After the surgery the benefits are not readily apparent. There is a lot of pain, swelling and bruising of the surgical site. This may take quite a while to dissipate. As a result you may start to question the wisdom of the choice you made in regards to the surgery. All of this can lead to these depressive type feelings. If you start to experience depression do not be afraid to speak with your doctor. He is aware of this condition and can assist you in understanding that these feelings are not uncommon.

Depending on how extensive your surgery is you may be allowed to drive 10-14 days following surgery. By this time you have followed a program of increasing activity without overdoing it. By the end of the second week you should not need any pain medications. While there may be some residual tenderness this does not usually require medication.

Tummy Tuck Recovery Week 3 & Beyond

By the end of the second week you may be allowed to return to work depending on the type of job that you do. If you have a job that is not physically demanding your doctor may clear you for work. It is during this period that you have to be careful not to excessively exert yourself. You are still healing even though you are feeling like a new person compared to the first week. It should take from 4-6 weeks for recovery. Keep in mind that not everyone is the same and you may require more time to heal. This is very individual so don’t despair if it takes you a little longer to fully recover. Generally the better physical condition you are in going into the surgery, the faster your recovery will be.

The final frontier in your recovery is your surgical scar. This is a very large scar that will take a lot of time before it starts to look better. It may take more than a year for the scar to fade and become less noticeable. There are a number of products that claim to limit the time for the scar to heal fully. Speak with your doctor and see if he can recommend any of these products as some are just a waste of money.

With a little planning ahead of time you can make as uneventful recovery as possible. Knowing what to expect is key to this process.

References:
Society Of Plastic Surgeons (2011). Retrieved June 5, 2011, from http://plasticsurgery.org/cosmetic-procedures/tummy-tuck.html
University Of Michigan Depression Center (2006, January). Retrieved June 5, 2011, from http://med.umich.edu/depression/condition/htm