Christopher K. Patronella
MD, FACS, FICS

Dr. Patronella’s Tummy Tuck Recovery Guide

Preparation for Tummy Tuck Surgery

These recommendations have a specific purpose such as reducing risk of bleeding (herbal supplements, aspirin, Advil, etc.), blood clots (estrogen hormones, smoking), wound healing complications (smoking). Begin 2-4 weeks before surgery.

  1. Continue or begin conditioning exercise such as aerobic exercise, yoga, Pilates, swimming or weight training. Strengthening your body through aerobic exercise will enable you to recover from surgery more quickly.
  1. Begin a high protein diet that includes foods such as lean chicken, fish, eggs, beans, and protein shakes. Protein enables your body to more effectively heal wounds.
  1. NO SMOKING for one month before surgery and one month after surgery. There should be NO SMOKING by anyone in any closed environment during this period. Smoking compromises the body’s ability to heal and increases the likelihood of complications occurring.
  1. Stop birth control pills or hormone replacement therapy, including topical or vaginal estrogen creams, for one month before and one month after surgery.
  1. Avoid aspirin and other over the counter anti-inflammatory medications such as Advil or Aleve (for a full list contact my office) for two weeks before and two weeks after surgery.
  1. Avoid over-the-counter herbal supplements For two weeks before and two weeks after surgery.
  1. Do not shave the pubic area for one week before surgery to lessen infection potential.
  1. Two weeks before surgery, begin taking the VitaMedica Recovery Support vitamins that are provided to you to aid in wound healing and lessen bruising and swelling.

Tummy tuck recovery tips from a patient’s perspective

For at least one to two weeks following your tummy tuck procedure, it will be important for you to pamper and care for yourself and to allow others to, as well. When you’re a busy mom who is used to caring for others and running a busy household, it can be tough to switch gears to be on the receiving end of care. However, as one tummy tuck patient and mother of grown children advised, “Be kind to yourself and rest.” Doing so will speed your recovery and help you to return to your normal daily routine feeling more refreshed and renewed.

  • If you have young children, you will want to arrange for help to care for them.
  • Some patients plan to have a cleaning service come to their homes prior to their surgery and/or while they are recuperating.
  • Consider preparing or purchasing meals ahead of time that can be frozen and reheated.

In addition to making arrangements for household help, it will be helpful for you to have certain items on hand prior to your surgery:

  • Loose, soft clothing such as yoga pants or sweatpants—you’ll temporarily be more swollen than usual, so loose clothing will be most comfortable. Also you’ll want to avoid anything with a snug waistband that could potentially irritate your incision.
  • Antibacterial soap for your hands and antibacterial body wash—this will be important to help prevent infection of your incision.
  • Books, magazines, DVDs, recorded television shows, a laptop—these are nice to have on hand while you are recovering and taking it easy.
  • Laxatives such Miralax and Ducolax—constipation is common the first week following surgery.
  • A big water bottle—you will need to ensure you drink plenty of water and/or fruit juices to help you stay hydrated—at least eight cups a day, or 16 cups if you have liposuction

The Day before Tummy Tuck Surgery

  1. To reduce constipation after surgery, eat a liquid diet, and have a bowel movement, even if a laxative or Fleets enema is required.
  1. To reduce the risk of infection, thoroughly cleanse with antiseptic soap at least the night before and the morning of surgery. Areas of most concern include the armpits, genitalia, and anal areas. Do not shave the pubic area.
  1. Take a Xanax or sleeping medication to help you sleep, if needed.

Surgery Day

Have nothing to eat or drink after midnight. Do not chew gum.

Evening After Surgery

  1. Most Patients will stay overnight in our fully accredited facility with attentive and prompt care provided.
  1. Sequential Compression Devices (SCD’s) will be kept on the legs overnight to reduce the risk of blood clots and to eliminate the need to get out of bed for a walk that evening.
  1. Many patients (if deemed clinically appropriate) will receive an injection of a blood thinner (Lovenox, Arixtra) for three days after surgery to the reduce risk of blood clots.
  1. Dressing and garment change will occur between 5 am-6 am the morning after surgery, and discharge from the surgical center will occur at about 7 a.m.

Days 1-3 after tummy tuck surgery

  1. During surgery, a long-acting non-narcotic local anesthetic injection (Exparel) is given, or a pain catheter may be placed into the area where it is most needed for pain control. This will reduce discomfort, though it will not eliminate it completely. Pain medication will be required, and is better to take it and get up and around than to lay all day avoiding movement for fear of pain.
  1. Getting out of bed and walking with assistance for 10-15 minutes every two hours during normal waking hours is critically important to speed recovery and reduce the risk of clots.
  1. Beginning on the  second day after surgery, you may shower with assistance using an antiseptic soap such as Dial. The shower should be equipped with a stable plastic sitting stool. A hand-held shower head can be helpful, as well. You should NOT be left alone in the shower as it is common to experience lightheadedness and unsteadiness. Bathtub showers are difficult to use and should be avoided during your recovery because of the challenge that is presented to get in and out of them.
  1. To avoid straining sutures, walking in a slightly flexed (stooped) position at the hips is required for 4-7 days, gradually becoming more upright each day.
  1. Flexion and extension of the feet at the ankles activates the calf muscles and pumps blood out of the legs, reducing risk of blood clots. This should be done consistently throughout the day while awake.
  1. Eating a light diet of foods that are easily digestible (to avoid constipation), high in protein (improves wound healing), and low in salt (reduces swelling) is ideal.
  1. An ACPS certified home healthcare provider will come to your place of stay on the second and third days after surgery to assist and teach wound care and dressing change.
  1. Constipation is common, especially when using pain medication. We advise regular use of laxatives for the first week or so and drinking plenty of water (at least 8-12 cups a day).
  1. Alternating or adjusting resting positions is helpful to avoid muscle stiffness and tightness.

 Days 3-5 after tummy tuck surgery

  1. Gradually increasing light activity is recommended. Walking without assistance for 15-30 minutes every two hours and improving posture should be pursued.
  1. A family member should have been trained to assist with dressing changes once daily by now, usually done after a shower.
  1. You may still need assistance when showering.
  1. It is advisable to shower after bowel movements.
  1. Avoiding contact with animals reduces risk of infection.
  1. Avoiding contact with ill family members is mandatory.
  1. Eat a high protein diet with limited salt intake.

Tummy tuck recovery tips from a patient’s perspective

In the first week of tummy tuck surgery, it is normal to feel a mix of emotions. At this point, you may still feel swollen, sore and tight, and your attractive new contours are not yet fully visible due to swelling. However, with each passing day, you’ll feel better and stronger. One of the number one pieces of advice our tummy tuck patients recommend is to carefully follow Dr. Patronella’s recovery instructions. These guidelines will help to speed and optimize your healing and provide a positive recovery experience.

Days 5-7 after tummy tuck surgery

  1. You will become progressively more mobile with about 30% of your time spent up and about in the home engaging in light activities such as walking, sitting, flexing at the knees and hips, and limited household duties.
  1. No driving or exercising.
  1. It is normal to have a slight stoop while walking, progressing to a fully upright standing position by 7-8 days.
  1. Incisional care is simplified to cleansing with mild soap and water with application of steri-strips (supportive paper tape). These are provided for you and changed about every 3-4 days. You will use these for 5-6 weeks. If an allergic reaction occurs, indicated by redness, irritation, whelps or blistering, remove the strips and notify my clinical care team.
  1. Most sutures (stitches) are dissolvable; only a few suture tags require removal.
  1. Usually the pain pump catheter and the drains (if present) are removed in this time frame. Being freed from the suction drains and the pain catheter provides some relief and added comfort.

Tummy tuck recovery tips from a patient’s perspective

“During the first week of my recovery after tummy tuck surgery, I was wondering if I had done the right thing. But after the first week, I turned a corner—it got better and better. What really helped me was having the postsurgical therapeutic massages at Dr. Patronella’s Added Touch Medical Spa. They helped to ease swelling and discomfort.”

A., Missouri City, Tx

Days 7-10 after tummy tuck surgery

  1. Fully upright walking is expected, though it may be slightly tight and uncomfortable initially.
  1. Leaving the home to attend indoor activities is encouraged. Riding in a car is acceptable, but should be limited to no more than 30 minutes at a time. Lengthy drives in a car or a plane can predispose a postoperative patient to blood clots and should be avoided.
  1. Walking for half a mile twice a day in cool temperatures is encouraged.

Tummy tuck recovery tips from a patient’s perspective:

“When you’re recovering from surgery, look six weeks down the road to the great clothes you’ll be able to wear. That’s the great fun—trying on clothes you never thought you’d be able to wear, and seeing how great you look in them! You’re going to love your new tummy.”

Days 10-14 days after tummy tuck surgery

  1. Increasing walks to one mile twice a day in cool temperatures improves mobility and prepares you for return to work during this time.
  1. Usually a minimum of 10 full days of recovery is required before you can return to work with light duty restrictions: no lifting, stooping, prolonged standing (two hours or more), physical exertion, or strenuous activity.
  1. Continued incisional care with twice weekly application of new steri-strips
  1. Driving is allowed at the 12-14 day point if you are fully mobile, with good torso turning ability, and do not require pain medication.

Weeks 2 to 4 after tummy tuck surgery

  1. Exercise is limited to brisk walking or a stationary bicycle for 45-60 minutes. Be careful to avoid straining or lifting.
  1. Travel should be limited to short trips of no more than one hour in a plane or car.

Weeks 4 to 6 after tummy tuck surgery

  1. Patients are beginning to feel pretty good by now, so the tendency is to push harder with physical activity. The key to avoiding a setback is to progress slowly and cautiously. Keeping the exercise routine to about 75% of what you feel you are capable of is prudent at this juncture.
  1. While increasing aerobic exercise with walking, stationary bicycle, or elliptical trainer, proceed with caution, avoiding abdominal straining at all times. Light upper body weights for toning is acceptable as long as there is minimal abdominal work required.
  1. Swimming may begin.
  1. Travel in a plane or car should be limited to 2 hours, with a short walk at the midway point to ensure good venous circulation in the legs.
  1. Continued use of steri-strips through the 5-6 week mark is beneficial for optimal protection and support of the incision.

Weeks 6-12 after tummy tuck surgery

  1. Progressively increasing exercise tolerance to full capacity is acceptable as long as it is reached gradually. You may begin incorporating more strenuous exercises such as aerobic exercise, jogging, Pilates and yoga. Isolated abdominal exercise (sit-ups, crunches, etc) are not allowed until a full 12 weeks from the date of surgery has been reached. Weight lifting can proceed with caution, avoiding intense abdominal straining until the full 12 week mark.
  1. Travelling more than 2 hours in a plane or car is acceptable, as long as a short walk is taken every hour during the trip. An aisle seat for plane travel is advised.
  1. Dr. P’s Scar Therapy Program begins at 5-6 weeks. Several products are used to optimize the appearance of the scar. Treatment is required for 6-12 months depending on scar responsiveness. Consistent use and patience is essential.

Tummy tuck recovery tips from a patient’s perspective

In the months following tummy tuck surgery, it is common to experience numbness, which may take one to two years to diminish, and occasional twinges of pain in the abdomen. In addition, swelling may come and go for months. To help alleviate this, shapewear that provides compression such as Spanx can be worn. This can be purchased online or at department stores.

The tummy tuck scar will continue to fade over a period of one to two years. To ensure optimum diminishment of the scar, is it important that you consistently follow the ACPS scar therapy program for 6-12 months. To prevent darkening of the scar, liberally apply sunscreen to the scar, and avoid exposing it to the sun.

For Dr. Patronella’s patients, tummy tuck surgery is enormously rewarding for the aesthetic transformation and accompanying increase in self-confidence that it provides. The results typically are long-lasting provided that you follow healthy eating and exercise habits that help you to maintain a stable weight. Many patients find that tummy tuck surgery inspires them to implement positive lifestyle habits that help them to feel their best and maintain their new attractive new contours.

Copyright © 2011 Christopher K. Patronella, M.D. All rights reserved.

TRUE FORM TUMMY TUCK, TRUE FORM ABDOMINOPLASTY,TRUE DEFINITION ABDOMINOPLASTY, and TRUE DEFINITION TUMMY TUCK are trademarks of Christopher K. Patronella, M.D.

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As Dr. Patronella's patient coordinator for nearly 20 years, Eva Cadena will work with you to ensure that your experience is professional, courteous, and rewarding in every way. Please call her with any questions you may have.

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Houston, TX 77024

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