RECOVERING FROM A TUMMY TUCK
Patients who undergo an abdominoplasty procedure will have approximately 6 to 8 weeks of normal recovery. Immediate postoperatively, patients are placed in the semi-Fowler position, and abdominal binders are placed in the operating room. If suctioning of the hips is performed, Reston foam is also placed on the bilateral hip areas. Patients will have two 10 mm Jackson-Pratt drains placed to remove fluid, serous as well as old blood, from underneath the abdominal flap as well as to allow for scarring and reattachment of the abdominal flap back to the abdominal wall. Drainage tubes normally stay in for approximately 10 days and then removed once less than 25 cc a day of fluid is being pulled out of each drain.
The patients wear an abdominal binder for approximately 6 to 8 weeks. This will allow for reduction of swelling edema as well as allow the scarring back down to the abdominal musculature and fascia as well. Patients are maintained on antibiotics for at least 7 days. We normally use Keflex 500 mg, four times a day for 7 days. If allergic to penicillin, we may continue with Ciprofloxacin 500 mg twice a day. Patients are instructed not to perform any heavy lifting. They will also walk at an angle, stooped over, in order to reduce tension on the incision site for approximately 7 to 10 days.
Patients are seen postoperative day one in which the dressings are all removed and replaced with clean, dry 4×4 gauge. The Reston foam is then removed as well.
The next visit on day 7 or 10, the Jackson-Pratt drains are removed. The holes do not need to be sutured as a small amount of fluid will be evacuated over the next 72 hours onto the clean, dry dressings. Patients are instructed after 7 days to change the dressings twice to three times a day in order to keep the areas clean and dry.
On day 14, the patients return and sutures are then removed and on day 17 to 20, final sutures are removed, especially around the umbilical region. At this time the abdominal binder may be replaced with a Dr. Linder Band. The Dr. Linder Band is a compressive device with multiple clips in the front which allows for nice compression of the abdominal region, reducing swelling and further edema. It is made of 90% cotton and 10% Spandex, and it is extremely comfortable. The outer layer is 90% Nylon and 10% Spandex, which allows for support and comfort. The Dr. Linder Band and Dr. Linder Bra can be seen on www.linderproducts.com
TUMMY TUCK RECOVERY PRECAUTIONS
1. After your tummy tuck surgery, do not perform any heavy or increase exertion of the abdominal wall midriff area. Patients in our practice are instructed for six to eight weeks not to do any severe heavy lifting due to increased risk of tearing the rectus sutures that are placed in the rectus sheath in order to prevent this from tearing which could lead to hematoma or dehiscence of the rectus fascia.
2. Maintain clean, dry incision sites. Our patients are instructed to keep the incision sites dry for up to 17 days. No shower or bathing is allowed to prevent cellulitis, staph infections or even a possible abscess of the extraabdominal space. Our patients are placed on antibiotics for seven days or longer until the Jackson-Pratt drains are placed.
3. Do not return to work until drains are removed and no lifting at work. Patients are instructed that they may not return to work until the Jackson-Pratt drains are removed, which may be at least 10 days post op until less than 25 cc per drain is removed. They are also instructed not to engage in any heavy lifting or exertion of the mid abdominal area which could cause tearing, bleeding, dehiscence of the rectus sheath or even opening of the lower abdominal incision site.
4. Do not remove sutures presumptuously too early. Sutures are maintained in three layers, sometimes removed at different intervals in order to prevent dehiscence of the incision or widespread scarring. This may take up to four weeks for final sutures to be removed. Subcuticular sutures are normally removed at 17 days and the simple cuticular sutures can take up to three to four weeks. Once sutures are removed, Bio Corneum or Kelo-Cote silicone gel spray is used twice a day for the next three to six months in order to aid with reduction of scar formation.
5. Do not evaluate your final results too early. It can take well up to eight months to a year for final swelling, edema and scarring to resolve. After your one-year checkup, clinical analysis is useful, including scarring, residual adiposity or lipodystrophy of the lower abdominal flap, dog-ear formation on the hips and tightening of the mid central area.