Abdominoplasty Discharge
AFTERCARE TUMMY TUCK (ABDOMINOPLASTY)
BANDAGES: Drainage from your incision is normal for the first 2-3 days after surgery. Especially if you had a lot of liposuction, you can leak a fair amount of bloody looking fluid and you may need to replace the gauze pads under your compression garment with something clean and absorbent such as a small towel. Hydrogen peroxide can get any stains out of towels, sheets and clothing.
DRAINS: You will not have a drain so you need to keep your compression garment nice and snug in order to limit fluid build up.You may need to either tighten or loosen or adjust this binder if it has moved out of position or if you think it is either too tight or too loose. If you do develop fluid, it will feel like a water balloon just above the center part of your incision, typically 1-3 weeks after surgery. If this happens, please call so we can see you for a quick drainage procedure. Don’t be scared it will make you feel better! In these cases, you will most likely need to come back for drainage more than once.The sooner the better!
KEEP IT CLEAN: Shower with Hibiclens(chlorhexidine) soap the night before or morning of surgery. When you feel ready, typically 2-3 days after surgery, you can shower and launder your garments. Remove any bloody gauze, fabric, or thick foam tape. Steristrips are the thin sticky tapes which will stay on for a week or two, but if they are bloody, they may come off sooner. Make sure any fabric that touches your incision is clean and will let skin breathe. Garments can be washed and dried with minimal heat to prevent shrinking.
COMPRESSION: Either 3 days after surgery or after your first office visit, you can shower, and put on the compression garment. Many people like to continue to wear the velcro binder over their compression garment. The compression garment helps create a smooth even surface over your tummy. Most people like to have some kind of compression for a couple weeks after surgery. After the first couple weeks, you may choose to switch into snug high waisted yoga pants, Spanx or anything that makes you feel good. Be careful not to injure the skin on your tummy.
INCISION: Tummy tuck incisions heal slowly and are fragile due to the weak blood supply. Your incision will be bumpy and pleated for several weeks.There may be dried blood on your Steristrips which we will change during your first visit.Your skin is numb, so you will have to be extra careful not to damage it with anything too tight, too scratchy, too hot or too cold. Keep the skin clean and dry.Your stitches are below the skin and will dissolve over time. At your first appointment we give you some hydrating lotion to rub into your tummy skin after showering.This process is called lymphatic massage and it helps smooth fluid and increase circulation. At your one month follow up, we will discuss whether extra scar care will be necessary.
BRUISING: You should expect swelling and bruising of your groin area and upper thighs. This is normal.
BREATHE: You will be sent home from surgery with a little plastic device (incentive spirometer) which allows you to see how well you are keeping your lungs open.Your lungs bring oxygen into your system.Too much shallow breathing will let your lungs temporarily shrink and make it hard to get enough oxygen. Oxygen helps make you feel better and heal better. You won’t be able to avoid infection and heal well without plenty of oxygen. Oxygen is very very important for tummy tuck patients who need to really work avoid shallow breathing in the early days after surgery.
HELP: An adult must stay with you after surgery because the effects of anesthesia and your body’s response to surgery put you at an increased risk of falling and making bad decisions. Tummy tuck is a big surgery, so you may need someone around to help you get in and out of bed, to the bathroom and to drive for at least a week.
ACTIVITY: Walk around, stretch your legs, but avoid strenuous activity for the first 3 days. Early after surgery DO NOT spend prolonged periods of time in a sitting position. Bending your knees and hips is not good for circulation and can lead to an increased risk of blood clot. If you drive home, adjust the seat so you can stretch out and take some walking breaks. Practice standing up straight and over the following days and weeks.Work towards pulling your shoulders back and practice good posture.This will help rebuild your core! Whenever you feel ready to exercise, your body will let you know what is good.
BLOOD CLOTS: Staying hydrated and moving your legs after surgery helps prevent this potentially deadly complication. Any significant asymmetric leg swelling or calf tenderness might indicate a blood clot in your leg. If the blood clot moves through your heart to your lungs, you may have shortness of breath, rapid pulse rate, and or sudden chest pain.These symptoms require rapid attention in and emergency room. If you tell them you are concerned you have a pulmonary embolus, they should move you to the very top of the list and see you immediately. All patients should be off of hormone supplements for 2 weeks prior to surgery to limit risk of this condition. If you have a personal history of blood clots or hereditary condition, you should consider taking blood thinner after surgery to minimize risk. This needs to be identified and discussed prior to surgery.
ICE: Heat or ice on your incision can cause tissue damage which can prolong the healing process. Protect that sensitive skin!
SLEEP: You will need more of this after surgery. During sleep, your body gets to focus on healing. Please never take drugs make you sleep. Even if you are not fully asleep, resting your body and mind is very healthy. Get ready to take naps especially as you start to get more active!
DIET: After surgery you will retain fluid and may not be very hungry or thirsty.Your body is good at knowing what it wants and needs.You may not be hungry, this is normal. Eat small portions when you feel like eating. Remember in the first three days after surgery (at least) your body will retain fluid. Limit high salt foods, keep your rings off, and do not obsess about what the scale says. Protein and electrolyte drinks are good to have on hand so that you get the best bang for your buck when you drink and eat. Staying hydrated helps with healing and it will help your bowels. If you’re concerned about constipation try a little milk of magnesia, fiber powder with plenty of fluid, fresh grapes or maybe a suppository after 4-5 days if you have not had a bowel movement. Oral laxatives can create diarrhea, so just be patient and gentle with your system. If you experienced a lot of bruising, you may also need to look at ensuring you are getting plenty of iron to rebuild your red blood cells.
PAIN: Please be in charge of your own pain pills. Only you know what works for you.The dose written on your prescriptions is simply a maximum dose. Most patients choose to take much less than this! Keep a written record of what you take because you will forget! Alternate your prescription pain pill which typically containsTylenol with plain ibuprofen. Maximum recommended ibuprofen is 2-3 over the counter pills or 400-600mg up to 4 times a day. If you are not taking the maximum dose of narcotics (which contain Tylenol), you can safely take plain Tylenol 500 – 1000mg up to 4 times a day. Give each medication at least 30 minutes before deciding to increase your dose from one pain pill to two.Valium is a muscle relaxer and very effective for increasing comfort for some people. You may want to take Valium the night before or the morning of your surgery, but do not takeValium for the first day or two after your surgery until your anesthesia medications have worn off.Valium can help you relax, but please do not take any medications to make you sleep.Taking too many pain pills can cause nausea and can be dangerous if you are too sleepy to breathe well. Expect your pain to get more intense on the second or third day after surgery as the numbing medications wear off. Specific areas of pain located at different areas of your tummy is due to bruising or pull from temporary deep sutures and should not be a cause for alarm.We do not recommend heat or ice as the numbness from surgery can prevent you from knowing what is safe.
NAUSEA: Nausea in the first few days after surgery is often a sign of low blood pressure, which is a normal response to surgery. Lay down, elevate your legs on a couple of pillows and apply a cold compress to your head to help ease the nausea. Be very careful not to faint and hurt yourself. If you have motion sickness problems we can prescribe a patch to wear before and during your surgery. Zofran is a medication which can treat but should NOT be used to prevent nausea. Nausea resulting from too much narcotic is difficult to treat. Usually you just need to transition away from pain pills other than plain Tylenol and ibuprofen in this case. Nausea after one week can be any early sign of infection, so keep an eye on your wound and other symptoms which might suggest infection and need attention/treatment.
DO NOT DRIVE: No driving for the first week after surgery. No driving as long as you are taking prescription pain medication.
NO SMOKING: This should go without saying. Any nicotine you were exposed to for a month before your surgery will hurt how well you heal because is blocks circulation and oxygenation. Smoking/nicotine each directly interferes with your result.
INFECTION: True infections rare, but fever with no other symptoms is common in the first several days after surgery. High, sustained fever with nausea, poor appetite and rapidly increasing redness and discharge from your wound requires attention.
SCAR CARE: Once your wound has healed to the point where there are no scabs (2-5 weeks after surgery), you are ready to use either silicone lotion or silicone tape. Scars improve over a period of two years after surgery. After a minimum of 12 months, you may chose to have a scar revision, to help refine the contour of your result and adjust the skin tightness.The reason to wait 12 months is so that circulation to the scar and surrounding tissues can grow back and swelling and your weight have stabilized.
REVISIONS: Sometimes patients choose to have revisions a year after surgery. Additional liposuction and more skin tightening and scar improvement are reasons to consider a revision.These revisions are performed either in the office or operating room at an additional, discounted rate.