Recovery from a Tummy tuck has to balance two things: the need to get your body going as quickly as possible, versus the need to keep things quiet until your body has had a chance to heal well. So what is the recovery time for Tummy tuck?
In the past, patients were told to stay very still for a long time following Abdominoplasty, but that created its own set of problems such as blood clots in the legs, or problems with the lungs. Nowadays patients are encouraged to get moving soon, but that can also have its own set of problems such as wound separations, infections, or fluid collections.
Like most things in life, the best answer is found somewhere in the middle. Here is how we advise our own abdominoplasty post op patients who have undergone surgery in our Baltimore surgery center. We hope you find it helpful as you contemplate whether a Tummy tuck might be right for you.
Tummy tuck recovery: week 1 (first 5 days)
The first few days after surgery should be quiet time. Your body needs to rest and recover. Here are more details about what to do in the first five days following your surgery:
Bed rest and diet
Following Abdominoplasty surgery, you should be in bed with the head of the bed elevated and multiple pillows under your (slightly bent) knees. This is important because keeping your torso elevated helps expand your lungs, decreasing the likelihood of lung problems. This position also relaxes the skin on your belly, which was stretched at the time of closure. With the relaxed skin you have less tension on the wound, so less wound problems and better blood supply for healing.
During these first five days you should not be walking around. Walking should be goal-driven only–such as to the bathroom or to the refrigerator. Too much motion can cause the skin layer to slide against the muscle layer so the two tissues cannot knit together. This results in either fluid collections (seroma) or blood collection (hematoma). Drains can help prevent this, but if you move too much fluid will accumulate despite the drains.
You can resume a normal diet as tolerated, but be sure to drink LOTS of fluids, especially in the first 72 hours following surgery. Fluids should not be diet sodas, but rather fluids such as juices or gatorade.
We have our patients wear a compression garment to diminish swelling and prevent fluid accumulations. It is extremely important that you do NOT take off the compression garment during the first five days post op! It not only helps you heal faster, it also influences your final surgical result!
The compression garment extends at least to mid thigh and has suspenders to prevent folding or displacement of the garment while you are resting.
You should wear the garment 24/7 during this initial post op period. The garment should NOT be removed during the first 5 days.
Drains and pain pump
The pain pump is optional, but it is highly recommended and most patients do opt for it. It is inserted at the end of the procedure while you’re still in the Operating Room. It will dispense local anesthetic to the incision area and will provide pain relief. Most patients are able to stand upright much sooner IF they have the pain pump! Learn more about how the pain pump reduces pain from cosmetic surgery in my video journal.
All Tummy tucks surgery patients will have drains put in to collect fluid. Without the drains, the fluid would stay in the wound area and create problems! The drain bulb should be emptied when full and the amount of fluid should be recorded each time you empty it. This process is repeated until the drain is removed in my office. The pain pump is often removed at the same time as the drains.
Bathroom and hygiene
Get up to go to the bathroom as often as necessary, but always be accompanied by someone who can provide support. You will need the help!
You should be able to use the bathroom without removing the compression garment.
During the first five days, do NOT take a shower. Without removing the compression garment, you may sponge bathe your arms, legs, and face. However, you should not be getting the garment wet and you must not remove the garment.
Following surgery, it is normal to have pain and discomfort. If you have pain, don’t be afraid to take pain medication.
Pain meds help you to get rest, to breathe better, and to get up as needed with less discomfort. It is absolutely fine to have a pain pump *and* still take the pain meds. Doing both is not too much!
The pain pump is only a local anesthetic, so it works very differently than the pain pills, which are a narcotic. When both the pain pump and pain meds are used together during this initial period, they can really speed up your recovery!
First post op office visit
On the 5th day post op, I usually see my Tummy tuck patients in my office. Most patients have their drains and the pain pump removed at this time.
With all of the tubes and drains removed, you are feeling more mobile. During this initial post op visit the compression garment is also removed and you’re given a new, clean garment. We then determine the plan of action for your follow during the next week of post op.
After this post op office visit, you can shower or bathe. However, the new garment should be put back on immediately to prevent swelling and fluid accumulations.
Tummy tuck recovery: week 2
After the sixth day following your surgery, the muscle layer is beginning to knit against the skin layer, but things are not quite set. But now I want the patient to start moving around. 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 the calves.
But remember, don’t over do it because you could still cause the muscle layer to slide against the skin layer and separate, causing a hematoma or seroma. That is why we recommend that you keep wearing the compression garment at all times (24/7) during the second week.
At this point, it is also still important to keep the skin layer relaxed, so keep the head of the bed elevated and your knees bent while resting in bed. When walking, stay a little bent over. Do not try to stand up straight yet, as this will pull on the wound.
During this second week post op, you may still need help getting the compression garment on and off, so it is a good idea to have family and friends nearby. When you go into the shower, use cool water. Don’t take a warm shower at first because when you remove the garment, the blood vessels relax, and the warm water makes them relax even more. If they get relaxed enough, blood can flow away from your veins to your lower body and you may faint. So be sure to use cool (not cold) water.
As far as pain medications, I usually recommend at this time to start tapering the dose. There are several reasons. First, pain can be a feedback mechanism for your body to tell you if you are doing too much. And second, sometimes patients feel too good with pain medications and tend to do too much. Finally, pain pills can make you very constipated, and straining at stool can harm the muscle repair.
Tummy tuck recovery: week 3
At this point we begin the recovery phase. Start by going around the house, but refrain from doing much outside activity. You are now beginning to get a feel for your activity level and how much you can tolerate. Let your body guide you. If you can stand completely straight, it’s great, but don’t push it!
Don’t overdo the walking and do not lift anything heavier than a gallon of milk. You should still not be driving at all.
At week three, you are no longer required to wear the compression garment 24/7, but you must still wear it at least half of the time. You can take the garment off at night, but if you don’t feel totally comfortable, keep it on. Most patients do keep it on the whole month, stating it makes them feel more secure. This is your body telling you things are still a little tight or there is still swelling. Listen to your body and don’t push it.
Tummy tuck recovery: week 4
You can now venture out the house, but it is still not time to go shopping at the mall or go on prolonged trips! Many patients do go back to work, provided that there are no physical demands.
Start trying to stretch, gently. Don’t try to lift anything over 5 pounds. You should still not wear any tight garments other than the compression garment.
Even though you are in pretty good shape, it is till not a good idea to drive. During the fourth week post op, sudden turns or slamming on the brakes can still damage your muscle repair.
At this point you may feel a hardness along your wound. Don’t panic, it’s called a healing ridge, and it’s the collagen your body lays down to knit the wound together. It will disappear over the next few weeks. You are still swollen here and there and some areas are numb. This will all get better.
Tummy tuck recovery: week 5
At week 5, you can now start to resume normal activities! I should see you sometime during this week for the 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’re considering a Tummy tuck, you should plan for 3 weeks off of work, with no driving during that initial recovery period.
Every body is unique and it’s my hope that this detailed explanation of the first five weeks following abdominoplasty helps you be prepared for your own Tummy tuck recovery time.