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Christopher K. Patronella, Md, Facs, Fics

Recovery Guide

Christopher K. Patronella - MD, FACS, FICS

Preparing for Your 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.

Healthy Lifestyle

Exercise: Continue or begin conditioning workouts such as aerobic exercise, yoga, Pilates, swimming, or weight training at least 4 weeks before surgery. Strengthening your body through aerobic exercise will enable you to recover from surgery more quickly.

Diet: Begin a high protein diet that includes foods such as lean chicken, fish, eggs, beans, and protein shakes at least 4 weeks before surgery. Protein enables your body to more effectively heal wounds.

VitaMedica Recovery Support Vitamins: Dr. Patronella provides his patients with this vitamin system to support their recovery from surgery. They are to be taken for 2 weeks prior to surgery and 2 weeks after. These vitamins are formulated with nutrients known to speed wound healing, support the immune system, minimize inflammation, and reduce bruising. Their nutrients include vitamin A, vitamin C, copper, selenium, bioflavonoids, bromelain, quercetin, and homeopathic Arnica montana.


Cessation

Smoking: Patients must not smoke for 1 month before surgery and 1 month after surgery. There should also be NO SMOKING by anyone in any closed environment with the patient during this period. Smoking compromises the body’s ability to heal and increases the likelihood of complications occurring.
Birth Control: Stop birth control pills or hormone replacement therapy, including topical or vaginal estrogen creams, for 1 month before and 1 month after surgery.

Certain Medications: 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.

Herbal Supplements: Avoid over-the-counter herbal supplements for two weeks before and two weeks after surgery.

Shaving: Do not shave the pubic area for one week before surgery to lessen infection potential.


Supplies and Arrangements

Have Items on Hand

  • Loose, soft clothing such as yoga pants or sweatpants—you’ll temporarily be more swollen than usual, so loose clothing will be most comfortable. 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 Dulcolax®—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 8 cups a day, or 16 cups if you also have liposuction.

Make Arrangements for Help

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 home prior to their surgery and/or while they are recuperating.
  • Consider preparing or purchasing meals ahead of time that can be frozen and reheated.

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 patient recommends 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.

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.

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.

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

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.” — M., Humble, Texas

Read More Testimonials

True Form Tummy Tuck® Recovery Timeline

The Day Before Tummy Tuck Surgery

  • To reduce constipation after surgery, eat a liquid diet, and have a bowel movement, even if a laxative or Fleets enema is required.
  • 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.
  • 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

  • Most patients will stay overnight in our fully accredited facility with attentive and prompt care provided.
  • Sequential Compression Devices (SCDs) 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.
  • Many patients (if deemed clinically appropriate) will be given an injectable or oral blood thinner after surgery to reduce the risk of blood clots.
  • Dressing and garment change will occur between 5 a.m. to 6 a.m. the morning after surgery, and discharge from the surgical center will occur at about 7 a.m.

Days 1 to 3 After

  • 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 it is better to take it and get up and around than to lay all day avoiding movement for fear of pain.
Learn More About EXPAREL®
  • Getting out of bed and walking with assistance for 10 to 15 minutes every 2 hours during normal waking hours is critically important to speed recovery and reduce the risk of clots.
  • 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 getting in and out of them.
  • To avoid straining the incision line, walking in a slightly flexed (stooped) position at the hips is required for 4 to 7 days, gradually becoming more upright each day.
  • 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.
  • Eating a light diet of foods that are easily digestible (to avoid constipation), high in protein (to improve wound healing), and low in salt (to reduce swelling) is ideal.
  • 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.
  • 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 to 12 cups a day).
  • Alternating or adjusting resting positions is helpful to avoid muscle stiffness and tightness.

Days 3 to 5 After

  • Gradually increasing light activity is recommended. Walking without assistance for 15 minutes every 2 hours and improving posture should be pursued.
  • A family member should have been trained to assist with dressing changes once daily by now, usually done after a shower. You may still need assistance when showering.
  • It is advisable to shower after bowel movements.
  • Avoiding contact with animals reduces the risk of infection.
  • Avoiding contact with ill family members is mandatory.
  • Eat a high-protein diet with limited salt intake.

Days 5 to 7 After

  • 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.
  • No driving or exercising.
  • It is normal to have a slight stoop while walking, progressing to a fully upright standing position by 7 to 8 days.
  • Incisional care is simplified to cleansing with mild soap and water followed by the application of steri-strips (supportive paper tape), which we will provide for you. These are to be changed about every 3 to 4 days for 5 to 6 weeks. If an allergic reaction occurs, indicated by redness, irritation, whelps, or blistering, remove the strips and notify my clinical care team.
  • Most sutures (stitches) are dissolvable; only a few suture tags require removal.
  • 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.

Days 7 to 10 After

  • Fully upright walking is expected, though it may be slightly tight and uncomfortable initially.
  • 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.
  • Walking for half a mile at a slow pace twice a day in cool temperatures is encouraged.

 Days 10 to 14 After

  • Increasing walks to 1 mile twice a day in cool temperatures improves mobility and prepares you for your return to work.
  • 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 (2 hours or more), physical exertion, or strenuous activity.
  • Continued incisional care with twice weekly application of new steri-strips as long as there is no skin irritation.
  • Driving is allowed at the 12 to 14 day point if you are fully mobile, with good torso turning ability, and do not require pain medication.

Weeks 2 to 4 After

  • Exercise is limited to brisk walking or a stationary bicycle for 45 to 60 minutes. Be careful to avoid straining or lifting.
  • Travel should be limited to short trips of no more than 1 hour in a plane or car. Advise your doctor regarding travel plans for additional recommendations.

Weeks 4 to 6 After

  • 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.
  • 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.
  • Swimming may begin.
  • 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.
  • Continued use of steri-strips through the 5 to 6 week mark is beneficial for optimal protection and support of the incision.

Weeks 6 to 12 After

  • 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.
  • 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.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.

Schedule a Consultation

Dr. Patronella’s warm and friendly patient care team will be happy to assist you with any questions you may have and schedule your appointment with Dr. Patronella in Houston, TX.

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