Cosmetic Surgery

Cosmetic Surgery

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After - Tummy Tuck Surgery

The first few hours after Tummy Tuck surgery are spent in the recovery room with a Registered Nurse trained in post-anesthesia recovery and with the surgeon and the anesthesiologist checking on the patient's status periodically. When the patient is fully alert and comfortable, he/she may go home with a responsible adult.

If a Tummy Tuck is the only surgical procedure a patient is having, he/she may go home the same day. The On-Q™ pain pump greatly helps with postoperative discomfort, as it gently disperses local anesthetic directly into the surgical site for three to four days following surgery. It does this by means of two very small gauge plastic catheters that are inserted through the skin of the upper abdomen. The external portion of the tubing is taped to the skin of the upper chest and it is the heat of the skin that runs the two tiny pumps located in the lumen of the tubing. The pumps are fed by a supply of local anesthetic (Marcaine™ or bupivicaine) that has been loaded into a balloon reservoir about the size of a tennis ball. The balloon reservoir is stored in a small zippered bag with a strap to go around the neck for ease of mobility after surgery. As the Marcaine™ is used up, the balloon shrinks in size until it is empty. At this point, the On-Q™ catheters are easily and painlessly removed.

A patient must have adequate help at home for the day of surgery, as he/she should not get out of bed unaccompanied for the first 24 hours. Due to lingering effects of general anesthesia, a patient can become dizzy and fall unexpectedly during this time period. Also, due to discomfort of the Tummy Tuck surgery itself, it is best that a patient has someone to prepare food and keep liquids easily accessible. It is good to have someone to remind the patient to take his/her antibiotic and pain medications on time and other medications as needed, as he/she may still be a little foggy from residual anesthesia, as well as the pain medication itself. The Jackson-Pratt drains will need to be emptied twice a day or more and it is helpful to be able to delegate this to a caretaker.

Very often, especially if surgery in addition to the Tummy Tuck is done, a 23-hour overnight stay at the surgery center is required. This is a welcome option for many patients as it assures optimal management of pain and (although rare) nausea, provides licensed medical supervision during the most critical post-operative and post-anesthesia time period and relieves the patient (and the family) of the chore of emptying the Jackson-Pratt drains while he/she are most active.

The sergon personally checks on overnight patients the following morning before discharging them to go home with a friend or family member.

The early postoperative recovery after a Tummy Tuck is focused on preventing blood clots the day of surgery and throughout the recovery period. These are some of the important steps in prevention:

  • Pneumatic sleeve leggings are used around the calves before, during and after surgery, until the patient is again ambulatory.
  • When in bed, the patient's knees should be bent, or flexed, by having pillows under the knee joints.
  • The patient's temperature is controlled, especially during surgery.
  • The patient is discharged home with T.E.D.™ (Thrombo Embolic Deterrent) stockings (anti-embolism compression stockings).
  • The patient is advised to ambulate every hour at home while awake.

The patient will not be able to stand up straight immediately after surgery, as it will be more comfortable to stand and walk a little bit bent over. This is because the skin is stretched and sewn snugly to give the smoothest and flattest result possible. The skin eases and stretches out within a week or so to where the patient will be able to stand and walk normally.

A surgeon should encourage early ambulation to reduce swelling and promote blood circulation. The patient should avoid any strenuous activity, lifting, or bending. The pain is described as moderate and is successfully controlled with pain medications and the pain pump. This significantly improves within three to seven days.

The drains will be removed at seven to ten days. The drains are used to remove any fluid that accumulates underneath the skin. Prior to drain removal and for 24 hours following drain removal, bathing is restricted to sponge baths only, keeping the dressings entirely dry. The patient may shower or bathe 24 hours after drain removal. By this time, the drain site incisions will have sealed and the patient is again "waterproof" and considered safe from bacteria entering at these sites.

Bruising and swelling begins to dissipate at seven to ten days and sutures are removed in approximately ten days.

The abdominal compression garment is worn for approximately four to six weeks. A patient should be able to go back to work 10-14 days after surgery, although jobs demanding higher levels of physical activity may require a longer recovery period. It is strongly advised that a patient wait until four weeks after the Tummy Tuck to insure adequate healing has taken place before he/she resume any formal exercise.

It takes at least six months to see the final results of a Tummy Tuck. By this time, most of the tightness and numbness will have resolved and the incisions will begin to fade.

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