By: Douglas Leppink M.D.
A “Mommy Makeover”, which often includes a “Tummy Tuck” and Breast Surgery, is a common and effective way to restore a youthful contour to a woman’s figure after pregnancy or weight loss. The “Tummy Tuck” procedure involves both removal of excess skin as well as tightening of abdominal “core” muscles. Breast surgery may include Breast Augmentation and/or Breast Lift. Performing these procedures together may be possible, and less costly, than having each done separately. However patient safety and recovery is always a priority when considering combination surgery. The abdominal portion of any “Mommy Makeover” will require the longest recovery period, as it involves the “core” muscles that we use constantly. Prospective patients often are concerned about what the recovery period will be like. Having a clear expectation of what to expect post-surgery can alleviate a lot of anxiety for patients; the following is a guide of what you should expect:
After your surgery is finished at the Centre for Plastic Surgery you will awaken in the recovery area. You will be in a “beach chair” position with your back and legs elevated. This will be the most comfortable position for you to be in during the next two weeks. After a “Tummy Tuck” your abdomen will be sore and very tight, but will not affect your breathing or eating. Breast surgery will result in a very tight or swollen sensation to your breasts, with mild pain. Your care-giver will be instructed on the drains you have, and you will also have an abdominal binder and/or bra which can be adjusted as necessary to provide support to your tummy and breasts. You will require assistance getting up from a chair, bed or recliner for two to three days, but once you are up you will be able to walk on your own with minimal assistance. The tightness of your abdomen will require you to walk “hunched over” for one to two weeks. Mild back pain may occur due to this position, but will improve as you stand up straighter. It is important to take short walks around the house to prevent blood clots in your legs.
Pain management is always tailored to the patient’s specific needs and the extent of their surgery. Most often a combination of medications is used to help patients feel comfortable after surgery. These options include pre- and post-op anti-inflammatory medications (Celebrex), intra-operative local anesthesia blocks with long-acting local anesthetics, muscle relaxants (Valium) and narcotic pain medication (or non-narcotic Tramadol). Following post-op instructions with ice, elevation and rest also help to decrease swelling and pain. Some patients need more medication than others, and your Plastic Surgeon will work with you to find the combination that works well for you and has minimal side-effects.
Your diet will be light for the first week, but generally if it sounds good it will be tolerated well. Drinking plenty of water will help to flush the swelling out of your body
During the first week you should expect to be more painful with activity and very tired. Having help with children and your household chores (laundry, bed-making, meals) for the first 1-2 weeks will be necessary. Moving around in the house is important, as it helps to prevent blood clots from forming in your legs. As the first week progresses you should be able to get up from a chair or bed by yourself. You will shower daily beginning on the second day after surgery, and will be given a lanyard to attach your drains to when in the shower. When removing your binder (and possibly bra) you may feel light-headed, and you should have someone with you during your first shower. Washing with soap and water is fine, as we want to keep the incisions clean.
Your drains will probably be removed sometime in the first 7-10 days in the office. This is a briefly painful procedure that resolves quickly, leaving you feeling better than before. Taking some pain medication before your drain removal is a good idea.
During weeks 3-4 you will begin to stand up straight, although as the day progresses you may find yourself bending over slightly. You will be sleeping in bed with one or two pillows under your knees. Your lower abdomen will be swollen, and may get worse at the end of the day. This swelling will improve during the night as you are resting and sleeping.
Short walks are encouraged at this point, and patients with a light activity job will return to work. You will be extremely fatigued at the end of the day, which is normal.
The period of recovery is almost complete. Patients with a more strenuous job description will be returning to work, although perhaps at a slightly slower pace. Gentle exercise which is increased gradually is appropriate. Each patient is different in their ability to return to full activity.