Tummy Tuck (Abdominoplasty)

Hey guys, April Gring, registered nurse here again, coming to talk to you about one of our favorite surgeries—an abdominoplasty, or tummy tuck. The items you’ll need at home are your prescription medications. You’ll receive prescriptions for an antibiotic, nausea medication, pain medication, and a Lovenox shot, which you’ll bring with you to surgery and we’ll administer there. You’ll also get Arnica medication; this homeopathic Arnica helps with bruising and swelling after surgery. You’ll take a pre-op dose the night before surgery, a post-op dose when you get home, and another at bedtime. Then you’ll continue taking it three times a day. Your pharmacist should label the instructions on the bottle, and you’ll take your antibiotic the night before surgery, as well.

You’ll also need Q-tips, hydrogen peroxide, and distilled water to clean your incision sites. You’ll want Johnson & Johnson surgical dressing pads, or even feminine maxi pads work fine. It’s also helpful to have a laxative or stool softener on hand, or start taking one a few days before surgery to help with constipation from anesthesia and pain meds. If you’re traveling from out of town or prone to nausea, bring one pain pill and one nausea medication with you on the day of surgery in case you need it on the way home.

Please shave your upper pubic area the night before surgery so we don’t have to do it in the OR. Avoid using any lotion on the surgical area, as it can interfere with the surgical markings.

Now, let’s talk about the procedure itself. The main goals of an abdominoplasty are to remove the excess tissue in the lower abdomen and tighten the underlying muscles. Your belly button will be repositioned, and you’ll have a scar running from hip to hip just above the pubic area.

Post-op care is important. If you experience any profuse bleeding from the incision, give us a call. Bruising is normal, especially if liposuction was performed around the waist or flanks, and should fade within three to six weeks. If you’ve had a C-section, you’ll find that forceful coughing or sneezing can be uncomfortable—try to suppress it if possible for seven to ten days, and hold a pillow against your abdomen if you need to cough or sneeze.

For discomfort, you’ll likely receive Exparel, a long-lasting bupivacaine injection that helps manage pain for up to 72 hours. After surgery, avoid stretching or standing fully upright for the first two to three weeks. Most people find it comfortable to sleep in a “beach chair” position with a pillow under their knees, either in a recliner or propped up in bed.

You’ll have drains on both sides of your abdomen to help with healing. Initially, the drainage may look like a blood-tinged Kool-Aid color, gradually turning straw-colored. You’ll need to track the drainage output, aiming for less than 20 milliliters in a 24-hour period, typically around five to seven days after surgery. Keep a log of drainage from each side, emptying the drains about every 12 hours when they’re halfway full. We’ll have a video to show you exactly how to empty and reset the drains.

A little oozing at the incision site is okay, but if there’s any heavy bleeding, let us know. You’ll have a transparent dressing over your belly button for the first night, which we’ll remove at your follow-up the next day. After that, gently clean the belly button with a Q-tip dipped in a mixture of hydrogen peroxide and distilled water two to four times daily.

You’ll also wear an abdominal binder until Dr. Branman gives you the okay to remove it. This provides compression to help reduce swelling. For the first few days, surgical dressing pads can help with any drainage or leaking from the incision. After your follow-up appointment, you can start showering, but avoid baths or submerging in water for six weeks. Have someone assist you for your first shower, as you might feel lightheaded. Using a lanyard or rack in the shower to hold your drains can also be helpful.

If the tape over your incision starts to come loose, you can gently pat it dry and use a cool hair dryer setting to help it re-adhere. Avoid any heat settings, as you may have temporary numbness in the area.

Swelling typically peaks around 72 hours post-surgery, with about 80% of it resolving in two to six weeks, and the rest in three to six months. To minimize swelling, continue resting in a reclined position for about two weeks. Contact us immediately if you notice any severe purple swelling.

Do not drive while taking pain medication. Running a slight fever is common in the first few days; increase water intake, take Tylenol if needed (make sure you’re not doubling up on Tylenol if it’s in your pain meds), and call us if it doesn’t drop below 101.5°F.

Expect some numbness, firmness, and tenderness around the incision, which should gradually improve over several months to about two years. Avoid lifting, bending, or strenuous activity for six weeks, and no contact sports for three to four months. You can resume moderate walking after two to four weeks.

Direct sun exposure on your scar should be avoided for six to twelve months, as it can cause hyperpigmentation. You’ll have follow-up appointments about five to seven days post-surgery for drain removal, at two weeks, and additional visits as needed.

If you haven’t had a bowel movement within three days post-surgery, try a laxative, and call us if you’re still having issues. Your pre-op packet includes information on the procedure, informed consent, our accreditation, and Cynic, which helps with bruising and swelling.

Thanks for watching, and we can’t wait to see you at your pre-op. You’re going to love your results—have a great day!

Hey y’all, April here! Today I’m going to show you how to take care of your JP drain. Most of the time, we use these with a tummy tuck, and there will be two of them—one on the right side of your abdomen and one on the left.

The first thing you’ll need to do is empty it. To do this, unplug the top, then empty it into a little measuring cup. If you don’t have one, we can give you one, but a simple medicine measuring cup will work just fine. Make sure to note how much you’ve emptied and write that down.

To reset the drain and restore suction, you’ll want to squeeze it down tightly, keeping it compressed as you screw the lid back on. That compression is what maintains the suction, helping to pull out the extra fluid.

Another thing you should know is how to “milk” the tubing. If you see little clots or pieces of blood stuck in there, you’ll want to make sure the suction is maintained by clearing those clots. To do this, put a bit of soap between your fingers, hold the tubing near the insertion point to avoid pulling, and then squeeze down the tubing all the way to remove any clots. It’s a good idea to do this a couple of times a day, maybe after or before you drain them, especially if you notice a piece stuck.

When you’re done, you can clip the drains back onto your abdominal binder. Just remember to measure each drain at the same time, even if one seems a bit fuller than the other. This will help us get a more consistent reading.

If you ever notice the drains filling very rapidly with bright red blood and you can’t keep up with emptying them, definitely give us a call. That’s basically it—just keep up with these steps, and you’ll do great. Thanks guys!

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Taylor DA, Merten SL, Sandercoe GD, Gahankari D, Ingram SB, Moncrieff NJ, Ho K, Sellars GD, Magnusson MR. Abdominoplasty Improves Low Back Pain and Urinary Incontinence. Plastic and Reconstructive Surgery. 2018 Mar;141(3):637-645. doi: 10.1097/PRS.0000000000004100.

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