Plastic & Cosmetic Surgery Blog
Posted on February 28, 2019 by Esther
Diet: Start with liquids the first few hours and then progress to your regular diet.
Activity: You should “take it easy” the day of your operation and the following days.
You may feel more comfortable sleeping with your body a little flexed- like having a pillow under your knees if you are on your back or you can sleep on your side with your hips flexed to relieve tension on your abdominal closure. You will be able to get out of bed the day of surgery, but start physical activity slowly and let your body’s response guide you. The first night after your surgery you will have a Foley catheter that will keep you from having to get up throughout the night to go to the bathroom, however it is very important that whoever is taking care of you help you get up and walk around the room every 3 hours to promote circulation in your legs and prevent blood clots. When you are lying down but not sleeping you should be doing heel toe stretches regularly, for one week, to also promote circulation. For the first ten days walk slightly stooped over to relieve strain on your incision. Because of your medications, you may need assistance getting to and from the bathroom for the first several days. Wear the abdominal binder snugly at all times.
TED Hose: The Hose we instructed you to buy and wear is for the prevention of deep venous thrombosis (blood clots). Deep venous thrombosis affects mainly the veins in the lower leg and the thigh. This clot may interfere with circulation of the area, and it may break off and travel through the blood stream. This clot can then lodge in the brain, lungs, heart, or other areas, causing severe damage to that organ or even death. Any surgical procedure that will inhibit your activity post operatively, especially abdominoplasty, there is a risk of blood clots. You will be required to wear your TED Hose during surgery and keep them on for 2 weeks after.
Medications: Take the medications we prescribed according to the instructions on the Bottle. You may feel a bit drowsy, so have someone help you. If you need a refill, call the office and give us the number of your drugstore or pharmacy. Do not take aspirin or ibuprofen for two weeks before or after your surgery. For more detailed instructions you may refer to the post-operative medication sheet that you will receive upon discharge.
Foley Catheter: For your comfort, our nursing staff will insert a catheter into your bladder to facilitate and measure urination during surgery. We frequently send you home with the catheter so you don’t have to get up all night to urinate. The morning after surgery the person caring for you will need to help you remove the foley bladder catheter. They will simply cut the rubber tube above the ORANGE tape, a small amount of water will drain out, then gently slide the catheter out.
Incision Care: 48 hours after surgery you may gently remove the binder and dressings from your abdomen. You may take a sponge bath at this time. However, you must ensure that the drain site does not get wet. Use a soft cloth, mild soap and water to wash your abdomen (it is okay to get your incision wet at this time). If you have dried blood around your incision you may use hydrogen peroxide and gauze to clean. Even though the majority of the incision line is closed tight and healing well after 48 hours, there will occasionally be small areas of scabbing or open raw wounds that will require a few more days of polysporin ointment applied to those areas only. Keep the entire incision line covered with sterile non- stick gauze (Telfa) for at least 2 weeks. This protects the incision from becoming irritated from the binder. You should wear a cotton undershirt under your binder to keep it from rubbing the skin. Have someone help you put the binder back on, the binder must be as tight as the line marked on your binder from surgery, but keep in mind that it should gradually be getting tighter as the swelling goes down.
Delayed Healing: Occasionally there may be small areas of skin breakdown that will be slow to heal. These areas should not be steri-striped and instead treated with polysporin ointment and a bandaid after you bathe. With time they will heal on their own or rarely have to be surgically revised.
Drain Care: Beginning 48 hours after surgery you must begin caring for the drain site. Apply Polysporin ointment around the site, then take two bandaids and wrap them around the tube, on the skin, making an X like pattern to completely cover the site. This is very important due to the fact that the drain site is an open wound. You want to make certain that dirt or bacteria does not enter the wound causing an infection.
Pain Pump (IF YOU CHOOSE TO HAVE ONE) 72 hours after tummy tuck surgery you will need to remove the pain pump. Remove the transparent dressing over the insertion site. Cut the 2 blue stitches and pull stitches out gently. Pull gently on the clear catheters and they will slide out. Place a bandaid over the insertion site. You may refer to the pain pump pamphlet for more detailed instructions.
Pain: The period of greatest discomfort usually lasts about twenty-four to forty-eight hours. Thereafter, you should have less discomfort and less need for medication. Occasionally, it lasts a bit longer, as different people have different pain tolerances.
Hormone replacement therapy and birth control pills increase the incidence of blood clots. STOP 2 WEEKS BEFORE AND AFTER SURGERY
Caffeine– Excessive use of products with caffeine such as coffee, tea, or soft drinks, especially Diet Coke, can have similar effects as nicotine. STOP ALL CAFFEINE PRODUCTS 2 WEEKS BEFORE AND AFTER SURGERY.
Smoking: Smoking or nicotine use (chewing tobacco, nicotine gum, snuff) can have a severe detrimental effect on wound healing. The nicotine decreases the vital blood supply to the skin and can cause poor healing or even skin death. STOP ALL NICOTINE PRODUCTS 2 MONTHS BEFORE AND AFTER SURGERY.
Alcohol: Do not drink alcohol for five days after surgery or when taking pain medication.
Driving: You may drive when you feel up to it, starting 3-5 days after surgery.
Never drive under the influence of pain medication or sedative.
Bathing: Sponge bathe while the drains are in place. You may shower 48 hours after the drains have been removed, generally one to three weeks after your surgery. Do not use very hot water. Do not loosen the tapes on the incisions. Continue wearing the elastic binder for at least three weeks.
Sun: Do not sit in the sun at all for three weeks after surgery. You may then gradually increase sunbathing. If the incisions are exposed, apply sunscreen for 6 months.
Sports: Strenuous sports such as tennis, swimming, jogging, aerobics, or bicycling may be resumed after four weeks. Refrain from any activity which significantly raises your body temperature, blood pressure, or heart rate for four weeks after surgery. Avoid sit-ups or selectively working out your “abs”.
Work: Depending on the kind of work you do, you may be able to return to your job as soon as you are comfortable. If your work is fairly sedentary, you may go back to work in a week. If your work involves physical activity, you will want to wait longer before returning, up to 4-6 weeks.
Postoperative visits: Five to six days after surgery, you will be seen at our center.
Your abdomen will be examined at that time. Subsequent visits: The timing of the drain removal and all further office visits will be determined by your progress. Typically, the stitches will be removed 5-6 days after surgery. Your drains will be removed when the drainage turns clear and is below 50cc/day, that is usually 1 to 3 weeks postoperatively.
Steri-strips, or tape, are the single most important factor that reduces scarring. The tape helps to flatten the scar and keeps it from spreading or widening as the internal sutures dissolve. The steri-strips will be placed on your abdominal incisions after the sutures are removed. Watch how the nurse applies the glue and tape, as you will be doing this once a week for four to six weeks. Depending on your skin oils and physical activities,i.e., sweating, bathing, or swimming, your tape may or may not stay on very long. The longer you can have your tape on the incisions without changing, the better the scar result. Frequent tape changes can sometimes cause an allergic rash manifested by redness, swelling, and itching. If this happens, stop the tape and glue immediately and call our office. The rash will generally subside on its own, or we may need to prescribe a cortisone ointment. If any of the areas along the incision exhibit irritation, redness, drainage, or open skin, DO NOT APPLY THE TAPE.
Scars- Although most scars are acceptable, poor scarring is the single biggest drawback to this surgery. Individuals with varied skin types scar differently and despite our best efforts we cannot predict or guarantee how you will scar.
In individuals with light colored skin, the scar is usually red for a few months then fades. In darker pigmented individuals scar may become and remain darker than the surrounding skin. The scar can even become raised and tender; this is a called hypertrophic or keloid scarring. Sometimes raised or keloid scars can be treated with cortisone tape or injections. Other scars that are wide or hyperpigmented may be improved with scar revisions. A scar revision, if advised by Dr. Toledo, is usually performed after waiting at least 6 months and will carry an additional expense.
You will be more comfortable using the private postoperative waiting room for your initial postoperative visits. Park at the handicap spot in front of the Sherry Lane door. Press the doorbell and we’ll let you in from the inside.
Please feel free to call us at any time during your healing period. THE OUTCOME OF YOUR SURGERY IS IN YOUR HANDS AS WELL AS THE DOCTOR’S. IT IS YOUR RESPONSIBILITY TO FOLLOW ALL INSTRUCTIONS GIVEN TO YOU.