Abdominoplasty

Your Procedure

You have had an abdominoplasty, sometimes combined with a rectus muscle repair.

Certain patients will also have a vertical incision from the sternum to the pubic bone. This style of abdominoplasty is known as a fleur-de-lis.

Select patients have an incision that passes 360 degrees around their abdomen, sides, and atop their buttocks. This is known as a circumferential body lift.

Pre-operatively

Visit your family doctor and discuss any medications that you are currently taking, including vitamins. Some medications increase bleeding and should be avoided for at least 10 days before surgery (i.e. Aspirin, Coumadin, Plavix, Ginger or Gingko supplements). Have nothing to eat or drink after midnight on the night before surgery. Plan to shower the night prior and morning of your surgery using a chlorhexidine sponge - instructions for this will be emailed to you separately.
As this is daycare surgery, you will need a responsible adult to take you home and stay with you that night.

What to Expect

As this is daycare surgery, you will need a responsible adult to take you home and stay with you that night.

You may tire easily for the first few weeks after surgery and will therefore need plenty of rest. In order to protect incisions and promote healing, strenuous activity must be limited for 4-6 weeks after surgery. Your abdomen will feel tight. Maintaining a slouched or bent over position will feel more comfortable and place less strain on your incision. Lying on your side or with pillows under your knees and standing with a slight bend at the waist can help. You may need to prepare assistance with activities around the house. Return to work varies between 1-6 weeks, depending on the nature of your work.

This surgery is associated with temporary bruising, swelling, and soreness. Most of the swelling is gone after a few weeks but can take 3 months to resolve, and scars take 12 months to mature.

Surgical Site Care

For daycare surgery, arrangements will be made with the office nurse for initial wound care.

You will have an abdominal binder or garment that you need to wear at all times, day and night.

If you have drains, you may not shower until they are removed. The recovery room nurse will show you how to empty these and keep track of the drainage. They will be removed in the doctor’s office 4-7 days following surgery, typically once each drain is emptying less than 30 cc/24 hours. Each drain may be removed at a different time. Each person is individual as to the amount of drainage that will occur, and this is why there is such a variance in removal time.

If you do not have drains, you may remove your dressings and shower 48 hours after surgery.

Special surgical tape (Steri-strips (thin tapes) or Prineo (a light purple colored mesh) has been placed with a dry dressing on top. Do not remove the surgical tape; it will remain in place 2-3 weeks and will be removed by the office nurse, and is designed to get wet in the shower. You may use soap and water, rinse, and use a soft towel to pat dry. New dry dressings may be applied as required to absorb small amounts of expected drainage from the incision.

The sutures are dissolvable, but sometimes get pushed out through the incision before they can dissolve. The skin will close up 2-3 days after they come out.

Scar care and an information sheet will be reviewed in your postoperative visits.

Activity and Care at Home

It is beneficial to stay moderately mobile right away and take leisurely walks once you are comfortable. You should drink plenty of fluids, (no citric juice or diet soft drinks) for the first several days following surgery. If you are not urinating as much as normal, increase the amount of fluid you are drinking. If after this you continue to urinate less than normal, call the doctor.
You should avoid heavy lifting for 4 weeks, or 8 weeks if you have had a muscle repair done. Continue to wear the abdominal binder for the same length of time.
You must not operate vehicles, boats, power tools, or machinery for the first 24 hours after a general anesthetic, and should not drive until you feel safely fully in control of the vehicle and are not taking narcotics.

Medications and Pain Management

To manage pain take Ibuprofen (Advil) and plain Tylenol every 6 hours for the first 48 hours. If that is not sufficient, then take the prescription medication. Do not take more Tylenol or Ibuprofen than is recommended on the bottle in 24 hours. Ice or gel cool packs may help in the first couple of days, but do not leave ice on for longer than 10 minutes at a time.
If you have had a muscle repair and are taking narcotic medication, it is advisable to also take a stool softener such as Colace.

What to watch for / when to call / who to call

If any of the following occur, please call the office:

Increasing pain rather than decreasing pain.
Signs of infection: fever (38 degrees Celsius), chills, increasing redness or swelling
Foul odour and/or increased drainage from incisions.
Excessive bleeding that is not controlled with pressure.
Swelling or excessive bruising that occurs only on one side.
Shortness of breath or pain in your calf.

Even if you are going to the Emergency Department at the hospital, a call to the surgeon can save you a significant wait.

Follow-up

Your post-operative visits should be pre-scheduled at the time of surgical booking. If you are unsure of your follow up dates, please contact our office.