Posts

After Tummy Tuck with Muscle Repair

Not all tummy tucks are alike. Some involve more extensive surgery than others, and for this reason, what to expect during recovery can vary from person to person. The aim of the tummy tuck is to slim and tighten the waist for a more shapely and youthful appearance, but the surgical route to get you there (and into some cute new clothes) can vary quite a bit.

Depending on the amount of excess skin and fat to be removed, incisions can be shorter or more extensive, including the repositioning of the belly button. But one of the biggest factors to impact recovery from a tummy tuck, also called an abdominoplasty, is whether or not a muscle repair is included.

Why the muscle sometimes needs a repair

If you have seen the abs on even one superhero you will know the muscle we are talking about. It is called the rectus abdominis and it runs vertically from your sternum to your pubic bone. It has a left and right side separated down the middle by a band of tissue called the linea alba.

The linea alba can become over stretched, usually during pregnancy but also due to extreme weight gain or a lifting injury. When this happens the two sides of the muscle move further apart, resulting in an outward bulging of the belly that doesn’t go away, even when weight (baby or otherwise) is gone. This condition is called diastasis recti.

Besides being a cosmetic issue for some people, this condition can affect posture and trunk strength. It can cause pain in the abdomen, hips, and back, as well as bowel and bladder issues, all of which can have a huge impact on quality of life.

Why the muscle sometimes doesn’t need a repair

Not all tummy tucks include a muscle repair because not all bellies that can benefit from a tummy tuck have a diastasis recti. Even when the linea alba is stretched out, it can sometimes return to its normal size on its own. Furthermore, if a woman has had a cesarean section, a repair will likely have already been completed at that time.

How the muscle is repaired

Diastasis recti can be corrected by a general surgeon, but plastic surgeons routinely do this as part of their tummy tuck procedure. The surgery involves folding over the stretched tissue of the linea alba and suturing the two sides of the rectus abdominis muscle together. Though you can’t see it from the outside of the body, this involves suturing up and down the whole length of the abdomen.

Why a muscle repair impacts tummy tuck recovery

The difference in recovery between a tummy tuck with muscle repair versus one without has to do with the fact that muscles contract. Unlike the skin and fatty tissue that cover the abdomen, the muscles underneath (and the rectus abdominis is a big one) are prime movers and stabilizers of the whole trunk. This means that they contract nearly any time you move your body. Even simple movements like lifting your arms when sitting upright or rolling over in bed can engage these muscles — and then there’s coughing and sneezing.

When the muscle is repaired it needs time to rest so that it can heal up. Over exerting yourself too early can compromise your results and will certainly be painful.

How a muscle repair impacts recovery

When a muscle repair is included with your tummy tuck, you will be required to be more careful and your recovery will take a bit longer — from three to four weeks longer.

Symptoms
After a muscle repair patients often experience feeling more full quickly when eating and the sensation of not being able to take as deep a breath as they used to. This is due to a decrease in the amount of room inside the abdominal cavity caused by tightening the muscles. The stomach has less room to expand and the diaphragm meets more resistance as it moves down to allow you to take a breath. Both of these issues, if they occur, typically resolve within four to six weeks.

Abdominal Binder
Shortly after surgery you will be given an abdominal binder to help support the repaired muscle and to reduce overall swelling. You will be given instructions on how to put it on and will be told to wear it regularly. You will probably need help putting it on and taking it off in the first few days.

Lifting restrictions
After surgery, your doctor will restrict you to lifting no more than about 10-15 pounds. You will be prohibited from lifting anything heavier for a full six to eight weeks after surgery. You will also not be allowed to do any core strengthening exercises, such as sit-ups, to avoid stressing and potentially tearing the repair.

Posture
It is typical of all patients after a tummy tuck to have slightly hunched over posture. This is normal and it is important not to force an upright position and put undue strain while your incision heals. This becomes even more important after a muscle repair. You may even be given a walker to get around the first week after surgery.

You still have to get out of bed
Even with a muscle repair, your surgeon will require that you begin moving about within a day of your surgery. This includes getting up to go to the bathroom and with some restrictions, taking a shower. This is important for your overall health and healing and the prevention of blood clots. Many patients opt to sleep in a recliner to make these movements easier. Have someone at home to help you, especially during the first couple of weeks.

Though the muscle repair does add some challenges to your recovery, the long term benefits can far outweigh them. A study published last fall (2019), showed postpartum women who underwent a rectus abdominis repair had significant improvements in trunk function, urinary incontinence, and overall quality of life.

If you are considering a tummy tuck and want to know more about muscle repair, Dr. Slack would be pleased to offer a consultation in his office near McKinney, TX. Please contact us now to schedule your appointment.

After Breast Reduction Surgery: How to Keep Those Girls at Attention

You did it: you finally got that breast reduction you’ve been wanting, you made it through the first months of recovery, and now you are enjoying the results. Like many of our patients, you may even be thinking, “I should have done this years ago.” You can now look forward to all the new clothes you can buy (including strapless tops) and to the activities you previously avoided (like running). But the most important thing to think about now is how to keep your fabulous results fabulous for years to come.

There is no expiration date on the results of breast reduction surgery, but as part of a living, breathing body, breasts change over time. Because your breasts are lighter than they were before surgery, they will sag far less than they would have, but age and the effects of gravity can’t be avoided completely. Even so, you can take steps to keep your breasts looking as good as they can for as long as they can.

Follow doctor’s orders: first 18 months

During the first days, weeks, and months after surgery, it is critical that you follow doctors orders to avoid infection and injury. This also sets you up for the best possible results. Even when the incisions have healed and you have returned to work, you will remain under your doctor’s care. That’s because your body will continue to heal for up to 18 months after surgery.

Scar care
Scars will fade and flatten over time. You can help this along by using any creams or silicone strips that your doctors has recommended. Learn more about scar care here.

Ease into exercise
Make sure you get clearance from your surgeon before returning to weight training and high impact exercise. These activities can put a lot of stress on healing tissue, so wait till your doctor says you are ready.

Beware of underwires
Though breast reductions come with a variety of incision types, you will likely have some healing tissue underneath your breasts. Underwire bras, if worn too soon, can irritate that healing tissue. Underwires can become a part of your future if you want them too, but make sure you clear them with your doctor.

Take Care of Your Health

Your breasts don’t stand alone – they are part of your body. So anything that affects your overall health can affect them, too.

Don’t smoke
We’ve all heard about the many dangers of smoking – it increases the risk of heart disease and causes lung cancer. That alone should be reason enough to avoid it. But smoking also ages our skin and impairs wound healing. Do yourself a favor and quit this habit before it damages your beautiful surgical results.

Eat well
Few things affect our bodies like the food we consume day in and day out. Choose to eat healthy whole foods that have been minimally processed – brightly colored fruits and vegetables, whole grains, and modest amounts of healthy proteins and fats. Pro tip: if it comes in a package or has ingredients you can’t pronounce, eat it sparingly.

Exercise for health and fitness
The benefits of exercise are impossible to ignore – it helps keep your body healthy, strong, and young. This is good for your overall health, including your breasts (just be sure to wear a supportive bra that fits well when you exercise). However, it is not possible to “spot tone” your breasts. The pectoral muscles that lie beneath the breasts can keep the chest strong and affect the overall look of your chest. However, strong pecs won’t directly affect the breast tissue itself so they don’t prevent sagging.

Take Care of Your Skin

Preventing wrinkles and maintaining skin’s elasticity help keep that youthful glow and make great surgical results appear even better.

Don’t tan
As tempting as it may seem to try to get a tan “safely” – either in the sun or a tanning bed – it is simply not a good idea if you want to postpone wrinkled, saggy skin for as long as possible. The sun’s rays can also cause skin cancer. Just say “No!” to tanning!

Use sunscreen
Even the most careful among us can’t avoid the sun’s damaging rays all the time. This is why it’s important to wear sunscreen regularly. Make it a part of your daily routine to apply sunscreen to your face and chest, as these areas are often exposed to damaging UVA and UVB rays when we aren’t even aware of it. And when you spent time outdoors, use an all over sunscreen to keep your skin safe.

Avoid pregnancy or fluctuations in weight
Pregnancy and significant changes in weight both cause stretching of the skin that can change your breasts over time. For the longest lasting results, try to be at a steady weight and have completed your family before opting for breast reduction surgery.

Finally, if something doesn’t seem right with your breasts, contact your surgeon. It’s also important to have realistic expectations. Know that your breasts will continue to age – right along with the rest of your body – even after surgery.

Even so, your breasts will be smaller and in a better position. They won’t sag as they would without the surgery. If your breasts have been interfering with your life, this surgery can change that for you. Contact Dr. Slack to learn if breast reduction surgery is right for you.

Best Way to Recover from Breast Reduction Surgery

Relax and recover from breast reduction surgery

The path that leads a woman to get a breast reduction is often long. The surgery is often sought after years of discomfort, and then it takes time, energy, and money to plan a procedure like this. The surgery itself takes just a couple of hours, but the recovery requires another good investment of your time and attention. To get the best possible results, the role you play in your recovery is important, especially during the first day, week, and month after surgery.

After Breast Reduction: The First Day

The day of your breast reduction surgery will also likely be the first day of your recovery at home. Done under general anesthesia, this outpatient surgery is followed by a recovery period of an hour or two. As you slowly wake up, your job is to let your nurses know about any pain or nausea, so they can insure you are as comfortable as possible.

Once you are alert enough, you will be given home instructions which may include incision care, activity restrictions, and prescription medication use. Ask as many questions as you need. Then you will be discharged into the care of whomever you have pre-arranged to take you home.

You will have bandages covering the incisions and will likely be wearing a post-operative bra that was put on after surgery. You will notice right away that, though they are a little swollen, your breasts are smaller. You probably won’t see your incisions that first day because they will be covered with gauze. Under that gauze your body will be busy starting the healing process. To help that along, your job is simply to rest.

After Breast Reduction: The First Week

Ideally you will have arranged to take the first week or two off from work and other taxing obligations, so you can continue to rest and recover. Some patients have been able to return to work after three or four days, particularly if they have desk jobs. The early post-op period is a time to eat well, drink plenty of fluids, and avoid heavy lifting and strenuous activity.

You will also be dealing with some post surgical pain during this first week. The degree of pain varies from patient to patient but remarkably most patients are pleasantly surprised that the pain is less then they were expecting. In fact most patients complain more of a “tight” feeling then severe pain. Nonetheless, it is important not to let the pain get ahead of you, especially during the first three to five days after surgery. Take your pain medications on schedule, as they can take a little while to kick in. When able, you may be able to switch to an over-the-counter pain medication as discussed with your doctor.

Take a few moments to go through the instructions given to you at your pre—operative appointment and after surgery once or twice more during this week. Make sure you understand them and don’t be afraid to call the office if you have any questions or concerns. Following doctor’s orders is the best way to ensure the best possible outcome. This may include incision care and bandaging to prevent infection, as well as specific activity restrictions. The internet is a convenient source of all kinds of post operative advice; however, this advice may not be what your surgeon wants you to do. Since the internet didn’t perform your surgery, it probably shouldn’t be taking care of you after surgery.

While you do need to rest and take precautions you should not spend this first week just staying in bed. Part of your recovery should include gentle activity, like walking, and a gradual return to self-care activities. Also, if you quit smoking before surgery, don’t give in to the temptation to start again. Smoking can get in the way of the healing process.

After Breast Reduction: The First Month

Incredible change happens this first month; your incisions will heal, and you will begin feeling like yourself again. You will also start experiencing the benefits of your breast reduction, like decreased neck and shoulder pain, better fitting clothes, and increased freedom of movement. These benefits depend largely on the reasons you went in for a breast reduction in the first place.

Enjoy these things but remember you are still in the early stages of healing, so don’t jump back into full activity too soon. Don’t hesitate to ask if you are not sure whether an activity is too rigorous. After a week or so, your surgeon will probably clear you to return to work (depending on your job requirements) and you’ll likely be driving by then as well. Near the end of the month you may be allowed to begin low-impact exercise.

It may be tempting to wear tight fitting clothes that you couldn’t before, but for now, stick to soft undergarments and looser clothing that won’t interfere with the healing at your incisions sites. Once your incisions have healed, your surgeon will also likely suggest you start using some sort of silicone-based product (cream or tape) on them. These can be very effective at reducing the appearance of scars in the long run.

During the first month after surgery your body is working hard to heal and recover from surgery. Though more subtle, this process continues as the months progress. It can take 12-18 months to see the full results of your surgery, including how your scars will look. How well you follow your doctor’s orders and take care of yourself during that time will make all the difference. It will be an investment, but you are worth it.

If you are interested in finding out if you are a candidate for a breast reduction and have questions about recovery, call our office and schedule a consultation today.