Tummy Tuck Recovery Guide – Everything You Need to Know

Just had a tummy tuck? This complete guide covers everything you need to know about your tummy tuck recovery.

There are so many common questions tummy tuck patients ask. This post will put your mind at ease. You will learn: 

• Can you cough or sneeze?  
• What medications you should take
• When to start exercising again
• When you can return to work

As a board certified plastic surgeon who has been in private practice for more than 25 years, and who has done many tummy tucks, I have refined my post op regime into a system that allows almost everyone to get back quite quickly to work and play. 

First and foremost, I would advise my patients to ignore the things you have read on the internet or advice you have gotten from a friend. The problem with the internet is that anyone can post anything. There are people who love to complain about everything and they tend to be most prolific on the internet. Also, with the internet, anyone can call themselves an expert. Anyone can find a person who describes their horrendous post op surgical experience, no matter how minor their surgery. The vast majority of my patients have found their tummy tuck recovery far easier than they expected. 

Is Tummy Tuck Recovery Painful?

The question is why is there any pain? The discomfort after a tummy tuck does not come from the incision in most cases. Due to the fact that many sensory nerves are cut during the surgery, the abdominal skin will actually feel numb. When I perform a tummy tuck, I inject the incision with a long lasting local anesthetic, so it is rare that people complain about incisional pain.

The most common discomfort complaints after a tummy tuck are:

1. A tight feeling in the abdomen
2. Discomfort in the flanks since I usually perform liposuction to the flank area during a tummy tuck.  Does everyone know what a flank is

The tight feeling in the abdomen is because I almost always tighten the fascia over the rectus abdominis muscle (abdominal muscle) with a series of permanent sutures. The fascia is a thin layer of tissue (somewhat like a thin coat of leather) that encloses the muscles. Many people describe this as feeling like they have done way too many sit ups! It will feel tight and this will make it somewhat challenging to stand up straight or to get up from a lying down position. 

Tummy Tuck Recovery vs C-Section

Almost every woman will say that their C-section surgery was much more painful. This would make sense since a C-section requires going much deeper into and through the abdominal wall. Also, the uterus has to be cut, the baby is removed and then the uterus is sutured closed. Contrary to what some people seem to think – No muscles are cut during a tummy tuck. – they are only tightened. 

What About Coughing, Laughing, Sneezing etc? Will I Come Apart?

Not surprisingly, coughing, laughing or sneezing can be uncomfortable after a tummy tuck. The reason for this is because doing these activities results in a strain that comes from inside of the muscle layer. When you strain or cough, the best thing you can do is to hold a pillow firmly against your abdomen, to provide a counter force. However, rest assured that you will NOT come apart, even if it hurts or is uncomfortable. 

When Should I Be Walking? Should I Stay in Bed All Day Long?

I believe one of the main reasons that my patients bounce back far quicker than most other surgeon’s patients, is that I strongly encourage my patients to stand up straight immediately following surgery. I also strongly encourage them to start walking around the house (including doing stairs) right after surgery and several times per day.

Some patients worry that they will come apart if they stand up straight but this has never happened to my patients. All meals should be eaten at the kitchen table and not in your bed. The worst thing you can do is to spend all day laying in bed. You will get stiff and your muscles will get tight.

This will make it much, much harder to get mobile and loose. I encourage gentle stretching. Patients worry far too much about “damaging something” by moving around. Of course, like everything in life, it is a balance. It is also important to give yourself time to rest and nap. 

Walking also helps prevent blood clots from forming in your legs so this is very important. It also helps with digestion and helps prevent constipation. 

What is the Best Position to be in Bed? Do I Have to Lie Perfectly on my Back? Can I Lie on My Side?

When you are resting in bed, it is going to be more comfortable if you have 4-6 pillows behind your head and 1-2 pillows behind your knees. You can lie on your back or you can lie somewhat on your side. Your body will find the most comfortable position. 

Pain Medication? What Should I Take and What Should I Avoid?

Everyone is different but I give the following prescriptions to almost all of my patents. At the conclusion of your tummy tuck, there is local anesthetic infiltrated into your incision and also you are given some painkillers through your IV. 

I give all of my patients, Celebrex, which is a long acting NSAID (like Motrin, Ibuprofen, Aleve etc), as long as  there is no serious sulfa allergy. I also prescribe either Percocet or Norco which is a narcotic. 

Most of my patients do not require narcotics very often. If they do, they generally don’t need them for more than a few days. Most will just take for a day or two and then quickly switch to only at night for maybe one more night. Most are off of them by day 3 or 4. 

What works very nicely is to alternate Tylenol with Motrin/Advil etc and avoid the narcotics.

All narcotics have the side effect of constipation. They can also make your brain a bit foggy. I have noticed very consistently that as soon as my patients are off all narcotics, they feel much better.

I also instruct my patients to avoid aspirin containing products such as Bufferin (which is completely different than Tylenol) because they are potent anti-coagulants. 

How Long Before I Can Return to Work?

This will, of course, depend on your job. If you work from home, and if you are really motivated, you should be able to put in a few hours of work after 3-4 days – but definitely don’t plan on doing more than 2 hours at a time. 

If you work in an office, then most healthy people can return in 10-14 days. Closer to 10 days, if you are in good shape and more like 14 days, if you are on the older side.

My senior office manager, Cheryl, had a tummy tuck by me, many years ago. She came back to work in 6 days and then worked 12 hours per day. I have had a few other patients go back to work in 6 days, but this is unusually fast. You just said that Cheryl went back to work in 6 days.

If you have a more physical job such as a waitress or floor nurse, you can expect to be back at work in around 3 weeks. This however, depends on how much lifting you have to do. 

It is important to remember that even if  you have returned to work, you will not necessarily feel 100%. Healing is a gradual process. Be patient with your healing process and you should certainly expect to be feeling healthy within a few months.

When Can I Exercise After a Tummy Tuck? 

This, of course, will vary from person to person. Generally, I would suggest that you avoid driving your heart rate up for about 2 weeks. If you overdo it early in the first 12 days, then  there is an increased risk of seroma formation. A seroma formation is a build up of fluid under the surface of your skin. 

When you start exercising, I would suggest something like the elliptical or a spinning class or maybe light weights. Most of my runners will be running by 3 weeks. By 6 weeks, there are no restrictions at all on what you can do. 

Tummy Tuck Recovery With a Baby or Small Child

I have found that a lot of patients need a relative to move in  for a few weeks. If you are in good health, you really should be able to manage very soon (after just 2-3 days at the most) totally on your own. However, you will want to pay a friend to take your small child for 2 hours each morning and afternoon, so that you can rest up and take a nap. If you have a small infant, it should not be a problem holding them in your arms.

If you have a small child, you can trick them. What I mean by this, is that you can let them lie next to you in bed, or you can sit on the floor with them. Since you are close to them, they will not realize that you have not picked them up. When the time comes to get them into a high chair or car seat, you will find tricks, such as using your knee or foot, to help them climb up if you find it hard to lift them.  

Breast Surgery (Either an Augmentation or Reduction) At the Same Time As a Tummy Tuck?

This generally will save you money for the cost of the procedure. Also your total time away from work will be less than if you did each procedure separately. However, it will definitely slow your recovery down a bit because you now have 2 different areas of your body recovering. I have had some patients recover very fast and I have had a few patients who definitely took closer to a week to feel more comfortable. 

When Can I Resume Marital Relations?

I am much more liberal than most surgeons in this regard. You can resume relations and the various options in that sphere, whenever you feel up to it. I would not try for any new records but I have had patients resume sexual relations within a week and for others, it is several weeks later. 

How Are Things Different in the Recovery if You Do Not Have a Muscle Repair?

If you do not have a muscle repair, which is uncommon but in select cases, I have done this, then your recovery is very quick. You should have much less discomfort since most discomfort, comes from tightening the muscle. You can return to full exercising in just 2 weeks. 

Quick Summary of the Do’s and Don’ts

1. Do get out of bed and walk around, including the stairs. 
2. Do walk straight and not bent over
3. Shower either the following night (30 hours after surgery) or at the latest by 48 hours. You can get everything wet and can shower daily. You will feel much better after your shower. 
4. It is definitely a balance between being active and also resting. Your recovery will be much quicker if you listen to your body. You know yourself best. Your body will tell you if you need to push a bit harder or rest up a bit more.
5. Don’t let the pain get ahead of you. On the other hand, just because you have some discomfort, does not mean that a narcotic is required. You don’t need to worry about getting addicted to narcotics, if you are only taking a few narcotics for significant pain, for a short period of time.
6. Watch out for constipation. I tell all of my patients, that if you have not had a bowel movement by day 3, then you need to start taking Dulcolax (or a similar laxative) aggressively starting the 3rd morning. You should take the Dulcolax first thing in the morning and then repeat in 2-3 hours. 
7. Never be afraid to text me your concerns or questions. All of my post op patients are given my personal phone number and are encouraged to reach out to me. You are never bothering me.