Doctor Explains What Abdominoplasty Recovery Feels Like

Abdominoplasty surgery is only half the battle, the challenge still goes on for a few months during the rehabilitation period after abdominoplasty. 

That’s why we invited a specialized abdominoplasty surgeon, Dr. Christina Brunner, to help explain all the nuances of what recovery from abdominoplasty is like.

In this article, we’ll take a step-by-step look at all the stages of recovery after surgery, from hospital care to full recovery, what kind of postoperative restrictions you should expect, how long rehabilitation takes, and even unexpected problems after abdominoplasty.

First Abdominoplasty Post-Op Days

From Dr. Brunner’s experience, “Abdominoplasty is an easy procedure, a little bit painful for the patient in the first one to two post-operational days, but then it just turns into an endurable routine.”

The patient should spend the first two days after the surgery in the hospital, laying as still as possible in the half-sitting position (similar to the beach chair position). Doctors use a urinary catheter to remove body waste, and surgical drains to remove excess fluid and blood that accumulate around the surgical site.

After the second day, the drains and the catheter are removed, and then the patient can get up. But what is important is to walk as little as possible and in a slightly bent position, and sleep with the upper part of the body up. This state should last for five days, and after that, the patient can move normally and check out of the hospital.

Today’s sutures are made from resolvable materials, it takes around 6 weeks to 6 months for them to dissolve. As for the stitches, they are removed within 2 weeks.

Wearing a Compression Garment

Since it is necessary to minimize physical activity in the first weeks after surgery, patients are assisted by a compression garment binder. Such a tool is used to apply gentle, constant pressure to the abdomen [2]. It helps with:

• Reducing abdominoplasty swelling and bruising.
• Improving comfort and pain management.
• Supporting abdominal muscles and skin tissues.
• Improving scar appearance and body contour.

As mentioned by Dr. Brunner, “a compression garment is used for six to eight weeks to get the best possible shape”. Such an item also requires care for the most comfortable wear, so it is better to get two identical binders to alternate between them and wash them on time. 

Don’t forget to take short breaks from wearing it (about 30 min for every 4–6 hours of wearing it) to allow your skin to breathe and avoid irritation.

Taking Care of the Scar During Abdominoplasty Recovery

Source: freepik.com

It’s important to manage expectations regarding the scar appearance after post-operative abdominoplasty. Typically, preliminary results are noticeable after six months, however, Dr. Brunner noted that “full recovery takes up to a year, and the scar becomes less noticeable. After two years, the scars almost disappear and match your skin color.”

High scars and vertical scars can affect the patient’s self-esteem. This aspect should be discussed before the surgery, especially if the abdomen is tight. In such cases, it may make more sense to opt for a smaller, vertical scar in the middle of the abdomen, where the belly button is located.

Abdominoplasty Swelling Treatment

During the procedure, lymphatic vessels may be affected or temporarily disrupted, leading to an interruption of lymphatic circulation. This disruption can result in postoperative swelling, a common side effect during the recovery period. 

Swelling and “dog ears”In plastic surgery, 'dog ears' refer to excess skin and fat that folds outwards at the ends of an incision line, resembling the floppy ears of a dog. are a common occurrence during the recovery phase following abdominoplasty. There’s no need to worry if you notice swelling — it’s a natural part of the healing process. Typically, swelling becomes noticeable in the first 1–2 days, peaks, and then gradually lessens over the following weeks. 

Depending on how long the skin sticks after abdominoplasty, scarring and swelling often lead to the so-called orange peel texture effect. Walking and the gradual addition of physical activity over time will restore the elasticity of the skin, but you can also turn to lymphatic drainage to help with the healing process [3]. 

This is rare for my patients, but sometimes a fatty layer can form around the scar, usually on top. It’s quite normal, and it should disappear on its own over time. However, if fatty deposits remain after six months, a small liposuction procedure can help contour the area.

— Dr. Christina Brunner

Abdominoplasty Scar Massaging

Scar massaging can be beneficial in the later stages of the recovery process, This helps in loosening the tissue and promoting better flexibility. The key is to start with very light pressure and progress gradually over time. “When massaging, you should focus on delicate and round movements,” said Dr. Christina Brunner.

Applying a fragrance-free moisturizer before massaging can help with reducing friction. Be consistent, and aim for 5–10 minutes of massage, 2–3 times a day. Mind that massaging is not recommended during the first post-surgery weeks.

Abdominoplasty Recovery Restrictions

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Sleeping Positions

Earlier, we described the recommended sleeping positions during the first days of recovery in the hospital. As for home care, are there any special restrictions?

The answer is no, there are not. There are only certain conditions that should be observed during the first two weeks. It is better to keep a semi-sitting sleeping position for 1 week after a tummy tuck. As Dr. Brunner mentions, “Putting two pillows under the upper part of the body should be enough, and they can also use a pillow under the knees.” 

Sleeping on your side after abdominoplasty is not recommended for the first two or three days at home, it is better to try to keep a straight posture and not to stretch out. Then you can gradually turn on the side. And, of course, no sleeping on the stomach for at least 6–8 weeks.

Diet Restrictions

After tummy tuck surgery, the first day means no solid food to avoid any issues with the stomach, like colon atonyColon atony is also called 'lazy bowel' — a condition when where colon muscles get weak and sluggish, leading to difficulty passing stool and potential constipation.. Solid food is withheld due to the delicate nature of the fascia application, and to prevent complications like vomiting, patients get an infusion for nutrition.

Things start to get better already on the second day. Patients can eat lighter stuff like soups that are easy on the stomach. By the second day, patients can go back to their normal eating habits.

However, we advise you to follow a few tips:

• Drink plenty of water to stay hydrated and promote circulation.
• Limit processed foods, sugary drinks, and unhealthy fats to avoid inflammation.
• Reduce salt, as it can contribute to swelling.

Exercise Restrictions

Source: Yan Krukau

The most important thing in abdominoplasty rehabilitation is to be careful with any physical activities, considering the amount of sitting after abdominoplasty. So, during recovery, it’s best to avoid heavy lifting, bending, and stretching to make sure the muscles don’t get strained, and the scar doesn’t break.

This is the most crucial during the first 2 weeks of recovery, a patient should treat it similarly to getting the flu, meaning they should lay down and rest as much as possible. After two weeks of such rest, you can gradually move on to walks. And then after six to eight weeks, you can start or return to your favorite sports of all kinds.

Walks are the Best!

The second week allows for gentle walks outside. But even here, it’s important not to overextend yourself, as it can be too much of a good thing, too.

Dr. Brunner advises: “The best way to start physical activities is by doing 20-minute walks, then slowly increasing the time to half an hour and an hour, respectively.” Walking is good for general recovery, especially if you use a garment. But if you ever feel any discomfort or pain, it’s a sign to take it easy. Listen to your body and don’t push too hard to make sure you heal well.

Avoiding Bad Habits

Since nicotine inhibits the healing process and can cause complications after plastic surgery, it is recommended to stop smoking and drinking one week before surgery. In addition to that, it’s strongly advised for patients to avoid smoking and consuming alcohol whatsoever [4]. 

While it’s best not to smoke and drink at all for 3 months, if you must, try to keep it to a maximum of three cigarettes a day after two post-op weeks. In Dr. Brunner’s tummy tuck experience, there were cases of people who smoked a lot without listening to this advice, which led to serious issues with their wounds healing properly.

Avoiding Sauna

Since the abdominal surgery creates a large wound area, about 0.155 square inches (1 cm²), it’s essential to avoid exposing the wound to heat and sweat in the first three months. That includes not only avoiding direct sunlight but also sauna procedures.

As for the sunlight, it can affect scar formation, in the best case, there will be just a noticeable difference in skin tone, which will affect the visibility of the scar. It’s best to keep the scars, especially around the umbilicus, covered or protected with sunscreen of at least 50 SPF.

Abdominoplasty Recovery Complications

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In practice, side effects after a tummy tuck are rare. Swelling and bruising cannot be attributed to this category, as they are completely natural and disappear over time. The most common abdominoplasty risks and complications are bleeding and infections.

To avoid any possible complications during recovery, patients must receive a thorough prescription detailing the post-surgery expectations and guidelines during their consultation before checking out of the hospital. As Dr. Brunner mentions:

I reiterate specific instructions and expectations during a meeting, either online or in person. My patients are provided with a written set of instructions for reference. I also share my contacts to encourage them to reach out at any time, day or night, through calls or messages.

— Dr. Christina Brunner

Quite often, complications include numbness of tissues in the area of surgery and loss of skin sensitivity in the abdomen. Large amounts of tissue and fiber reduction may cause bruising and seroma. However, the worst complications include necrosis and gangrene [5]. Gangrene refers to tissue death caused by a lack of blood circulation, it can be as well caused by dehydration and smoking.

Post-Op Abdominoplasty Check-Ups

After your tummy tuck, it is important to see your doctor regularly to monitor your progress, address any concerns, and make sure you have healed properly. Follow-up meetings during abdominoplasty recovery time include such stages:

• After 10–14 days: As we mentioned previously, this is where doctors take a look at your sutures and scar appearance.
• After 4–6 weeks: This check-up focuses on assessing overall healing progress, including scar formation, swelling, and potential complications.
• After 6 months: This visit offers a broader picture of the outcome, evaluating scar appearance, muscle function, and any lingering concerns.

2 Things Most People Don’t Expect During Abdominoplasty Recovery

Source: Markus Spiske

Scar Itching

You need to be mentally prepared for this, especially at the beginning of rehabilitation. Scar irritation can be caused by both natural cell regeneration and external irritants, including overdrying of the skin and the presence of excess skin particles.

To address scar itching, I suggest my patients start using cream approximately two weeks after the stitches have been removed. We encourage scar treatment once the scar is free of any crusts and is smooth and clean. Patients can try silicone gels along with massaging, which turned out to be highly effective.

— Dr. Christina Brunner

Alternatively, some patients prefer to use body oils or scar oils for this purpose. The key is to incorporate scar massage into the routine and apply the chosen product in a slim stripe post-massage, providing a valuable approach for achieving more inconspicuous scars.

Using the Toilet

Another aspect that may catch people off guard is toilet restrictions. Similar to how to sit after abdominoplasty, limited activity during the first weeks of rehabilitation also includes not straining the lower abdominal muscles while using the restroom.

To avoid this problem, doctors recommend including fiber-rich foods in the diet and even consider stool softeners [1].

Summary

Many patients have questions about recovering and rehabilitating after abdominoplasty. In this article, we have tried to cover all aspects and special postoperative conditions in a short and meaningful way.

We hope this article was useful to you and that it made it easier to think about the consequences of abdominoplasty surgery. Together with Dr. Christina Brunner, we have shown that rehabilitation after a tummy tuck is not as scary and draining as it seems.

FAQ

References

1. Deal RC, Maningas T, Bonnor R, Fogleman T. A Novel Treatment for Opioid-Induced Constipation After Abdominoplasty. The American Journal of Cosmetic Surgery. 2017;34(4):200-203.

2. Kosloski, F. R., Barbosa, M. V. J., Rodrigues, M. A., Martins, M. R. C., Ferreira, L. M., Nahas, F. X., & Nahas, F. X. (2024). Effect of Compression Garments on the Ventilatory Function After Abdominoplasty. Aesthetic Surgery Journal, 44(2), 174–182.

3. Maningas T, Sturm L, Mangler A, Pazdernik VK. Manual Lymphatic Drainage in Postoperative Abdominoplasty With Core Liposuction Patients. The American Journal of Cosmetic Surgery. 2020;37(1):45-49. doi:10.1177/0748806819874941

4. Momeni, A., Heier, M., Bannasch, H., & Stark, G. B. (2009). Complications in abdominoplasty: A risk factor analysis. Journal of Plastic, Reconstructive & Aesthetic Surgery, 62(10), 1250–1254. https://doi.org/10.1016/j.bjps.2008.03.043

5. Vidal, P., Berner, J. E., & Will, P. A. (2017). Managing Complications in Abdominoplasty: A Literature Review. Archives of plastic surgery, 44(5), 457–468. https://doi.org/10.5999/aps.2017.44.5.457