At Atlantic Coast Aesthetics, we’re very pleased at the number of people who ask specific questions about their particular cosmetic surgery needs. We have always encouraged our patients to educate themselves and be their own best advocates, and the topic of this week’s Ask Dr. Pane segment is no exception. During our Instagram Live chat with Dr. Thomas A. Pane, ACA’s founder and Chief Medical Officer, this question came in. We’re pleased to showcase this question both for its specificity and to demonstrate to others that we encourage all questions, no matter how simple or complex! The patient asked, “How long is the healing process for a tummy tuck with umbilical hernia repair? Also, how long do I have to be out of work and how long do I need to keep my drains in?”
A tummy tuck (abdominoplasty)
Is a cosmetic procedure designed to enhance a patient’s body contour by removing excess skin and fat from around the abdominal wall, either to counter the lingering aftereffects of pregnancy in gestational parents or, across genders, to sculpt the torso when diet and exercise alone or nonsurgical fat reduction techniques fail to yield the shape the patient desires. It is often used in women partially to correct diastasis recti, or spreading of the abdominal muscles during pregnancy.
Surgical tightening of the abdominal muscles is a common, but not always essential, part of a tummy tuck procedure. This is usually but not always done as a body lift procedure which removes excess skin, which may in some cases be combined with another surgical procedure such as some forms of buttock lift or even a neck lift to tighten skin in the affected areas. There are several types of tummy tucks, ranging from so-called “minitummy tucks” which may or may not include muscle repair, to a full tummy tuck surgery procedure which may be done as .
Dr. Pane says for most abdominal surgery, he usually prefers to leave the drainage tubes at the incision site in place for between 5-7 days following surgery, although many other medical professionals favor a more relaxed recovery timeline of between 7-10 days. In Dr. Pane’s experience, the rationale for removing the drain earlier is because once the recovery period reaches a certain point, the drain becomes just another piece of “something” attached to you which can get in the way or cause its own problems and it really doesn’t add much value beyond the 7-day after surgery mark anyway in his experience. The sooner it’s out, the better, but he wants to ensure there is a low likelihood of fluid gathering in the area, as it’s a nuisance to deal with once the drains are no longer in place. Typically, most patients can have their drains removed no more than one week after surgery, assuming the fluid drainage has subsided to a point which makes removal practical and safe.
Now let’s shift our attention to hernias. A hernia is a protrusion through the musculature of the abdominal wall, usually caused by a bulge in the intestines near the belly button. In fact, arthroscopic surgery through the belly button is perhaps the most commonplace method of correcting this disorder. It can be caused by improper lifting, accidents, complications from pregnancy or other factors.
Dr. Pane says a fairly sizable hernia repair is certainly possible, but that gets into the general major surgery realm rather than that of cosmetic surgery. It should be noted here that surgeon Dr. Pane is a board certified plastic surgeon and member of the American Society of Plastic Surgeons, as well as a board-certified general surgeon. If the hernia is too severe, needs more intensive reconstructive surgeries than normal cosmetic surgery provides for and/or requires hospitalization and more rigorous postoperative care or monitoring than is typical, Dr. Pane says he would probably decline to do the procedure simply because such care is beyond the scope of normal care for his typical aesthetic plaster surgery patients. That said, 98-99% of the hernia cases Dr. Pane has seen to date could be and were handled at the time of surgery. Given this, it would be an exceedingly unusual or complex case for Dr. Pane to turn a patient away on that basis.
Ideal candidates for tummy tuck procedures are those who have no intention, or ability, to get pregnant again; who have excess fat and excess skin they would like to have removed from the abdominal area; and have not had previous abdominal surgery, although a Caesarian section or appendectomy are generally not considered problematic for this type of procedure. Patients are strongly advised to stop smoking at least two weeks before surgery, and longer is preferable when possible. They should also abstain from drinking alcohol in any form for at least a week, and excessively at least a month beforehand.
With proper adherence to postsurgical care instructions, including wearing the compression garment as directed to help prevent blood clots and encourage healing, as well as taking pain medications as prescribed, the average patient experiences a return home the same day; resumption of normal activities within a week postop; and full tummy tuck recovery times of around six weeks. This information is covered at the initial consultation to be as specific to your case as possible, and again during postoperative discharge debriefing. ACA also offers live and online patient resources on our website and can recommend others, such as the Smart Beauty Guide, for those who want a second opinion, a different point of view or simply extra information.
If you have concerns, questions or are simply curious about anything to do with cosmetic surgery, Dr. Pane and the staff of Atlantic Coast Aesthetics welcome the opportunity to address your interests. Simply call us at (561) 513-4763; or follow us on Facebook, Instagram, Twitter and LinkedIn. Your question could be answered personally by Dr. Pane himself in an upcoming Ask Dr. Pane segment, helping us educate and inform others while giving you the factual information you need to make the best choices for your own care. Remember, at ACA we believe the only bad question is the one you DON’T ask!