A tummy tuck, or abdominoplasty, is a cosmetic surgery procedure that removes excess skin and fat from the abdominal area and tightens muscles to give you a more toned, flat stomach.
It’s not unusual for people who have had this procedure to experience muscle pain after their operation. This is called “surgical site pain” and it can occur at any time after your surgery. In this guide, we review the aspects of Leg Pain After Tummy Tuck, nerve pain in leg after tummy tuck, thigh pain after tummy tuck, and muscle repair pain after tummy tuck.
If you’re experiencing this type of pain, it’s important to understand what is normal versus what could be cause for concern.
Leg Pain After Tummy Tuck
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.
Hip And Leg Pain After Tummy Tuck
As you are recovering from your surgery, there are practical things that you can do during the first few months to prevent pain from starting and to reduce your pain if you have any.
- Maintain physical activity: As you recover, you should continue to carry out simple day-to-day tasks and regularly get up and walk around your home. This is recommended to reduce your risk of developing harmful blood clots, and it also prevents you from remaining in one position for too long, which can make it painful when you finally get up and move.
- Avoid strenuous exercise: As you are recovering and your wounds are healing, you should not put a strain on your incisions by engaging in strenuous activity or lifting heavy objects for at least six weeks or until you get the green light from your healthcare provider. If you would like to begin or get back to challenging exercises once you are fully recovered, it is a good idea to maintain some level of fitness by walking for exercise throughout your recovery period.
- Don’t smoke: To enhance the healing process, you should avoid the use of tobacco. Nicotine severely compromises the body’s ability to heal. It causes blood vessels to narrow, making the delivery of oxygen to the skin cells at the incision site more difficult, ultimately delaying the healing process.
- Avoid constipation: You may be constipated if you are not eating due to nausea or fatigue. Narcotic pain medications also cause constipation, which eventually leads to abdominal pain. Try to eat food that is high in fiber and drink ample amounts of fluid to avoid constipation. If nausea or constipation are persistent, you may need to take over-the-counter or prescription medication.
Pain Management
Often, tummy tuck procedures include injection of pain medications into the area around the sensory nerves, resulting in a nerve block. This pre-emptive measure has been shown to reduce postoperative pain. However, if you experience postoperative pain, you may need treatment as you recover from your tummy tuck surgery. Options include:
- Over-the-counter medication: Many surgeons recommend taking ibuprofen or naproxen 24 to 48 hours after the procedure if there is no evidence of bleeding. NSAIDS can decrease the swelling and offer pain relief which can allow patients to stop narcotics earlier resulting in fewer side effects from those drugs.
- Prescription medications: Long-acting narcotic pain medications are often prescribed because they do not cause bleeding. However, at low doses, narcotics can cause constipation; at high doses, they can cause breathing and heart problems, as well as addiction risk.
- Pain pump: If you have severe nausea and cannot take medication by mouth, a pain pump—a device that delivers medication directly into the body via an inserted tube—can be another alternative. If your pain is severe, a pain pump can reduce your need for high doses of prescription narcotic pain medication.
Post-Operative Care
There are some routine things you need to take care of as you heal after your surgery, including wearing a compression garment, wound care, and drain care. Paying careful attention to these tasks can help reduce or prevent pain.
- Compression garment: After surgery, you will be wrapped in or given a compression garment to wear. The compression garment will reduce swelling and support the abdomen, promoting proper healing. You should expect to wear this for two weeks to two months, depending on how quickly you are healing. Be sure to tell your medical team if the compression garment is causing any pain, as adjustments may be needed.
- Incision care: Surgical dressings or bandages will be applied to your incision area. You will be given instructions about whether you should change these bandages and, if so, how often and how to do it. The most important aspect of your at-home wound care is that you keep your wound clean and remain gentle with it to avoid injury or bleeding. You will also be given instructions to be on the lookout for problems, such as pain from the incision site, swelling, redness, pus, warmth, or bleeding.
- Drain care: After an abdominoplasty, temporary tubes to drain excess fluid from the surgical site will be inserted under your skin. They will be removed during the first week of recovery or when your healthcare provider is assured that the fluid no longer needs to be drained. If you experience pain at the drain site, or if you notice redness, swelling, or oozing of pus or blood, tell your healthcare provider’s office.
- Antibiotics: You may be given a prescription for medication to apply to your surgical site and/or to take orally to reduce your risk of developing a postoperative infection. An infection can cause pain, but more common symptoms of infection include fever, swelling, warmth, or pus.
Nerve Pain In Leg After Tummy Tuck
Persistent postsurgical pain is a well-recognized problem after a number of common surgical procedures, such as amputation, thoracotomy, and inguinal hernia repair. Less is known about persistent pain after cosmetic surgical procedures. We, therefore, decided to study the incidence and characteristics of persistent pain after abdominoplasty, which is one of the most frequent cosmetic surgical procedures.
Methods:
In September 2014, a link to a web-based questionnaire was mailed to 217 patients who had undergone abdominoplasty between 2006 and 2014 at the Department of Plastic Surgery, Aalborg University Hospital, Denmark. The questionnaire included questions about pain and sensory abnormalities located to the abdominal skin, and physical and psychological function; patient satisfaction with surgery was rated on a 4-point scale.
Results:
One hundred seventy patients answered the questionnaire. Fourteen patients (8.2%) reported pain within the past 7 days related to the abdominoplasty. Abnormal abdominal skin sensation was common and reported by 138 patients (81%). Sensory hypersensitivity was associated with the presence of persistent pain. Satisfaction with the procedure was reported by 149 (88%) patients. The majority of patients reported improvement on all physical and psychological factors. Patients with pain were more often disappointed with the surgery and unwilling to recommend the surgery.
Conclusions:
Overall, patients were satisfied with the procedure, although abnormal abdominal skin sensation was common. However, there is a risk of developing persistent neuropathic pain after abdominoplasty, and patients should be informed about this before surgery.
Abdominoplasty continues to be one of the most common cosmetic procedures. According to recent statistics of the American Society of Plastic Surgeons, a total of 111,986 abdominoplasties were performed in the United States in 2013. This is an increase of 78% in comparison with 2000. The number of procedures is likely to continue to increase in the future not only because of the overall increase in the number of esthetic surgical procedures, but also as a consequence of the large number of obese patients achieving massive weight loss after undergoing bariatric surgery. The purpose of abdominoplasty is to remove excessive skin and to tighten the loose abdominal muscles, leaving a natural-looking umbilicus and a minimal amount of visible scars.
Given the increasing number of abdominoplasties performed, the importance of understanding the possible complications and morbidity associated with the procedure is critical.
Complications can be divided into immediate, early, and late complications. Immediate complications are rare, but life-threatening, with deep vein thrombosis and pulmonary embolism as the most frequent. Common early complications, seen within a month, include hematoma, seroma, local infections, skin or fat necrosis, and wound dehiscence. Late complications include recurrent diastasis, scar hypertrophy, and symptoms related to nerve injury.
Besides these known complications, immediate postoperative pain is also well described. However, only a few studies exist regarding persistent pain after abdominoplasty, that is, pain that persists for at least 3 months after surgery. These studies estimate the risk of persistent pain to be 0.5–4.4%, but they are all based on retrospective medical chart reviews, which may underestimate the prevalence, and they provide no detailed description of the pain and its impact on daily life.
The purpose of this study was to determine the incidence, impact, and characteristics of persistent pain and sensory abnormalities after abdominoplasty because of weight loss with or without bariatric surgery or because of postpregnancy sequelae. In addition, the study assessed patients’ satisfaction with the procedure.
Questionnaire
The web-based questionnaire included questions about smoking, preoperative and current weight, and surgical history. The patients were asked to report the primary cause of the abdominoplasty procedure from a list (Table 1). The patients’ satisfaction with the procedure was evaluated on a 4-point verbal scale (very satisfied, satisfied, disappointed, and very disappointed) and by asking the patients if they would recommend the procedure to a friend (yes/no).
Nine current physical and psychological factors (ability to work, ability to walk, general physical activity, mood, self-esteem, interpersonal relations, quality of life, sleep, and sex life) were evaluated on a 5-point verbal scale (much better, better, the same, worse, and much worse) compared with before the abdominoplasty. These topics were selected on the basis of the Moorehead–Ardelt Quality of Life Questionnaire, which has been validated as a reliable tool for assessing quality of life in obese patients.
Patients were asked if they had abnormal abdominal skin sensation (hyposensitivity or hypersensitivity), and if they did, they rated how bothered they were by this on an 11-point numeric rating scale (NRS; with 0 being “no bother” and 10 being “worst imaginable bother”). In addition, patients with sensory abnormalities were asked to indicate the specific area(s) using the numbers of a diagram of the abdomen divided into 12 areas (Fig. 1).
Patients were asked if they had experienced pain caused by the abdominoplasty during the past week (yes/no) and also about other pain, including pain caused by previous abdominal surgery, if relevant. Patients with pain during the last week related to abdominoplasty answered questions about onset; duration; location (using the same diagram and numbers as for sensory abnormalities); average and maximal intensity during the past week (on a 0–10 NRS); the impact of pain on daily activities, mood, and sleep (on a 0–10 NRS); and use of analgesic medication. To estimate the likelihood of probable neuropathic pain according to the neuropathic pain grading system, the location of the pain was compared with the location of sensory abnormalities. In addition, characteristics of pain were described using the 7-item neuropathic pain diagnostic questionnaire (DN4) translated into Danish. The selection of at least 3 of the 7 pain descriptors (burning, painful cold, electric shocks, tingling, pins and needles, numbness, and itching) is suggestive of neuropathic pain with a sensitivity of 81.6% and a specificity of 85.7%. Finally, the patients were asked if they had pain caused by light touching of the skin, eg, by clothes (dynamic mechanical allodynia).
Statistical Analysis
Quantitative data were described as mean (SD) or median (range) and qualitative variables using frequency and percentages. Normality was checked using histograms and QQ-plots. Numerical data were analyzed using unpaired t test or Mann–Whitney U test and categorical data using χ2 or Fisher’s exact tests. There were no missing data. P values less than 0.05 were considered statistically significant.
The majority of patients were satisfied with the procedure: 93 (54.7%) were very satisfied and 56 (32.9%) were satisfied, 14 (8.2%) were disappointed, and 7 (4.1%) were very disappointed. In line with this, 158 (92.9%) patients reported that they would recommend the procedure to a friend in the same situation. Patients reported improvement on self-esteem, mood, and quality of life.
nerve pain in leg after tummy tuck
The Tummy tuck, or Abdominoplasty, is a great ‘mommy makeover’ postpartum, or an excellent solution for loose skin in both men and women following significant weight loss. Aside from the obvious aesthetic rewards, it can also help repair damage to lower stomach muscles, restore other abdominal functions and ease persistent back pain. Of course, as with any surgery, there is a lengthy list of risks and complications that you need to be aware of before going under the surgeons knife. Here, we’ve put together some sound information and advice about what to look out for post-procedure, to help you and your specialist surgeon manage and identify any problems that may come up during recovery.
Developing an exhaustive list of the potential complications of any surgery is problematic and here’s why: Each surgery, as well as each patient, is unique. Let us clarify this for you: If a surgeon tells you that there are never complications with their procedures, whether it’s a tummy tuck or any other surgery, they are either lying or, at the very least, incredibly inexperienced. Either way, choosing a surgeon who doesn’t completely understand the risks of the procedure himself could spell disaster for you and, in the worst case scenario, could even be deadly. This type of disinterest in a patients well being is were people run into trouble and, if this is your experience, we suggest you find an alternative specialist.
Download our short guide: “11 Important tummy tuck techniques that you need to know about”
Here’s the bottom line, complications are always a possibility and it’s up to you to choose a skilled FRACS surgeon who can handle any problem that arises and provide quality care with a great recovery plan, resulting in a positive outcome. While major complications are rare, it’s important you are informed and prepared for all eventualities related to your tummy tuck procedure. Some of the risks we discuss here are unique to abdominoplasty while others are general to all surgeries.
Serious Complications
Let’s break this down into simpler terms by starting with the most problematic of complications related to any type of surgery:
Heart problems
Heart problems, including heart attack during surgery are one of the top worries for patients and here’s why: Anesthesia and surgery have a range of effects on the cardiovascular system. BUT these days, unless there are any underlying heart conditions such as heart disease, these are very rare due to modern anesthetic techniques.
Anaesthesia
Anaesthesia can also affect how our lungs work after surgery and though lung problems can be serious, they are mostly manageable. More specifically, small areas of the lungs can collapse and, as a consequence, there is an increased risk of chest infection. This may require antibiotics and physiotherapy treatment. Thankfully, other potential lung complications are incredibly rare.
Blood clots
Blood clots in the legs with pain and swelling may occur and, rarely, part of such a clot may break off and move to the lungs, causing fatal complications. Again, these are very rare side effects but should still be discussed with your surgeon during consultation. Make a point of asking questions, such as, the relative risk according to your own personal health issues and concerns.
Manageable Complications
Next, let us walk you through some general surgery complications that are more easily managed than those mentioned above.
Allergic reactions
Allergic reactions to medications should be a priority during consultation with your surgeon pre-procedure. Obviously, it’s important for you to discuss any history of allergic reactions to medications but you also need to be aware of the signs and symptoms related to drug allergy.
Injuries to deeper structures
There is always the potential for injury to deeper structures from surgeries, such as to the nerves, blood vessels, and muscles. This will usually present as itching, tenderness, or exaggerated responses to hot or cold temperatures. Often this resolves during the healing process but, in rare cases, may be chronic and a management plan should be discussed with your surgeon as soon as possible.
Early complications
Some complications will present visually and need to be managed immediately. For instance, sutures may spontaneously poke through the skin, becoming visible or producing irritation that requires removal.
Things you can do to prevent complications
Discussing your current lifestyle with your surgeon is incredibly important and here’s why: some complications are often preventable, such as wound disruption or delayed wound healing, which are more likely to occur in patients who don’t stop smoking before their operation, as should be advised by your surgeon. Generally, if wounds are dressed daily, this heals up in a couple of months. Necrosis, or skin death, can also occur at this time but is very rare.
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Potential Problems Relating to your Tummy Tuck
Now, let’s take a look at some of the complications more specific to your tummy tuck procedure.
Abdominoplasty scar formation
Abdominoplasty scar formation around the umbilicus isn’t particularly unusual and is generally nothing to be concerned about. The scarring is very often pink but will fade to become white, soft and supple in the weeks or months after the operation. Most patients find that the wound heals quickly and that the appearance is ultimately acceptable to them. However, abnormal scarring occasionally occurs within the skin and deeper tissues and these may be unattractive and of a slightly different colour to the surrounding skin. Scars may also exhibit contour variations and “bunching” due to excess skin, or may even be asymmetrical, meaning a different appearance between the right and left side of the body. It is important to note that in some cases scars may require surgical revision or treatment, though this is no real cause for concern.
In rare cases keloid scars may form, which are thickened by an inflammatory process in the scar tissue. This occurs due to an abnormality of the patient’s healing process rather than through surgical error. In such instances, specialist cosmetic surgery provides a special silicone gel tape to wear over the incision after the operation, which will result in less-visible scars.
Tummy tuck infections
Infection after surgery is a big concern for patients in our experience but antibiotics are administered during the operation and you will be prescribed oral antibiotics to take afterwards as well, which will minimise any risk. Nevertheless, infections can occur and, should this be the case, they are treated either by oral antibiotics or, in severe cases, by admission to hospital for intravenous antibiotics and further drainage procedures. It is important to note that infections, superficial or deep, from an abdominoplasty happen in only about 1% of surgeries.
Pain from a tummy tuck
Postoperative pain is another common concern and will occur in varying degrees in each patient, from quite severe to moderate to mild on the first day. It gradually improves over the next few days and is usually well tolerated by patients if they take the painkillers prescribed. Increasing pain unresponsive to pain-killers should be brought to the attention of the surgeon as this may be an indication that complications are developing. Patients may not be able to stand fully erect for up to two weeks after the operation due to the tightness of the abdominal skin with resultant excessive pull on the surgical scar. Intermittent mild discomfort or intermittent sharp pains after the first few weeks after surgery is also common, as the swelling resolves and the nerves recover. Chronic pain, ranging from from mild aching pain to sharp nerve pain can persist for more than one year, but is very rare. While bruising and swelling is normal after the operation, this also varies from mild to severe with each patient.
Patient, Surgeon Management Plans
Finally, we’ll explain some of the most common complications, which are all minor wound related issues and easily managed between yourself and your surgeon.
For instance, bleeding and excessive bruising can indicate the potential for a haematoma developing, which is essentially a collection of blood under the skin. Though haematomas can often be treated with pressure, or needle aspirations in some instances they require removal through further surgery.
If you are considering an abdominoplasty you should also be aware that there are always rather long scars following surgery. Occasionally, a wide, thick or otherwise unfavourable, scars may be visible outside the underwear or bikini. Rare complications related to the liposuction can include injury to deeper structures such as the abdominal wall, bowel, nerves and blood vessels and some numbness in the lower abdomen will result. Sensation usually returns fully, though in rare cases some of the numbness will be permanent.
There is also the potential for a seroma to develop after surgery but this will often dissipate over time. A seroma is a collection of serous fluid, a liquid that your body makes to heal and seal wounds edges together. Generally the fluid naturally drains away, however, in some cases there may be too much fluid produced in the seroma, which will usually occur at the site of incision, and it may not drain away completely but calcify instead. In this case surgery may be necessary, so make sure you bring any prolonged or unusual swelling to the immediate attention of your specialist, so it can be properly monitored.
Surgical drains (tubing) are rarely required for a tummy tuck these days but on occasion, for example in the treatment of haematoma or seroma, they may be necessary and these tubes may protrude from or near my horizontal incision for up to one week.
Recovery Success
A tummy tuck is not a simple surgery and recovery can take time. Knowing the complications, risks and side effects discussed here may seem scary but the intent is to inform and prepare you for this big change in your life. We believe that knowledge is power and information is key. Being aware of potential risks as a result of any surgery could be life saving information.
The bottom line is that discussing these topics freely with your surgeon will allow you to better understand how they plan to manage any problems that may occur. If you feel your surgeon is not fully prepared for any eventuality, then this is an indication that your investment would be better spent elsewhere and your health and wellness placed in the hands of someone more capable.
thigh pain after tummy tuck
There are many patients who experience persistent groin pain following surgery or trauma. It is fairly common for patients who have undergone hernia repair, caesarian section, or other abdominal and urologic procedures to experience persistent postoperative pain. This pain is typically due to direct damage to one of the many nerves in the lower abdomen, groin, or thigh. The damaged nerve, or neuroma, becomes irritated and sends a constant pain signal that makes it difficult to perform daily activities. Even scar tissue surrounding a nerve can cause indirect injury to the nerve in the form of nerve compression. The average patient with chronic groin pain at Florida Plastic Surgery Group describes numbness or burning in the lower abdominal wall, the pubic area, the inner thigh area, the scrotum/the testicles in men or the labia in women, and/or along the front and side of the thigh (known as meralgia paresthetica).
Preparing for Treatment
What are the non-surgical treatment options for my groin & thigh pain? The first step in evaluating chronic groin pain is to schedule an appointment with a medical or surgical specialist interested in hernia, abdominal, urologic, or gynecologic surgery to rule out any underlying cause of your pain. They will examine you for possible causes including hernias or other intra-abdominal problems, infections, tumors, urinary blockage, cysts, or endometriosis. Your doctor may alter your physical activity, recommend physical therapy, or begin a trial of traditional pain and neuropathic medications. If your groin and thigh pain persists, a consultation with a pain management specialist may provide non-surgical options for pain relief.
Are there surgical treatment options for my chronic groin & thigh pain? If there is no underlying medical condition causing your chronic groin/thigh pain, and conservative treatment for pain relief has failed, then you may be a surgical candidate. When the pain is due to a damaged nerve, or neuroma, one or more nerves are removed, leaving an area of numbness in the lower abdomen, pubic or inner thigh areas. If the pain and decreased sensation (e.g. the front and side of the thigh as in Meralgia Paresthetica) is due to a nerve compression, then the pressure on the nerve is released and the nerve is not cut.
The Process
Am I a candidate for groin denervation/thigh decompression surgery? After ensuring there is no underlying medical reason for your persistent groin/thigh pain, our surgeons will perform a nerve block to identify the source of your pain. The nerve block is performed in the office setting, similar to a dental block performed by your dentist to alleviate your toothache. The nerve block targets the nerves sending pain signals to your groin, thigh, scrotum/testicle in men, and labia in women. If your pain is significantly relieved by the nerve block, then surgery can be up to 90% successful.
I have chronic groin/thigh pain, what is the next step? Prior to the initial consultation:
What is done at the initial consultation?
The initial consultation steps:
Surgery Expectations
Surgery is performed under general anesthesia under supervision of a board certified anesthesiologist.
For most patients, surgery is performed on an outpatient basis (you go home the same day). Depending on the number of nerves treated, surgery takes 1 to 2 hours to perform.
What should I expect during my recovery? Following surgery until the first visit (usually 7 days), we encourage patients to relax and not perform any strenuous activity. We recommend you use stool softeners to avoid straining and do not smoke as it can lead to coughing, both of which can increase your abdominal pressure and cause discomfort. A dressing is placed over the incision(s) and may be removed in 48 hours when you are able to shower. We may temporarily place a pain pump at the time of your surgery, which continually instills a local anesthetic to “numb” your surgical site. Activity is gradually increased and most patients are back to work within 2-3 weeks with a graduated lifting limit. You are not able to drive or operate heavy machinery while taking any postoperative narcotic pain medication.
While some patients experience immediate pain relief, the results of the procedure can take several months to take effect. If the groin was operated on, the groin will remain numb because nerves have been removed. If the front and side of the thigh was operated on, sensation should return as pain decreases.
What are the risks of surgery? In addition to common surgical risks, the unique risks of chronic groin pain surgery include:
To learn more about groin and thigh pain treatments and how our plastic surgeons can help you permanently relieve your pain, please contact our office today to schedule a consultation.
muscle repair pain after tummy tuck
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.