Post Operative Advice Sheet - Abdominoplasty

1. You should arrange for someone to drive you home from hospital and to stay with you for the first night following your discharge from hospital.
2. You will experience mild to moderate discomfort after your surgery and it is recommended that you take one or two pain relieving tablets (such as Paracetamol) on a regular basis for the first week or so.  DO NOT TAKE ASPIRIN OR ANY PRODUCTS CONTAINING ASPIRIN as this may prolong or cause bleeding in the early post operative period.
3. There maybe considerable bruising following surgery, but this should settle in the first two or three weeks.  You will notice the skin of your tummy as well as sometimes and occasionally the skin of your thighs may be entirely numb or tingling and is very often itchy from the bruising.  This area of impaired sensation will gradually improve over the coming months, however, during this early and intermediate period you may have lost protective sensation and will not be aware of pain in this area.  You should therefore take extreme precautions and avoid using any hotwater bottles as this can lead to a full thickness burn to these numb areas without you realising it.
4. Initially mobilisation is slow and painful.  If a lot of skin is removed from your tummy wall it may take at least a week before you can stand up right fully.  Sometimes you will find it more comfortable when you lie in bed to have your legs supported on a couple of pillows beneath the knees.  Though you will need a lot of rest in the first week post operatively it is very important in this early period that you set yourself a daily walking exercise programme.  It is important that you do not just lie in bed for protracted periods.
5. You will have been provided with a pressure garment or elasticated dressings to gently compress your abdominal wall.  If you have been provided with an elasticated corset you should wear this day and night for the first month.
6. You should avoid getting the wounds or dressings wet for the first week.
7. For your surgery, buried dissolvable stitches have been used.  These normally dissolve spontaneously in the first four to eight weeks, so there are no sutures to be removed.
8. At one week post operatively you will be seen by the nurse in the Dressing Clinic who will remove the dressing and inspect your wound.  If the wound is healing nicely at this stage you may recommence bathing then.  If the wounds are still a little moist after one week they will be redressed by the nurse and an appointment given to revisit the nurse in weeks time and you will be advised not to get this wet for a further week. Once the wounds are clean and dry you will be advised when you can recommence bathing.
9. It is very important in the early period after your operation that you move around your home as much as possible, setting yourself a daily walking programme and not lying in bed for protracted periods, however, you should abstain from all exercise from for at least three weeks. For the first week post operatively you should not do any household chores.  You should arrange for someone to drive you home from the hospital and stay with you for a couple of nights following discharge from hospital.  In the second post operative week you can start making cups of tea etc and by week three you maybe able to start light household duties.  You may commence very gentle exercises from four weeks post operatively and are ready to return to gym activities from week six working within the limits of comfort.
10. You may commence driving three weeks after your operation.  After this you may recommence driving once you feel confident to undertake an emergency stop, until you feel confident to do this you should refrain from driving.
11. I would have advised that it is important to stop smoking prior to your operation in order to reduce the risks of complications.  Once your wound has healed it is safe to recommence smoking if you wish to do so.  You should however, avoid smoking for the first two weeks post operatively.
12. Following surgery, the type of job that you do determines when you can return to work.  If you mainly confined to deskwork, you may feel able to return to work after three to four weeks.  More physical occupations may require five to six weeks of recuperation before you feel able to return to work.
13. The scar will take time to mature.  Over the first six weeks your scar will become stronger and stronger and by week six it will be as strong as it will ever be.  During those first six weeks the scar will pretty much look after itself.  By week six you should commence moisturising and massaging this scar with E45 cream and rubbing quite vigorously, the aim being to soften the scar and speed up final scar maturation.   The delicate scar tissue is at greater risk of sunburn if exposed to the sun, therefore, you are advised to avoid sun exposure to any scar tissue for the first six weeks of healing, after this if the area is to be exposed to sunlight you should apply sun protection factor 15 or greater sun block to exposed scar tissue.
14. Though most people experience uneventful post operative recovery, if you develop any of the following you should contact the ward on the telephone number printed below:
• Temperature greater than 38.5°
• Severe pain not alleviated by simple painkillers
• Fresh bleeding from the wound, other than a minor ooze
• Any wound discharge after 48 hours