Pre, Intra and Post
Before a patient undergoes surgery, one of the most important aspects is mental and physical preparation. In this interest, we want patients to understand the entire process before, during and after surgery. This education is paramount to a good result, as an educated patient is generally more relaxed than one who doesn’t know what to expect. To accomplish this goal, we’ve reviewed the salient points of preparation, surgery and recovery. While the below is a relatively thorough overview, it may not cover every aspect of surgery. Your surgeon will provide you with a complete list once your surgery is scheduled.
PREPARING FOR SURGERY
The most critical element leading up to your Mommy Makeover surgery is being the ideal weight. Here is the real information: Losing more weight after your procedure will prevent an optimum result. If you have excess fat, no tummy tuck or liposuction will produce your desired results. Many surgeons will not tell you that you need to lose weight because they do not want to lose you as a patient. If you know in your heart that you’re overweight, despite what your surgeon says, do not undergo surgery. A Mommy Makeover is an expensive, long and precise procedure. You want to do it when you get the best outcome.
The above applies to both the breasts and the abdomen. With regard to the breasts, they may look fine right after surgery, but as you lose more weight, they will sag more than anticipated. This can be avoided by achieving one’s ideal weight prior to undergoing a Mommy Makeover. Remember that the ideal weight does not necessarily mean the weight you were prior to having children. It simply means being at a weight where you feel comfortable, and are able to maintain throughout your life. Do not undergo any starvation diets, because after surgery you will rebound and also disrupt your outcome by regaining weight.
Additionally, patients must be in good health before undergoing a Mommy Makeover. While being one’s ideal weight is good for cosmetic reasons, it also helps ensure the surgery is safe and successful. In the months and weeks leading up to surgery, you and your surgeon will ensure you are physically prepared to undergo surgery. This begins with a medical history and thorough physical exam to determine your health for surgery. Based upon the results, your surgeon may recommend a fitness and diet regimen to ensure you’re at your ideal weight to get an optimum outcome. Once you are physically cleared for surgery, there are other preparatory actions to ensure your body is ready for the rigors of surgery, as well as the healing process:
- Establish support for the immediate portion of your recovery--1 to 2 weeks
- Arrange your home to be convenient during your recovery
- Arrange a ride after surgery and help around the house following your procedure
- Avoid any medications that can increase bleeding 2 weeks before surgery, such as aspirin or anti-inflammatories
- Stop all supplements that increase bleeding 2 weeks before surgery, such as flax seeds, fish oils and chia seeds
- Don’t drink excessively prior to your surgery, and no drinking two weeks prior to the date of your surgery--in particular red wine as it promotes bleeding
- Stop smoking at least 4 weeks prior to surgery, as smoking inhibits your ability to heal.
- Partake in physical activity at least several times per week
- Maintain a generally healthy diet
WHAT OCCURS DURING SURGERY
Depending on your surgeon’s arrangement, your Mommy Makeover may be performed in a standard, accredited hospital or in an independent, freestanding surgical facility. It is crucial that you do your homework and make sure the facility is properly accredited. Medicare-certified facilities are ideal.
While certain plastic surgery procedures only require local anesthetic, your Mommy Makeover will require general anesthesia. An anesthesiologist or nurse anesthetist may administer the anesthesia. Dr. Rahban recommends your surgeon use a board-certified anesthesiologist in order to ensure the highest level of safety. Additionally, your surgeon should be in the room with you as you undergo anesthesia and awaken from your procedure. This ensures that he’s continuously monitoring your experience.
Next comes the surgery itself. Your surgeon will perform the surgery according to your agreed upon surgical plan. During your surgery, you want to feel confident that your surgeon is doing what’s best. You want a surgeon who is paying attention to all others in the surgical environment, including the nurse, the surgical tech and the anesthesiologist.
Dr. Rahban firmly believes the surgeon should be the only one performing the procedure on the patient, and that includes closure. Make certain that your surgeon, not his tech or his assistant, will be the one closing you, as scars are one of the most important measures of outcome. Because you’re asleep and vulnerable during surgery, you have to trust your surgeon and know he has your back.
Once the surgery is over and your incisions are closed, surgical dressings will be placed, possibly along with devices called surgical drains. These are tubes placed to help extra fluid drain and prevent swelling.
Once everything is completed in the operating room, you go to a recovery room where you will be monitored for approximately an hour following surgery. When you are fully stable, you can go home with your arranged ride. In some cases, you may stay one or two nights in an accredited aftercare facility.
THE RECOVERY PROCESS
A Mommy Makeover is a significant surgery, and patients should be fully prepared for recovery. While the recovery is definitely tolerable, it is certainly not easy, and therefore we want to inform you so you are not underprepared. The following is a approximate timeline detailing the different stages of the recovery process. Dr. Rahban’s approach may be different than your surgeon’s, but the following roughly applies to most Mommy Makeovers.
- Directly after surgery, you will awaken from anesthesia, at which point you will have little to no pain, as both the general anesthesia and the local anesthesia are still present in your body. You will have a surgical bra on to hold the breast tissues in place, and an abdominal binder to hold the abdominal tissues in place. Dr. Rahban’s approach is to leave everything in place for one week until he sees you for your first post-operative visit.
- At one week, you will see Dr. Rahban, at which time your bandages will be removed along with some of your sutures. As Dr. Rahban does a multiple-layer closure using both absorbable and non-absorbable sutures, you have many layers of sutures that need to be incrementally removed. The second sutures will be removed at the second week. This technique ensures optimal scarring. He will then begin telling you how to care for your scars. Refer to Dr. Rahban’s scar management protocol for more information. [link]
- Most patients return to work after about 10 days. During this time, you will still need to wear surgical garments, but they can be taken off to shower. These garments ensure your tissues heal properly and that you get the best cosmetic result from your Mommy Makeover. Exercise should remain limited for about six weeks after surgery. If your surgery involves the abdomen, you will return to work in two weeks. If the surgery only included your breasts, it will take one week.
- The second visit occurs at 2 weeks after your surgery, at which time your pain is significantly less, and the focus is on wound care. The rest of your surface sutures will be removed at this time, leaving behind hundreds of deeper, absorbable sutures maintaining your wound integrity. As Dr. Rahban’s closure is quite compulsive, it is the deeper sutures that allow your wound to heal with minimal scarring. During this visit, Dr. Rahban will continue to ensure you know how to care for your scars.
- The next visit is at 6 weeks. You will be able to resume all strenuous activities and exercise. You will discard your surgical bra and binder and purchase your first set of bras.
Note that at this juncture, your scars will start to become more inflamed, and perhaps more obvious, as your body is beginning to do its healing work. Refer to Dr. Rahban’s timeline on wound healing in the wounds section for more information.
- After three months, most tissues will have settled into place and the swelling will have subsided. At this point, you will be enjoying the full results of your Mommy Makeover. Please note the incisions may be slightly red or inflamed. This is because they are still healing fully. But rest assured, after several more months, they will be virtually invisible.
- After one year, Dr. Rahban will see you for your final appointment. At this point, he checks the integrity of your results and makes sure everything is as it should be. He makes sure there is no scar formation or any other complication present.
Your relationship with Dr. Rahban continues long after your Mommy Makeover is over. At any point after your surgery, he and his office are available to help with any questions or concerns that arise. Even several years later, his door is open to patients who have concerns about their surgery.
During the duration of your recovery, it’s paramount that you follow all postoperative guidelines. You will be given a comprehensive list of such guidelines by your surgeon’s office. This will include instructions to help your body recover, along with problems to look out for. Your recovery time will vary based on which Mommy Makeover procedures you received, as well as your body’s natural ability to heal. Your postsurgical guidelines are the way in which you can ensure the smoothest recovery possible.
Some basic precautions and instructions include:
- During the first week, you must remain flexed at all times. This will include sleeping with pillows behind your back and a pillow under your knees to keep your legs slightly bent. This decreases tension on your tummy tuck incision.
- If you notice any potential problems, call your surgeon immediately for assistance. Such problems include severe pain, discharge from the wound, abnormal swelling or vomiting. Your surgeon will provide a complete list of red flags based on the procedures you will undergo.
- We will give you a surgical bra to wear after your breast surgery. This bra fulfills a very specific purpose. While normal bras lift the breasts up, this bra allows the breasts to settle naturally. If you were to wear a normal bra, the breasts would heal higher than they should.
- Similarly, you will wear an abdominal binder to help your abdomen heal. The abdominal binder is crucial as it allows the tissues to readhere and prevent fluid accumulation under your skin flap. Dr. Rahban is quite strict and recommends his patients wear the binder consistently for six weeks, except when showering.
- After a Mommy Makeover, there must be no significant physical activity for the first six weeks. This includes sports, jogging, strenuous exercise, heavy lifting, etc. Your surgeon will help you determine when you can get back to your usual activities.