Frequently Asked Questions

PETRUNGARO PLASTIC SURGERY, MUNSTER, IN
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How Long is the Recovery Period for Full Tummy Tuck?

In my practice, I counsel my patients that a full recovery from a tummy tuck takes about 6 weeks. But I stress the fact that this does not mean that you are bedridden and unable to function for those 6 weeks.

My typical breakdown with a patient is very simple. During week 1 after a tummy tuck, you will need to be off work and taking it easy. You will need to walk bent forward at the waist for about 2-3 days. Your own body will naturally relax and allow you stand up straight or lay flat during this time. You do NOT need to walk bent forward for weeks on end like many patients are told. During this first week you will need to manage your drains (I place 2 of them) and focus on resting, eating good proteins, and drinking plenty of fluids. Sleep in a recliner or with your head and back propped up on pillows. Be sure to walk around the house or around the block to keep the blood circulating in those legs.

During weeks 2-6 we slowly ramp you back up to normal activity. The drains are usually out by day 7. During week 2 I allow my patients to start using a treadmill or elliptical at a slow, walking pace. No sweating or getting dirty while the wounds heal! You see the trend — so during week 3/4/5 you can get more and more active.

I do not allow abdominal exercises (sit ups, crunches) until week 8. We need to allow that muscle plication to heal up nicely.

Patient are typically ready for the beach or bathing suits by week 6, but remember it takes 2-3 months to really see final results, no matter what anyone tells you. Wearing a compression garment after week 1 will significantly help you with postoperative swelling. You may feel some tugs or pulling during this time. As long as it is isolated and not constant and extremely painful, this is normal. Eventually everything will settle and look awesome!

Brazilian Butt Lift Recovery

There are many opinions on recovery from a Brazilian Butt Lift (BBL). Some Plastic Surgeons will forbid you from sitting on your buttocks for 8 weeks. I find this a bit excessive. I tell my patients that they need to avoid any type of prolonged sitting on the buttocks for the first 4 weeks after surgery. This will help prevent fat death and unintentional shifting of the fat. It takes 3-4 weeks for the transferred fat cells to grow their new blood supply, so it is important to treat this fat very delicately. Of course, patients can sit to use the bathroom, etc. Sleeping should be mainly on the belly. When patients do start to sit on their buttocks, I recommend a large soft pillow that is either in the shape of a cigar or donut.

Liposuction is a huge component of this surgery, and I think lots of patients (or their surgeons) downplay this. Although liposuction does not have a large incision(s), there is a significant amount of surface area that needs to heal, it is just under the skin. It can take 2-3 months for the areas treated with liposuction to really smooth out and get rid of their swelling. This is totally normal. Wearing a compression garment as much as possible during the first few months will help this process.

Most patients will be able to return to work within 1 week (at the earliest) or at the 2 week mark. Full recovery (meaning most restrictions are lifted) is at 6-8 weeks. Remember, it will take 6-12 months for you to realize your full results.

How long does it take for the belly button to heal after a tummy tuck?

The belly button incision is probably the part of a tummy tuck that has the most variation among Plastic Surgeons. Each surgeon has found their own best way of performing this part of the procedure, known as the umbilical transposition. I place a deep layer of dissolvable stitches below the skin, and then I place very very small nonabsorbable stitches externally in the skin, which I remove in my office at 5-7 days. If you talked to 10 different Plastic Surgeons, you would probably hear 10 different ways of doing this part of the surgery.

The incision will continue to look better and better each day. At six days, it is still very early for you. Be patient. You will likely be happy once you give it more time. If it is still unacceptable to you after 3-4 weeks, you should at least bring it up to your surgeon. He or she should be aware of this, and they can potentially revise it in a few months. Best of luck!

Tumescent liposuction uses a large volume of dilute epinephrine to cause intense constriction of the small blood vessels, which leads to less bleeding, less bruising and less swelling.

Is 18 too young for a breast augmentation?

In short, no, the age of 18 is not too young to have a breast augmentation. In the United States, 18 is the age of consent, so patients do not need parental permission for any type of surgery once they reach that age.
As far as your personal decision, it is important that you have given legitimate thought to surgery. If you are mentally, socially, and financially ready and able to have surgery, then go for it! In the United States, you are restricted to saline implants until the age of 22.

It is critically important that you select a true Plastic Surgeon who will sit down with you and explain the entire surgical process to you, including the fact that you will likely need future surgeries on your breasts if you elect to have a breast augmentation at the age of 18. Breast implants are permanent devices that don’t last permanently.

Waiting time depends on your surgeon and how busy he or she is. Most surgeons should be able to fit your surgery into their schedules within a few weeks, maybe a month at most.

I’m up 8-10 pounds after liposuction on my tummy 9 days post op. Is this normal?

Yes, it is very normal to be a bit up in weight especially after liposuction. The surgery itself involves injecting a large amount of fluid into the liposuction areas, and not all of it is suctioned out with the fat during surgery. Plus the body’s normal response to surgery is to retain fluid and swell up in the very early stages of wound healing. Most of this fluid will go down within a few weeks after liposuction, but I always tell my patients that they MUST be patient when waiting for final results. No matter what anyone tells you, it takes anywhere from 2-3 months to really start to see your final results from liposuction (during this time you may have instances when you swell up and down and you may feel some hard spots or bumps below the skin — don’t worry, it will go away, your body is healing!).

Remember, liposuction is NOT a weight loss surgery. I tell my liposuction patients to never step on a scale at any time after liposuction. You will likely not lose any significant amount of weight. Liposuction is a “look better” surgery. As long as you look better in the mirror, fit in smaller clothes, and people notice that you look great, surgery was a success!!!

What kind of physical restrictions will I have after my 6-8 week tummy tuck recovery?

Congratulations on your tummy tuck, it is among the most rewarding procedures we perform as Plastic Surgeons. You are clearly well-informed and I can see that you are invested in your recovery — that is great!
Your timeframe of 6-8 weeks is pretty much right on target. I tell my patients that at about 6 weeks they are clear to perform basically all activities, such as running, lifting weights, etc. I tell them to wait a full 8 weeks before they do any type of abdominal activities, such as sit ups. At this point you should be able to lift over 20 pounds. You need to let that muscle repair (yes, the diastasis) really heal and you don’t want to risk it coming back by breaking a suture from intense abdominal activity.

After 8 weeks, as long as you are feeling well and your surgeon clears you, there should be no major restrictions. It takes a full year for the healing process to be complete, so for the first 4-6 months you should always be aware of your tummy tuck and be sure you protect yourself from any injuries, trauma, or extreme over-exertion.

High intensity kickboxing is just that — high intensity. You need to specifically clear that with your surgeon. Remember, young healthy people “feel better” after surgery quickly and it is easy to assume that you are completely healed. Don’t overdo it. Listen to your surgeon’s postoperative instructions. No matter what I or any other surgeons tell you, always make sure you speak with your Plastic Surgeon first — he or she makes the ultimate decisions because they operated on you!For example, are you doing it because you feel your breasts are too small relative to your body contour or are you unhappy with the size and firmness of your breasts following pregnancy, breastfeeding or major weight loss? Unevenness between the breasts can also be a motivating factor. Your surgeon can help you make the right decision during your pre-surgical appointments.

What other procedures can be paired with arm lift after large weight loss?

This is an excellent question, as many weight loss patients are not sure where to start with body contouring after they have lost their weight. Congratulations on doing so, by the way!

Most Plastic Surgeons will agree that it is important to come up with a game plan for your surgeries. In massive weight loss patients, the most common procedures will be body lift, arm lift, thigh lift, and breast lift (in women) or possibly breast skin reduction (in men). There are other procedures, but these are the most common.

In my opinion, it is important to start with a good foundation in the core of the body, so I always recommend the body lift first. Because the arms are essentially completely separate from the body, I will often pair a body lift with an arm lift.

Once these surgeries have had time to heal over at least 6 months, I will discuss the remainder of the surgeries with the patient. If it is thighs and breast, then that is what we will safely do.

Too much surgery at once puts you at risk of adverse complications and poor outcomes. Don’t be in too much of a rush. Choose a board certified Plastic Surgeon who knows these surgeries well and knows how to take care of you both before and after your surgeries.

How long do I have to wait after a tummy tuck for a Brazilian Butt Lift to be done?

Great question. For many surgeons (myself included), a tummy tuck and Brazilian Butt Lift can be done at the same time. Some surgeons are against this combination because they think it is impossible to avoid putting pressure on either the buttocks or belly when you sleep, but this is not true. You can either lay down on your sides to avoid pressure or you can lay on your back with pillows under your back and thighs, which will elevate your buttocks off the bed.

If you do not want to tackle both procedures at once, then you should wait 3-6 months between procedures to allow the first one to heal appropriately. However, if you are truly interested in a BBL, then make sure you speak with your Plastic Surgeon about the amount of fat you have on your abdomen that he or she will need to use to transfer into your buttocks. If you have a tummy tuck first and most of this skin and fat is removed, then you will certainly decrease the amount of fat available for transfer into your buttocks during the BBL.

Always choose a board certified Plastic Surgeon for your care! Best of luck!

What are the calorie requirements during recovery from abdominoplasty and liposuction?

You ask a really good question and it is nice to see that you are taking your nutrition and your recovery seriously! Following all of your surgeon’s instructions is very important to get the best cosmetic results after a tummy tuck.

Don’t overthink things too much. As long as your weight was stable prior to surgery and you weren’t actively losing any weight, you should be in a good place in terms of nutrition during your recovery. I don’t typically assign a specific number as far as calories that my patients must consume after surgery. A better way of looking at your nutrition right now is to make sure you are eating 3 good meals a day that are full of good protein (chicken, lean meat), healthy fat (such as nuts like almonds), and some carbohydrates. Don’t be afraid to snack a few times each day. Colorful vegetables are good to make sure you get your vitamins and minerals, and it is OK to take a multivitamin. Good nutrition = good wound healing and better looking scars.

Don’t worry about the scale, you are correct that your weight might fluctuate a bit in the months following your surgery. But I would be concerned if you were consistently LOSING weight after surgery, so it is perfectly fine to check your weight every week or two. I hope this helps, and congratulations on your surgery!

Is all silicone for scar treatment equal?

You ask a great question. It is difficult to say if all silicone used for scar treatment is equal, but if you choose one that your Plastic Surgeon trusts I would be very comfortable with that product. I have my particular favorites that achieve good results, and your surgeon will too. I will typically start with the sheets.

Silicone scar therapy can take many forms. The main choices are sticky silicone sheets and silicone gel/ointment. There are multiple theories on how the silicone works, and one of the theories is via pressure, just like you mentioned (very good for you!). Other theories state that it may alter water content of scars, and some even think it alters the electric charge of the scar.

Realize that you might not even need silicone therapy. I will not recommend it or even allow it unless I start to see some aggressive or stubborn scar starting to form. Always follow the direction of your Plastic Surgeon. Good luck with your breast lift!

I consulted a doc and loved him. I checked on American Board of Plastic Surgery and he’s not board certified! What should I do?

This is an extremely important issue and one that has our society working diligently to educate the public to always choose a Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS). As the others have said, ABPS certification means that your Plastic Surgeon is trained to expertly take care of you before, during, and after your surgery. We are trained to make the proper decisions and to know not only HOW to operate but WHEN to operate, and we are trained to take care of any complications that may arise after your surgery.

Other “cosmetic surgeons” have not completed a formal residency program in Plastic Surgery. No matter what they may say, they were never trained by other ABPS certified Plastic Surgeons in the surgeries they perform, and unfortunately they lack the expertise to deal with any problems after your surgery, which might require you to seek out a board certified Plastic Surgeon to fix the problem. Which may end up costing you a LOT of money…

When can I return to work after breast augmentation?

Thank you for your question. Most patients feel good enough to return to a desk job (like yours) after 3-5 days out from a breast augmentation. That being said, I always recommend taking a full week off work if at all possible. It’s just a good idea to be able to really rest and relax after surgery and concentrate on eating well and avoiding too much exertion during that first 5-7 days.

If you are traveling for your surgery, be sure to speak with your surgeon to determine their requirements. My rule is that anyone who travels to me for surgery out of state MUST stay in town for a minimum of 1 week. I will want to see my patient a few times after surgery, and I certainly will need to see the patient at the 1 week point before clearing a flight back home. In my opinion, staying close to home for any elective cosmetic surgery is always the safest and best idea. Having access to your surgeon is very important in the postoperative period, especially if a complication occurs. Best wishes!

Can you still have children years after a tummy tuck?

Thank you for your question. The answer is yes, you can definitely have children years after a tummy tuck. It will be safe for the baby and safe for you. However, during a pregnancy your baby grows which in turn stretches out your belly, specifically the abdominal muscles and the skin. That is why many women have a bit of a “poochy” belly and stretch marks after pregnancy. If you have a tummy tuck and follow that with another pregnancy, you will likely stretch out, or “undo”, your tummy tuck results. Some patients will be affected more than others. Some women will even need a repeat or revision tummy tuck.

The main advice I always give my patients is to wait until you are done having children before you start any type of body contouring surgeries. You want your surgical results to last, so don’t do anything that risks compromising the very expensive surgery you had! Best wishes!

Tummy Tuck in Mexico?

I highly advise against traveling to Mexico for cosmetic procedures. First of all, a facelift, tummy tuck, and liposuction is a LOT of surgery to have done all at once. It isn’t impossible, but I would seriously recommend giving that some thought. No matter what surgery or surgeries you want done, it is imperative that you choose a board certified Plastic Surgeon here in the United States. By traveling out of the country for surgery, you have no guarantees of the level of training of your surgeon (is he or she even trained in Plastic Surgery?), no guarantees of the safety or cleanliness of the surgery center or hospital you are in, no guarantees of adequate postoperative care, no guarantees of personal safety, and no guarantees of adequate surgical results. If you have complications from your surgery, believe me, the surgeon in Mexico isn’t going to be there for you. And once you return to the United States, you will absolutely have an extremely difficult time finding a US Plastic Surgeon to assume your care. If you do need something done because of a complication, it will end up costing you thousands of dollars.

At the end of the day, yes, it will be more expensive to have surgery here in the United States close to home. You are paying for piece of mind and guaranteed surgical training and safety when you choose a board certified Plastic Surgeon.

Does a full tummy tuck remove stretch marks?

The answer is yes! A full tummy tuck will remove the majority of the stretch marks on your belly.

A tummy tuck will NOT remove stretch marks that are above your belly button. But stretch marks below the belly button (where the majority of stretch marks occur) should all be included in the skin that is removed from your belly during your tummy tuck.

So in other words, a full tummy tuck gets rid of most or all stretch marks, but if you have any above the belly button, those will remain after surgery.

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