Abdominoplasty Surgery Instructions
1. Do not take any aspirin (including any medication containing aspirin) for seven days prior to surgery and two days after surgery because aspirin always interferes with normal blood clotting. Do not take any prescription or over-the-counter anti-inflammatory medications for three days before surgery and for two days after surgery for the same reason. These drugs are used primarily to treat inflammation, mild to moderate pain and fever. Examples of these over-the-counter medications are Motrin, Advil, Aleve, etc. Stop any Vitamin E and herbal supplements for three weeks before and one week after surgery. Please check any multi-vitamin you may be taking. If you are using birth control pills or hormone replacement therapy (for example, Premarin), discuss this with Dr. Oldham as it may be necessary to temporarily discontinue these 2 weeks prior to your surgery.
2. Smokers should stop smoking as far in advance of the surgery date as possible to minimize complications from the anesthesia and to help minimize scarring. Be sure to inform Dr. Oldham if you smoke.
3. Immediately report any signs of a cold, infection, boils or pustules appearing within two weeks of surgery.
4. Do not eat or drink anything (including water) after midnight the night before your surgery. Do not chew gum after midnight.
5. Arrange for someone to drive you home after the surgery. Someone will also need to stay with you the first night.
6. For two days before and the morning of your surgery, cleanse your body with an anti-bacterial soap called Hibiclens (Chlorhexidine). This is available at most drug stores. If Dr. Oldham has done pre-operative marking, do not use the soap directly on the marks and pat your skin dry over the marks instead of rubbing. Do not apply the anti-bacterial soap near your face, eyes or ears. Do not use any lotion, moisturizer, make-up or other products on your skin.
AFTER YOUR SURGERY
1. If your pain is mild take extra-strength Tylenol. For more significant pain, take the prescription pain medication given to you by Dr. Oldham, but be sure to take it after eating to minimize nausea which is always a risk after taking any stronger pain medication. Regardless of whether you are taking extra-strength Tylenol, the prescription pain medication from Dr. Oldham, or alternating between the two, it is important to wait four (4) hours between doses in order to avoid potentially harmful over-dose of Tylenol (Acetaminophen).
2. Since most strong pain medication causes some degree of constipation, it is advisable to start taking Colace 100mg. (an over-the-counter stool softener) on the evening of your surgery and then take one, twice a day each day after, until you are no longer taking pain medication and you are having normal bowel movements.
3. If you normally have a bowel movement every day or two and you have not had a bowel movement approximately the third day after your surgery, you should take two tablespoons of milk of magnesia at bedtime. If you do not have a bowel movement the following morning, take four tablespoons of milk of magnesia that morning.
4. Do not use cold or hot compresses on the abdomen at any time. You will have some degree of numbness in the area and it is susceptible to burns or frostbite.
5. You may shower 48 hours after the surgery. Remove the gauze dressing when you shower then just replace the binder afterward. Do not take a bath for two weeks after the surgery.
6. Avoid strenuous activity for four weeks and do not lift over ten pounds (approximately a gallon of milk) for at least four weeks after the surgery. You may, however, do light exercise after two weeks, such as stationery bike, avoiding upper body and abdominal exercises.
7. Avoid any exposure of your incisions to the sun for several months to prevent permanent or prolonged discoloration and redness.
8. You can expect some degree of swelling for four to six months after the surgery. Numbness of the lower abdomen will gradually improve over six months to a year, but numbness of some of the lower abdomen will remain permanently.
9. During the surgery, Dr. Oldham will insert two small catheters approximately the size of a pencil lead and this will come out through the skin in the upper abdomen. These small catheters will be attached to a pain pump containing local anesthetic. In the first five days after the surgery, the local anesthetic is gradually delivered through these fine catheters to the area where the muscle contouring was performed. The local anesthetic will last approximately five days and is delivered automatically. There is nothing for you to do. One hundred twenty hours (five days) after the completion of the surgery the catheters can be easily removed. You will be given separate information on the pain pump which includes instruction on removing the catheters. If you do not feel comfortable removing the catheters, call the office for an appointment and we will be glad to remove the catheters for you.
10. Abdominoplasty surgery necessitates elevation of the skin from its muscular attachments which extends up to the rib cage. This changes the blood flow to the skin. Prior to the elevation of the skin, liposuction is performed in the upper abdomen to improve the contour. Liposuction must be limited and very conservative in the upper abdomen, however, in order to avoid permanently damaging the blood supply to the lower abdomen which could lead to loss of skin. For this reason, there may be some fat excess in the upper abdomen which could be safely suctioned at a later date. If you decide that you would like additional liposuction of the upper abdomen and Dr. Oldham feels that you are a good candidate for it, this would be an additional separate procedure and there would be additional charges.
11. Few people experience brief episodes of depression or anxiety following surgery, similar to the well-known post-partum depression. This is quite normal as your body adjusts to the physiological changes taking place.