A body lift is a multi-surgical procedure
designed to improve the over all appearance of the abdomen, legs, buttocks,
chest and arms. Because a body lift is so intricate and invasive, patients
should be prepared for a longer recovery period than is required for many other
procedures. It is not uncommon for your surgeon to suggest a night or two
at the hospital after your procedure, because of how complex the surgery is.
The actual surgery for a body lift can range from
four to seven hours. Due to the amount of surgery that is needed for a
patient, the procedures might be divided up into separate surgeries because of
how extensive it can be. This surgery is normally performed under general
anesthesia because of the length of the procedure.
You will be likely be dressed in a compression
garment or strapped in elastic bandages to help the skin conform to the new body
contours and reduce swelling.
Drains with thin flexible tubes may be
placed in your incision to help with any fluid accumulation so a seroma will
not occur.
The abdominal
area will be in some discomfort after the procedure. While
resting, place one to two pillows behind your knees in order to keep
these bent which will help reduce the tension in the abdominal muscles.
The first two weeks after your body lift are the
most difficult part of the recovery. The doctor will leave in drain tubes,
sutures will still be in place and there is likely to be significant pain in
these locations. You will either have a
pain pump or prescribed oral narcotic
pain medication. To make sure you do not experience any break through pain
episodes, the medication should be taken as prescribed.
Walking after
your surgery is a must to keep blood circulating and to prevent blood clots. Short
walks help the body return to normal and help with dissipating swelling and
increasing your range of motion.
Standing upright after surgery will be difficult for a few days and bearing all
of your weight on the lower body can be very stressful. Trying to stand up
straight when you can will help alleviate any back pain you might get from being
hunched over.
Within a few days
you will be able to
shower with some assistance.
If your
plastic surgeon has felt that it is best for you to have drains then
when you wake up you will see some tiny thin tubing placed in your
incisions to drain any excess fluid. Drains give the excess fluid
build up from the surgery a place to escape, so that healing is not
compromised. The more extensive work that is done
in the surgery the more likely you are probably going to have a
drain.
Image of a Jackson-Pratt Drain
These drains are left in place from a few days to
a couple of weeks depending on the amount of fluid that is being
collected. You will be given simple instructions on how to
empty these drains by your plastic surgeon. Your doctor will ask you to monitor how much fluid you are draining
from the surgical site and to keep a record of this so that he can
keep track of your drainage. The
drains are removed anywhere
from your first post op appointment to a couple of weeks after your
surgery. The drain tube is pulled out gently and usually there
is no pain associated with this at all.
If you have elected to have a
pain pumpfor the first 48-72 hours, then you will also
see the tiny thin tubing or catheter that is attached to the actual
device delivering the medication directly to the surgical site. The pain medication is delivered through the tiny thin
tubing/catheter to the actual procedure site and keeps the area
numb. Pain pumps are portable and can be worn anywhere;
however cannot get wet.
The two most common pain pumps that are used
are either
On-Q Pain Pump
or Stryker Pain Pump. Having the option of
a pain pump runs approximately $300 extra over and above your
surgery costs. The patients who do elect to have this option
of the pain pump, rave about how much easier recovery is.
Awakening from
anesthesia seems to affect everyone differently. You might
experience some blurred vision and your emotions might be on
overload ranging from being highly emotional to laughing and
giggling.
During the
surgery, your plastic surgeon uses epinephrine to help control some
of the bleeding. This is a vasoconstrictor, which once
introduced into your system tends constricts the blood vessels. Once you awaken from the procedure you might experience some
shivering and feeling very cold. This is all normal and will
pass as you start to come around after awakening. The
anesthesia
can also make you feel very sick to your stomach, but
most of the time the anesthesiologist will give you an anti-enemic
in your IV to stop the nausea.
If you have drains and
or a pain pump
inserted after the body lift procedure, you will not be able to take
a full shower until these are out. Make sure you ask your own
surgeon what he would like you to do regarding showering with
drains. More than likely your own plastic surgeon will give
you a list of what he wants you to do during the recovery process. Every surgeon is different with their list of post operative
instructions. Each physicians usually recommend
a sponge bath for the first week, so that the incision is given a
chance to heal without compromising the surgical area by getting it
wet.
If your physician has allowed you to
take a sponge bath, more than
likely he will not want you to get your incisions submerged under
water, mainly because bath water can have bacteria in it.
Using a public pool, Jacuzzi, or going into the ocean will normally
not be allowed for at least 6-8 weeks post op, as swimming before
then can open the patient up for infection, since the water is not
free of bacteria.
After
showering, you should try to keep the steri-strips paper tapes as
dry as possible. The steri-strips are intended to stay on for
several weeks to keep tension off of the incision so you will have a
thin small scar - and getting them wet might loosen them so they
come off sooner than they should.
Shampooing
your hair might prove to be a little bit difficult immediately after
this procedure, because you cannot raise your hands over your head
right away. Either have a friend or significant other help you
do this or make an appointment to go to your salon for a wash and
blow dry. This will certainly make you feel 100% better.
After
showering, make sure you keep all lotions, creams, etc. away from
the actual surgical incision. Your skin will be dry, so just be
careful around the actual incision. The chance of bacteria being
introduced into the surgical area is great with products like this.
Depending on
what procedures you had done, will predicate on what you will wear
home after your surgery.
Most patients
however will wake up wearing some sort of type of compression
garment that was
either purchased before surgery or supplied by your plastic surgeon. With a body lift procedure, the compression garment will help
re-contour the skin and tissue to the new shape. It will also
help keep the edema and swelling in check so that a seroma will not
form.
Post-Operative care does involve the use of wearing the
proper compression garments.
It is
extremely important for patients to make sure they take their
antibiotics on time and that they finish off the entire
prescription. By stopping the antibiotic before you are
finished, you run the risk of a possible resistant infection
occurring.
Keeping up
with the pain medication as written will help your body overcome any
break through pain episodes. Instead of waiting until you
experience pain, taking pain medication at certain regular times
will help keep the pain under control. It is harder to control
pain once it has started. One of the most common side effects of
the medication is gastrointestinal upset. This means you could
have either an upset stomach or diarrhea.
Constipation is a very
common side effect of narcotic pain medications, so you may want to
take a stool softener (such as Colace) around the time of surgery
and after will help tremendously. Eating a lot of high fiber foods
and drinking plenty of water will help get everything going again.
The sooner you are off the narcotics and sleeping tablets the
better. Make sure you are not drinking alcohol at the same
time you are taking narcotics. And also because narcotics can
make you drowsy make sure you are not driving while still taking
them.
Most plastic
surgeons will prescribe an anti-enemic medication to help prevent
nausea, which can be brought on by taking the antibiotics and the
pain medication on an empty stomach. Make sure you take all
medication with some food in your stomach, preferably something that
is bland like toast, crackers, etc.
It’s important
to make sure you watch your temperature after you have had surgery,
as any elevation in this could mean you have a possible infection
happening. Notify your surgeon of any elevation of temperature
immediately.
If your surgeon has told you that
you are allowed to use an ice pack to help with the swelling and bruising there
are a few options available. Patients have used bags of "Frozen Peas" or
other vegetables and chopped fruit to help relieve some of the swelling and
discomfort - which has worked out great, as the frozen vegetables have a
tendency to mold itself to the surgical area.
Cold
therapy helps reduce swelling and bruising resulting from any type of injury.
Cold therapy has also been shown to be greatly effective in reducing swelling by
slowing the flow of blood and other fluids to the injured area.
There are also newer ice packs
that you can buy at your local pharmacy, which resemble frozen peas. They
are called Peas Therapy packs - just like a bag of frozen peas, reusable "Peas"
conform and sooth wherever cold therapy is needed. Made of an innovative
soft gel pea shape, provides long lasting cold relief and mold to your contours
for a comfortable fit. The outer casing stays flexible when cold.
"Peas ice packs" provides therapy for pain, discomfort, swelling and bruising.
Recovery from
any surgery on any location of the body will have nerve regeneration
occurring during the recovery process. With any surgery, the
nerves regenerating will feel like a burning, tingling, and or
shooting pain sensation that happens periodically during the
recovery time. This is a good sign that the nerves are trying
to reconnect again, so that you will have feeling back inside the
lower body area. It these pains are accompanied by swelling or
redness, infection, and or bleeding; then you should notify your
surgeon immediately is of utmost importance.
Keeping the
incisions and the sutures complete dry is of utmost importance
during the first week post operatively. Most plastic surgeons
do apply Steri-Strips on top of your incision line and sutures to
help keep the tension off of the actual incision, so it will heal
with a thin scar. You will have internal sutures as well as
permanent sutures on the outside of the incision.
The internal
sutures are dissolvable sutures which will be reabsorbed into the
body within 60-90 days.
The external
sutures which are blue/black in color will be removed by the surgeon
usually between seven to fourteen
days depending on how well you heal. Tissue Glue is another
option that is being used more and more as a way of closing the
incisions instead of suture material.
Each plastic
surgeon will give you specific care instructions for your incisions
in writing at your pre operative appointment or before you are sent
home after surgery. It is important that you understand
everything that is written down so you will not have any unforeseen
problems as you are healing. It is extremely important
not to get any creams or lotions into the incision itself, as these
products could cause inflammation which could lead to an infection.
Sutures (mostly the
dissolvable ones) will work themselves to the surface of the incision. This
happens quite commonly, and actually when a stitch does pop out, it can come to
the surface with an inflamed red spot. Usually you can feel something like
‘fishing line’ around this area. It is best to call the Plastic Surgeon when
any suture makes it way to the surface for removal. You really do not want to
attempt to do this yourself, as this is way that infections can start, and you
have to make sure you are removing a suture that is not something that is
permanent. Dissolvable sutures are usually clear color (like fishing line), and
permanent sutures are dark blue in color.
There are various types of
suture material that is used in closing an incision. Some
patients do have problems with sutures, and some sutures are more likely to
cause this than others. Braided sutures (such as Vicryl) can cause this and,
for that reason, many surgeons have switched to monofilament (unbraided)
sutures, such as
Monocryl or
PDS.
Vicryl is an excellent and strong suture
material, but it has been associated with "spitting”.
It is very important that if
you see any discharge around this area, if the area feels inflamed or is hot to
the touch. Please call your Plastic Surgeon immediately, as this could mean
that you have an infection started, and you will need to start on antibiotics
immediately.
Scars can take
some time to fade completely. A lot has to do with the type of
skin a patient might have. The most important thing to
remember is to protect these scars from the ultra-violet rays of the
sun or a tanning bed. Even through a bathing suit, sunlight
can reach the skin and cause some damage. Wearing a sunscreen
with a skin protection factor (SPF) of at least 15 at all times will
help minimize any sun damage. The skin
will have reduced sensitivity after the surgery, so you have to make
sure you are not getting overly exposed.
Scars begin to fade within four to six weeks; topical steroid cream
or silicone gel can promote healing and reduce the chance of
developing raised, red or irregular scars. While most patients heal
well, scarring varies from patient to patient and is not totally
predictable. One of the best scar treatments is Silicone
Sheeting, as it helps with flattening and fading the scars.
Silicone Sheeting has the added benefit of adding pressure to the
scars while healing, so that the scars do not become
hypertrophic.
The scars are going to look worse right after surgery of course. They might appear red and raised after the sutures are removed.
Traditionally
scar therapy normally starts after about 6 – 8 weeks
post operatively. This is to ensure that the incision is
completely closed. Each plastic surgeon will have their own
time-table for when it is safe for you to start
using topical scar
creams or Silicone Sheeting, make sure you ask your own surgeon
before starting.
Retin A (Tretinoin)
is a topical form of Vitamin A that helps the
skin renew itself.
Applying this to your breast augmentation scar or surgical scar
after it has been completely healed and closed will help fade out
the scar. Appling paper tape over the
Retin A also helps with
the healing of scars. Retin A
is a prescription topical cream
that has to be prescribed by your physician.
If you have scars that are becoming
increasingly red and raised, make sure you notify your plastic
surgeon, so he may start some other treatments on you. This
could be the beginning of
hyper-trophic scarring or keloids.
It is not
uncommon for your menstrual cycle to be altered for a month or two
after you undergo surgery. The stress of the surgery and
anesthesia plays havoc on your system. Your period will return
to normal within a couple of months.
With a body lift procedure it is very common to have some swelling, bruising and
soreness in their breasts for several days after the procedure. Depending on any unforeseen
complications, bruising can last up to
several weeks. Wearing the supportive compression
garment that your plastic surgeon has recommended will help
tremendously.
Swelling has a
tendency to migrate downward from the abdominal area to the thighs, so you might see your stomach area being
very bloated looking. This is from the combination of the
saline you received during the surgery and the actual swelling from
the procedure, especially if you had
liposuction done at the same
time. Treatment for excessive swelling includes increasing
your daily fluid intake, a low sodium diet and mild exercise - such
as walking.
Drinking enough water does help with swelling tremendously.
You should not take any diuretics, not unless this was approved by
your surgeon.
Bruising
usually occurs with this surgery to some extent. If a patient has a large painful bruise that seems to be
growing, then it is very important that you contact your plastic
surgeon as soon as possible, as this could be a
hematoma
forming. Most normal bruising should subside
within a couple of weeks.
After
you are discharged from the surgery center after your procedure, you
will be sent home with instructions and important phone numbers to
call if there is any unforeseen problem or complication that should
arise. These are important numbers to have close by, as they
will be how to contact your surgeon and or the on-call surgeon.
If you experience anything that hasn’t been covered in what to
expect after surgery, call the surgeon immediately. This is
why they have given you the phone numbers in the first place.
Any elevated temperature or excessive bleeding from the incision
needs to be communicated immediately to the surgeon. You need
to remember that the instruction sheet that your plastic surgeon has
given you should always be adhered to. If the instructions you
are given are different that what you see on this website, do not
waiver from what your plastic surgeon has told you. Always
follow your own plastic surgeon’s instructions!
It is perfectly normal for a patient to experience mood swings, and
feel like crying off and on, especially during the first couple of
weeks. This is to be expected as it is a normal reaction to
the aftermath of major surgery, as medication and post-surgical
traumatic stress syndrome can occur. It is important during
this time not to be highly critical of your new surgical procedure,
as what you are seeing in the beginning right after surgery is
swelling, distortion, and bruising.
What you do need to remember with getting a body lift procedure
is one of the most complicated surgeries performed. You are
going to see a lot of changes in the days ahead following surgery.
It is hard in the beginning when all you see someone who is
bruised and swollen. Make sure you go
over your expectations of this surgery with your surgeon, so he can
be on the same page as you are. The effects of the anesthesia
and the
pain medication can contribute to some of the post
operative let down, but try to remember that these feelings will
pass with each new day.
Some women feel depressed or regretful about having undergone
elective surgery. Sometimes they do not know how to handle the
attention of questions that this procedure might bring. It is
good to talk about your feelings and to know that the women on the
forum here have experienced all the emotional highs and lows you
might be going through, and they will help you in anyway they can
along with your own plastic surgeon and his staff. If you do
feel that all of this is too much, then it would be best to seek
outside help so you can resolve some of these emotions. Most of
the women who do undergo this procedure are extremely happy they did
and would do it again in a heartbeat.