Exercising After A Tummy Tuck

Here’s the thing: a tummy tuck is designed to remove excess skin and fat from your abdomen. It will also tighten up your abdominal muscles and skin. But if you don’t do anything to maintain that new shape, it will slowly start to sag again over time. That’s why it’s so important to work out after your surgery—it keeps those muscles firm and tight so they stay where they’re supposed to be!

The good news is that exercising is actually much safer than most people think it is—and even safer than not exercising at all (because sitting around just waiting for your body to heal can cause its own problems). So go ahead and get started today.

Read on to learn more on Exercising After A Tummy Tuck and Symptoms Of Muscle Separation After Tummy Tuck

Exercising After A Tummy Tuck

If you’ve recently had a tummy tuck, you will likely want to know when it is safe to resume exercise and sexual activities. Also known as an abdominoplasty, a tummy tuck is a surgery to remove excess skin and fat from the belly.¹

Starting exercise too soon after a tummy tuck can lead to complications such as poor wound healing, scarring, or a need for follow-up surgery.²

This article offers advice on when you can safely return to physical activity as well as ways to modify your daily activities so that you can heal properly.

Immediately After Surgery

When you awaken from surgery, your abdomen will be covered with a sterile dressing, and you may have tiny tubes to help drain fluid from the wound. This is common and should not cause any concern.¹

On the day of your surgery, you will be directed to walk a bit to promote blood circulation and healing.² Don’t do this alone—you could be at risk of falling because your balance and strength might be impaired due to postoperative pain or the effects of anesthesia.

Once home, you will likely have trouble with bending, reaching, or standing for long periods of time. If you live alone, it helps to have someone stay with you for at least a couple of days until you are able to take care of everyday tasks.

Most surgeons recommend waiting at least two to three days after surgery before showering.³

Light cardio activity, such as walking, is started immediately after surgery and continued until your doctor clears you for more. You can walk a bit longer and farther each day to help build your strength.³

However, you have to avoid squatting and lifting heavy objects for the first few weeks. This includes lifting groceries and small children.³

Returning to Exercise

People who have had a tummy tuck are sometimes a bit too eager to return to exercise given their trim, new physique. This is something you need to avoid. Depending on the extent of your surgery, your surgeon may tell you to wait four to 10 weeks after your tummy tuck.²

When you do begin, start slowly with only a few repetitions, paying extra-close attention to form. If you have not exercised before, ask your surgeon for a referral to a personal trainer experienced in tummy tuck recovery. This helps ensure you proceed smartly and safely.

There are no standard guidelines on how to exercise after a tummy tuck, but most surgeons agree that you should avoid stressing the stomach muscles until the tissues are fully healed.

Start with light weights to slowly build strength and tone to the upper body. You can also perform exercises that strengthen the legs, such as calf raises, step-ups, and thigh exercises with resistance bands.

Until you are fully healed, avoid planks, squats, lunges, pull-ups, sit-ups, or any lifting exercises.

Once your surgeon gives you the OK, you can begin to do crunches, sit-ups, and planks as long as you start slowly and progress gradually. Pay attention to form, set reasonable goals, and listen to your body. If you experience any pain or something doesn’t feel right, ease back. Do not rush things.

Recap

Depending on the extent of your surgery, you may need to wait between four to 10 weeks before returning to exercise. Start with upper body and leg exercises, and only start abdominal exercises when your doctor gives you the OK.

Modifying Daily Activities

As for daily activity, you need to avoid lifting objects that weigh more than 5 pounds for six weeks because this can cause harm to the incision site, potentially leading to bleeding and scarring.⁴ Driving, cooking, or shopping is usually OK after the first week or two.³

Ask your surgeon how long you need to stay home after the surgery. This can vary based on the type of tummy tuck you’ve had. For more extensive procedures, expect to take off work for around four weeks.⁴

It’s generally advised to avoid bathing and swimming for the first month. Showering is fine, but avoid soaking the incision site or drying the skin vigorously.³

Most doctors will instruct you to wear a special compression bandage for the first month, ideally for 23 hours a day. Doing so helps the treated area heal evenly and prevents blood clots. After the first month, you may be given a different compression bandage to wear during active days.²

Recap

Avoid lifting objects that weigh more than 5 pounds for six weeks. For the first month, it is important to wear a compression bandage for around 23 hours a day.

Sleeping Position

Do not sleep on your stomach until you are no longer sore. You may find that sleeping with pillows under your back and head and/or under your knees may reduce discomfort.²

This is known as the semi-Fowler’s position and should be used for two weeks following surgery to avoid straining the incision site. Sleeping in a recliner is also often recommended since it puts less stress on the belly.¹

Resuming Sex

Most surgeons recommend that you wait at least two weeks (and up to four weeks) after a tummy tuck before having sex.⁵

When engaging in sex, it may be best to stand straight or lie flat on your back rather than squatting, lifting your legs, or being on top. Even lying on your side may pose problems as it can cause you to arch your back, which extends and stretches the abdominal muscles.

Don’t be embarrassed to speak with your surgeon about when it is safe to have sex again. And remember that sex is not just about intercourse. Until you are fully healed, mutual masturbation and oral sex may provide just as much pleasure.

Recap

Depending on the extent of your surgery, you should avoid sex for at least two weeks after a tummy tuck and up to four. Don’t be afraid to ask your doctor when it is safe to resume sex.

Summary

It takes time and rest to properly heal after tummy tuck surgery. While you heal, you need to avoid squatting, lifting, or any action that places stress on the surgical area. Doing so may interfere with healing and cause scarring.

Depending on the extent of the surgery, you may need to wait between four to 10 weeks before returning to routine exercise. Start with strength training exercises for the upper body and legs, and don’t start abdominal exercises until your doctor gives you the OK. If an exercise causes pain, ease back to avoid hurting yourself.

Exercises After Tummy Tuck Surgery

Recovery from a tummy tuck, or abdominoplasty, can be enhanced with regular exercise. 

But remember, a tummy tuck is a significant surgical procedure, and recovering from the operation is a serious business. 

Here, Dr. Scott Farber of Farber Plastic Surgery outlines a number of exercises that speed up recovery from a tummy tuck, and ensure patients achieve the results they desire. First, he explains exactly what happens to your body during a tummy tuck, and then how you can help your body recover from the procedure.

WHAT HAPPENS IN A TUMMY TUCK OPERATION?

For many patients, muscles in the abdominal region become detached or stretched during pregnancy or as a result of obesity. This also results in excess flabby skin around the midriff. 

A tummy tuck solves these problems. During a tummy tuck, your surgeon will make an incision along your lower abdomen. Through this incision, the surgeon is able to manipulate the muscles and skin of the abdominal region by reinforcing or tightening the muscles that have separated by pulling them closer together and fixing them in place. Excess skin can also be removed and remaining skin can be stretched over the abdomen to smooth the area and provide structural support to the lower spine and abdominal organs.  The surgeon then closes the incision with sutures, and your body begins the healing process. 

Due to the invasive nature of this surgery, the body experiences internal and external bruising, stretched muscles, and of course, the incision through which the operation is performed. Before you are able to return to normal function and activities, your body must first do some healing.

WHAT HAPPENS DURING RECOVERY FROM A TUMMY TUCK?

After the surgery, your abdomen will be bruised, swollen, and sensitive. 

Bruising occurs due to blood escaping from damaged blood vessels, which becomes trapped between the skin and the musculature.  

Bruising contributes to swelling, but swelling is also caused by your body’s defense systems protecting the damaged area. Fluids and white blood cells can pool in the abdominal region after a tummy tuck, leading to swelling. 

Regular exercise helps reduce this bruising and swelling, but not before your body is ready.

WHAT CAN I DO TO HELP MY BODY HEAL FROM A TUMMY TUCK?

FIRST TWENTY-FOUR HOURS

First and foremost, it is absolutely vital that you allow your body complete rest for the twenty-four hours immediately following your procedure. Giving your body a chance to adjust to the procedure and begin the healing process helps keep the altered musculature in place, and provides the incision with an opportunity to start to close properly. 

Many patients may spend the first day in the hospital, just to ensure there are no complications with the procedure. Sitting up on your own, and perhaps standing and sitting slowly, are the only exercises you should be doing during the first twenty-four hours. 

After the first day, you can start some very slow walking. This will help with blood circulation.

FIRST TWO WEEKS AFTER SURGERY

Proper circulation is important during the healing process as the blood transports waste material away from the site and delivers the building blocks for your body’s recovery. 

You must remember that the muscles of your abdomen need time to attach themselves properly, and stretching during these early days poses the risk of detaching the muscles or opening up the incision. For these reasons, it is crucial that you keep your hands beneath your shoulders, and you don’t stretch your abdomen.  

Light walking with a slight bend at the waist is all that you should do for the first two weeks, gradually increasing the distance with each day.

WEEKS THREE AND FOUR

After two weeks, you can begin to gently mobilize your waist, and partake in walking or gentle cycling. You should still avoid lifting weights and any exercises that target the abdominal region.  

This helps mobilize the area, further increasing blood flow and beginning to test the range of motion of the muscles, while giving the muscles and incision proper time to adjust and heal.

WEEKS FOUR TO SIX

 Provided there are no signs of pain or discomfort, you can begin slightly more intense exercise during this time. Slowly increase the range of motion without putting large amounts of stress on the abdominal region.

TWO MONTHS AFTER SURGERY

Depending on your rate of recovery, by this time, most patients can resume regular exercise. You can begin to increase cardio and also target the abdominal region with specific activities such as knee tucks, leg raises, oblique training, and planks.

Cardio exercise and proper diet is the best way to maintain your results from a tummy tuck. By gradually increasing aerobic activity and paying attention to your caloric intake during the first two months of recovery, you will help keep your weight down. Remember, take it slow as you recover from a tummy tuck.

Symptoms Of Muscle Separation After Tummy Tuck

Pregnancy is a magical time but growing another human takes a toll on your body. Excess skin, bulging belly, and stretch marks are only some of the cosmetic results of pregnancy. One very common, yet rarely mentioned, cosmetic problem after pregnancy is diastasis recti – separation of the rectus abdominis (the 6-pack muscle). When you have ab muscle separation, your belly will bulge forward. It can be a purely cosmetic problem, however, many studies have linked it to lower back pain, incontinence, hernia, and digestive problems. Diastasis recti repair surgery is the best method to treat split tummy muscles. It’s usually done during tummy tuck surgery (abdominoplasty), which aims to tighten and rejuvenate the belly, restoring the pre-pregnancy physique and improving your symptoms.

Dr Craig Rubinstein is one of the top certified plastic surgeons in Australia, and he has performed thousands of tummy tucks with and without muscle repair throughout the years.

What is diastasis recti?

Diastasis recti is a physical complication that usually happens after pregnancy, affecting more than half of women. Diagnoses can occur in the later stages of pregnancy or sometimes after delivery. There are several other names for diastasis recti including;

• Rectus diastasis
• Rectus divarication
• Ab separation
• Split tummy muscles

The condition happens as a result of the separation of the rectus abdominis muscle. The rectus abdominis muscle is the large muscle that extends along with the height of your belly. It has a right part and a left part, separated by a narrow band of tough collagenous tissue called “linea alba” that runs along your midline. When the linea alba becomes weak, thin, and wide, usually in the aftermath of pregnancy, the right and left parts of the rectus abdominis to become too far apart with a soft gap in between. The gap along the midline of your belly can be small or can extend along the whole midline of your abdomen. This makes your belly bulge forward (like a balloon), and can cause many problems like; a hernia, incontinence, and back pain, all of which can be treated with a tummy tuck.

What is the cause of rectus diastasis?

The main cause of rectus divarication is pregnancy and childbirth. During pregnancy, a woman’s body goes through a lot of hormonal and physical changes. The uterus grows and becomes massive to accommodate the developing fetus, pushing your organs away and stretching your abdomen in all directions. To help the muscles relax and stretch more, your placenta and ovaries also produce a hormone called “relaxin” in addition to progesterone.

Things don’t usually go back to how they were before pregnancy. In many women, the linea alba becomes irreversibly overstretched, and a soft gap in the middle of the abdomen between the ab muscles will develop. Abdominoplasty (tummy tuck) with muscle repair restores the integrity of the rectus abdominis, tightens your belly, and removes all the excess skin.

What problems does diastasis recti cause?

The problems and symptoms of diastasis recti are not purely cosmetic. Rectus divarication can cause a variety of aesthetic and functional problems, such as;

Bulging

The most common symptom of rectus diastasis is a bulging belly. Women who have separated tummy muscles usually complain of an obvious protrusion above, below, or all-around their belly button. In some women, the soft gap between the muscles becomes so wide that bulging can reach the size of a football.

Hernia

Your abdominal cavity is usually well protected and contained by your tough abdominal wall, which includes the rectus abdominis and the linea alba. Women who have rectus divarication have a very weak and stretched linea alba. In some of these women, the linea alba may rupture. When this happens, intestines and abdominal fat can slide through the defect and push up from under your skin. This is what doctors call a hernia.

A very common site of hernia is through the umbilicus (In many women, the belly button becomes “an outie” after giving birth, and this is usually a hernia). In such cases, the Rectus diastasis and hernia repair can be done simultaneously.

Hernias can cause many problems. If a bowel loop gets stuck in the defect, you can develop intestinal obstruction, which is a medical emergency that requires immediate surgery. This is why it is important to consult a surgeon if you suspect that you have ab separation or a hernia.

Lower back pain

One of the symptoms of diastasis recti is lower back pain. The rectus abdominis muscle is a crucial part of your core muscles; the muscles largely responsible for balance and posture. Rectus divarication weakens the rectus abdominis muscle and puts more stress on your back muscles which contract disproportionately to make up for the imbalance. This abnormal straining of the back muscles can cause chronic lower back pain. Fortunately, a tummy tuck with muscle repair can help improve back pain post-pregnancy.

Incontinence

Urinary incontinence is not uncommon after pregnancy and childbirth. Weak abdominal muscles and a weak pelvic floor are usually the cause of incontinence in women after pregnancy. Many women tend to use pads to avoid leaking urine when laughing, sneezing, or exercising. Abdominoplasty may help treat urinary incontinence after pregnancy. According to a 2018 study published in the journal of The American Society of Plastic Surgeons (ASPS), diastasis recti repair during a tummy tuck can significantly reduce incontinence.

Digestive problems

Rectus divarication can allow your intestines to move around inside your abdomen in ways they’re not meant to. This can lead to gastrointestinal problems, such as constipation and abdominal discomfort. If you have a hernia, the bowel loops can get stuck in the defect every now and then. This can cause both pain and constipation. If a loop gets stuck and doesn’t go back in, you risk developing a bowel obstruction. If this occurs you will need immediate surgery.

How do you treat rectus divarication?

Occasionally, rectus diastasis can improve without any intervention as your body recovers after pregnancy. For most women, however, this is not the case. One non-surgical way to treat diastasis recti is through physiotherapy. Special focused exercises with a certified physiotherapist can reduce tummy muscle separation and improve your bulging belly, however, this is not usually very effective.

The best and most effective way to treat diastasis recti is surgery. Diastasis recti surgery can permanently close the defect and bring the two sides of the rectus abdominis muscle tight together. Diastasis recti repair is usually done during abdominoplasty (tummy tuck) and not alone. A tummy tuck will strengthen your abdominal wall, remove the excess skin, and tighten your belly, all in one procedure. If you happen to have a hernia as well, Dr Rubinstein will also repair it during surgery.

Tummy tuck surgery has been shown to be effective in treating urinary incontinence and back pain after pregnancy. Moreover, abdominoplasty aims to restore your pre-pregnancy body by removing all the excess saggy skin. Liposuction can also be done during the same procedure to sculpt your body and remove the stubborn fat around your belly.

Can you get diastasis recti surgery without a tummy tuck?

Theoretically, yes you can, however, in practice, rectus repair is mostly done as part of a full tummy tuck. Nearly all women who have separation of the rectus abdominis muscle also have stretched tummy skin, lower belly fat, and excess tissue all over the abdomen. Diastasis recti surgery alone does not address the saggy abdominal skin and excess fat. This is why the vast majority of women choose to have the full abdominoplasty procedure, as they get the full cosmetic benefit of the surgery.

Abdominoplasty is an invasive surgical procedure, and there are several factors that play a role in reducing complications and determining the quality of the outcomes. You’re a good candidate for a tummy tuck if:

• You’re not planning on getting pregnant again
• More than 12 months have passed since your last pregnancy
• You don’t smoke (or you’re willing to quit 4-6 weeks before surgery)
• You’ve had a stable weight for the past 6 months and not planning further weight loss
• You have generally good health and your chronic conditions are under control
• You have realistic expectations for the surgery and can accept a thin scar along your bikini line

What are the benefits of diastasis recti repair surgery?

Diastasis recti repair surgery does not only improve aesthetics – it has functional benefits as well. Some of the benefits of a tummy tuck with muscle repair are:

• Rejuvenation of the abdomen: A tummy tuck removes saggy or overhanging skin, tightens your belly, and gives you a flat young belly without any irregularities.
• Decreased back pain: Diastasis recti surgery strengthens your core and improves lower back pain after pregnancy
• Decreased urinary incontinence: Rectus diastasis surgery strengthens your abdominal wall and helps reduce urinary incontinence after pregnancy.
• Hidden scar: The scar of the tummy tuck is well hidden in your bikini line, so it won’t be apparent if you wear revealing clothes or a swimsuit.

How is diastasis recti surgery performed?

• Diastasis recti repair surgery is usually done during a tummy tuck and will be carried out a hospital operating room.
• First, you will be given inhaled and intravenous anaesthetic drugs to go to sleep.
• Then, Dr Craig will perform a horizontal incision along your bikini line, right above your pubis.
• After pulling your skin aside, he will identify the two sides of your rectus abdominis and bring them closer to each other.
• Next, Dr Craig will plicate the muscles and suture them together, tightly closing the defect in-between.
• If you have a hernia as well, Dr Craig will also remove it and close the opening.
• In order to rejuvenate the abdomen, Dr Rubinstein will cut out the excess lax skin, subcutaneous tissue, and fat from your lower belly.
• He will then pull the skin together so that your whole abdomen is tight with no bulges or irregularities.
• In some case, your surgeon may need to create a new belly button.
• When all the tissue is removed and the edges approximated, Dr Craig will close your skin with a fine suture line.
• Your surgeon will also apply a compressive dressing before you wake up.

The procedure usually takes 2-4 hours to complete. You can choose to combine liposuction with a tummy tuck to further contour the abdomen and hips.



What to expect during recovery from rectus diastasis surgery?

After your surgery, you will be sent to your hospital room to recover, you might spend a night at the hospital for monitoring and be discharged the next day. You might notice one or two surgical drains coming out from your wounds to allow the fluid to drain away. These may be kept for a few days after your discharged and will be removed later in the clinic.

Since diastasis recti surgery involves muscle repair, you should expect some muscle soreness and pain for the first few days after your surgery. Your wounds will also show some swelling and bruising. These symptoms might take up to 2 weeks to subside. During this period you should rest and avoid moderate physical activity. Recovery time after rectus diastasis repair can take up to 6 weeks, after which you can usually resume your normal activities and get back to work. You will also need to wear compressive abdominal garments during this period.

Does rectus diastasis repair leave a scar?

Like any other surgery, abdominoplasty with muscle repair leaves a thin scar. The scar will be located along your bikini line, which means that it can be well hidden under your underwear. You can wear a swimsuit without worrying about your scar. We also offer several post-operative treatments to reduce scarring after surgery.

What are the possible complications of diastasis recti surgery?

Rectus diastasis repair is a safe procedure, however, there are some uncommon complications that can occur:

• Wound infection
• Blood collection in the wound (hematoma)
• Fluid collection in the wound (seroma)
• Wound dehiscence (sutures breaking)

You can reduce the risk of these complications with great aftercare and follow up by your plastic surgeon.

Does Medicare cover diastasis recti surgery?

Yes. If rectus diastasis is causing you abdominal discomfort, urinary incontinence, and/or lower back pain, the surgery will be covered by Medicare and third-party insurers. You will be eligible for a rebate if more than 12 months have elapsed since your last pregnancy, and rectus diastasis symptoms are interfering with your quality of life.

However, it’s important to note that you will most likely still have some out of pocket costs.

For more information, read Will Medicare Cover my Tummy Tuck Surgery?

Can exercise help fix diastasis recti?

Home exercises like crunches, planks, and sit-ups may worsen tummy muscle split since they increase the intraabdominal pressure. The only exercises that can help reduce rectus diastasis are certain exercises that focus on core exercises performed with a certified physiotherapist.

Rectus diastasis is a very common condition in women after pregnancy. Lower back pain, incontinence, hernia, and abdominal discomfort, are all possible complications of rectus diastasis. Thankfully, a tummy tuck with muscle repair can treat these symptoms and rejuvenate your abdomen, restoring your pre-pregnancy body.