Tummy Tuck With Pain Pump
The temporary device reduces pain by infusing a local anesthetic in the area of the abdominal wall where the nerves are located. Dr. Tjelmeland routinely uses pain pumps when performing abdominoplasties, keeping them in place for 3-4 days after surgery. They are painlessly removed at the first post-operative visit.
Before undergoing an abdominoplasty, also known as a tummy tuck, many patients think the incision will be the cause of pain. However, there is actually very little discomfort from the incision site. The true cause of most discomfort is the tightening of the abdominal wall. The introduction of an implantable pain pump has helped patients tolerate this discomfort with much greater ease than in the past and improve post-op recovery. read more on Muscle Tightening After Tummy Tuck/Trapped Wind After Tummy Tuck.
Tummy Tuck With Pain Pump
Anyone who has seriously considered a tummy tuck has certainly wondered, “Isn’t this recovery going to be painful?” The answer a few years ago would have simply been, “yes.” But now, with the introduction of new technology, patients can focus on the exciting results of their surgery and worry less about the pain of recovery.
Tummy tuck (abdominoplasty) is an excellent option for many women who have experienced stretched-out, hanging skin, excessive fat, and laxity of the abdominal wall following pregnancy and/or major weight loss. One major downside of the procedure: it hurts. Specifically, cinching in the abdominal wall by 4 or 5 inches can be very uncomfortable.
How do we best control the pain and ease your recovery? Unlike many surgeons in the Plano/Frisco area, I provide a pain pump for all full tummy tuck patients. This looks essentially like two very thin ( a few millimeters) epidural catheters that enter the upper abdomen . Marcaine, a long-acting local anesthetic, is dripped through the catheters onto your abdominal wall for about 72 hours after surgery. Although you will still require oral pain medication, the pain pump significantly reduces the discomfort associated with tummy tuck. In most cases, this means that you can go home a few hours after surgery. In addition, the manufacturer we use, Accufuser, allows a bolus feature; this means that , if you need it, you can push a button to give yourself an extra dose of local anesthetic at home.
Trapped Wind After Tummy Tuck
During the abdominoplasty recovery it’s recommended to walk slightly bent over to take tension off the incision. This bending at the waist can further worsen back pain. The pain is not permanent, and most don’t have these symptoms. The abdominal garment worn to help the stomach heal will help with any back issues or symptoms. Heating pads and other forms of heat application to the back is strictly forbidden during the recovery process. The numbness associated with surgery and the Pain-Buster can diminish the ability to detect heat. Burns can occur in rare circumstances. As I have said, no heat application of any type. Treatment for the back pain is the abdominal garment, standing straight, Motrin, and walking. The pain is usually minor and goes away in a short period of time.
Numbness
Numbness is common after many cosmetic operations. For example, after a face lift it’s normal to have numbness in the cheek area. After liposuction as well, it’s common to have associated numbness in the area treated. As far as a tummy tuck, essentially all patients will have stomach numbness. This is the nerves healing from the operation. It is most severe in the first 4-8 weeks. It gradually resolves over 6-12 months. This numb feeling is one of the reasons we should not apply heat to any surgical area. Heating pads as described above can injure the skin and are contraindicated. The numbness is minor and gradually goes away.
How does a tummy tuck work?
A tummy tuck is an outpatient surgery that uses general anesthesia and takes about 1 – 5 hours, depending on the case. First, Dr. Rao will use specialized techniques to surgically remove excess skin and small pockets of fat. Then, the remaining tissue will be pulled taut to achieve a tighter appearance. The incisions will be closed and dressed. From there, patients will be monitored before they are released to go home.
Tightness after a tummy tuck
After a tummy tuck, it’s normal to experience abdominal tightness. When any type of incision is created, the nerves are severed. This is unavoidable. In regard to a tummy tuck, abdominal tightness is the result of nerve damage. But, as you heal, this sensation will dissipate. Patients can expect to feel abdominal tightness for 6 – 12 weeks. In some cases, it can take up to a year to regain normal nerve function. While this can seem alarming, it’s a natural part of the healing process. Other factors that can contribute to abdominal tightness include muscle tightening and the skin being pulled tight and stitched together. Again, as the body recovers, these sensations should improve.
Importance of Gas After Surgery
You may have received medication to put you to sleep during surgery. The medication can slow down or even stop the gut from moving things from your stomach through the digestive tract. When this slowdown happens, it’s called a delay in gastric motility or POI.
A POI means that it takes your intestines longer to recover from anesthesia than the rest of you. The slowdown can be mild, or it can be severe enough to need medical treatment.1
The ability to pass gas is a clear sign that your digestive system is waking up. If you can pass gas, you either didn’t have a POI, or it is improving.
You may have had a bowel preparation to clean the stool out of your body before surgery. If so, it may be several days before you have a bowel movement. Gas may pass long before a stool does, showing that your bowels are working well.
If you had outpatient surgery, your healthcare team may even require you to pass gas before you go home. The staff doesn’t want to send you home with a POI that could become serious. That’s the reason it’s important to let them know when it happens.
Symptoms
A delay in gastric motility is usually brief. A more severe POI may call for a longer hospital stay.2 Severe symptoms can include:
- Nausea
- Bloating
- Vomiting
- Abdominal tenderness or pain
- Delayed or stopped passing of gas/stool
Sometimes people have nausea, vomiting, and pain after surgery. Because these symptoms can have different causes, it’s a good idea to talk to your doctor any time you have these symptoms while you are recovering.
Causes
Researchers have several theories about why postoperative ileus happens. POIs may be caused by different factors in different people.
One theory involves your nervous system. Your nervous system has two “departments.” The sympathetic nervous system (SNS) normally makes your intestines move less. The parasympathetic nervous system (PNS) makes your intestines move more. After surgery, your SNS may have more control for a short time.3
Another theory is that POI happens when your intestines are handled during surgery. For example, your surgeon may move them out of the way to reach other body parts. Or you may have had surgery directly on your intestines.
If your intestines were handled, your body’s immune system may be triggered. White blood cells and other types of cells may rush to the area, causing a slowdown.
Surgery can also unbalance your electrolytes. Electrolytes are minerals needed for key functions in the body, such as normal digestion.
It’s also possible that pain medications could raise your risk of a POI. Opioid medications can cause constipation after surgery. If you are taking opioid medications for pain relief, or if you already had issues with your intestines before this surgery, you have a higher risk of developing POI.
Muscle Tightening After Tummy Tuck
What Causes Tightness Following A Tummy Tuck? It is normal to experience abdominal tightness after tummy tuck surgery. This tightness is often caused by the muscle being sutured in an attempt to repair diastasis recti (separated abdominal muscles).
Not all tummy tucks are alike. Some involve more extensive surgery than others, and for this reason, what to expect during recovery can vary from person to person. The aim of the tummy tuck is to slim and tighten the waist for a more shapely and youthful appearance, but the surgical route to get you there (and into some cute new clothes) can vary quite a bit.
Depending on the amount of excess skin and fat to be removed, incisions can be shorter or more extensive, including the repositioning of the belly button. But one of the biggest factors to impact recovery from a tummy tuck, also called an abdominoplasty, is whether or not a muscle repair is included.
Why the muscle sometimes needs a repair
If you have seen the abs on even one superhero you will know the muscle we are talking about. It is called the rectus abdominis and it runs vertically from your sternum to your pubic bone. It has a left and right side separated down the middle by a band of tissue called the linea alba.
The linea alba can become over stretched, usually during pregnancy but also due to extreme weight gain or a lifting injury. When this happens the two sides of the muscle move further apart, resulting in an outward bulging of the belly that doesn’t go away, even when weight (baby or otherwise) is gone. This condition is called diastasis recti.
Besides being a cosmetic issue for some people, this condition can affect posture and trunk strength. It can cause pain in the abdomen, hips, and back, as well as bowel and bladder issues, all of which can have a huge impact on quality of life.
Why the muscle sometimes doesn’t need a repair
Not all tummy tucks include a muscle repair because not all bellies that can benefit from a tummy tuck have a diastasis recti. Even when the linea alba is stretched out, it can sometimes return to its normal size on its own. Furthermore, if a woman has had a cesarean section, a repair will likely have already been completed at that time.
How the muscle is repaired
Diastasis recti can be corrected by a general surgeon, but plastic surgeons routinely do this as part of their tummy tuck procedure. The surgery involves folding over the stretched tissue of the linea alba and suturing the two sides of the rectus abdominis muscle together. Though you can’t see it from the outside of the body, this involves suturing up and down the whole length of the abdomen.