Posted by Dr. Hardesty

Now that the mommy makeover procedure is complete and you are in the recovery room, you may be wondering, “what should I plan for and what should I expect?” The common questions and normal recovery process will be discussed, but here is what you can plan for:

The Postoperative Periods

Immediate

1. Communicate with your recovery room nurse (pain, nausea, etc.). Ask questions!
2. Do what you are asked to do. The nurses and the staff are there to facilitate your transfer from the surgicenter to your home or recovery center.
3. The nursing staff will again go over all your post-operative instructions with you and your care provider. You will be given another set of the same instructions you received at your preoperative appointment.
4. You will be provided garments:

• adjustable abdominal binder (adjust the tightness to comfort).
• an elastic and expandable bra.

At Discharge:

1. Anti DVT (deep vein thrombosis) which most often occurs the legs. Our preventative blood clot program:
   –  leg/foot exercises

   –  you will be given TED (thrombo emboli  device) hose, and

   –  You will be sent home with a portable and rechargeable Sequential Compression Device (SCD) to be used for two weeks after surgery. Get out of bed and walk around the house every 1-2 hours while not sleeping. Leave SCD’s on while sleeping or resting for the next two weeks.

2. Respiratory (breathing) because the anesthesia ventilators don’t work as effectively and efficiently as your lungs. We will provide an incentive spirometer device. It should be used every hour after surgery (improves breathing) after general anesthesia.
3. Swelling fluid – If drains are placed a measuring cup and recording chart will be provided for documenting drain output.
4. Urination – if needed, a foley catheter may be inserted to measure urine production. I may be removed prior to leaving surgicenter and have the patient remove 6 hours after surgery (some patients develop urinary retention while general anesthesia wears off and will require re-catheterization.
5. Exercise: We recommend early mobilization and ambulation. For the first four days, it is recommended to walk in a hunched-over position. Dr. Hardesty will provide a “loaner” walker for the patient.
6. Bed position: A “lazy boy” position (use recliner, hospital bed or pillows/foam wedges).
7. Diet: A progressive diet will be instructed for you to follow,  to prevent nausea: clear liquids (Gatorade, broth, tea) for first 8 hours, liquid diet next 8 hours (soups, pudding, and yogurt), and soft diet for next 8 hours (well-cooked oatmeal or pasta) after 24 hours regular diet. We recommend at least 100 grams of protein/day until all the incisions are healed.
8. Constipation: In some patients (especially those that are prone to constipation because of the anesthesia and pain medications, we recommend postoperative stool softeners and anti-constipation measures.
9. Pain management: Dr. Hardesty will inject long-acting local pain reducers into the surgical area and provide a postoperative non-narcotic pain pump reliever that lasts several days. It is ok to start using aspirin, Aleve, Motrin AFTER surgery and alternate with oral narcotics. Do not take pain medications on an empty stomach. Crackers before and after medications (to prevent nausea and upset stomach).
10. Incentive spirometer: helps open up the small breathing units found within the lungs that collapse during general anesthesia. Use once an hour while awake until you are able to obtain preoperative values.
11. Medication’s: Return to normal preoperative medication schedule.

First Four Postoperative Days

1. Wear SCD’s 24 hours a day, anti DVT exercises every hour.
2. Use incentive spirometer (it opens up small breathing units in your lungs) once an hour until you reach your preoperative values.
3. Walk hunched-over (use walker provided) and sleep in the “fetal position” using recliner or wedges/pillows.
4. If unable to have a bowel movement; start over the counter laxatives and stool softeners.
5. If breast implants placed you will begin the “5-5-5 program” = massaging:

• 5 minutes a time
• 5 times a day
• 5 weeks

Since the natural action of a subpectoral breast implantation to push the newly placed implants “up and put” instead of the usually desired placement of implants “down and in” (natural position with more cleavage).

Mommy Makeover Before & After

Before & After

5th Day to two weeks Postoperative

1. No restrictions in sleeping position or standing up straight. Use walker only as needed.
2. Non-narcotic pain-pump to be removed.
3. May shower but keep incision and drain exit sites dry (let shower spray backside and sponge bath front side of the body).
4. May remove SCD during ambulation (walking upright) but wear at all times when not.
5. Progressive ambulation (walking upright) and stretching to point of pain and fatigue.
6. Wean off narcotic pain pills and replace with Tylenol, Motrin or Aspirin like over the counter medications.
7. May drive as tolerated (must be off narcotics).
8. May switch from the provided binder to “spanks” like a garment for comfort and support.
9. May return to work as tolerated.
10. Continue with the “5-5-5” massage program until the desired position and shape are attained.

After two weeks

1. Progressive and non-high impact exercise (such as an elliptical trainer or stationary bicycle) to the point of pain or fatigue.
2. SCD not required (may continue).
3. Report to the office when individual drainage less than 25 ccs in a 24 hour period for serial removal). May shower without restrictions when drains are all removed.
4. Start anti scar programs: Embrace and silicone gel strips.
5. Continue with the “5-5-5” massage program until the desired position also known as “seated” or “fluffed”.

After six weeks

1. No restriction on exercise (use good judgment).
2. Continue to wear “spanks” like a garment for support and swelling (only as needed).
3. It will take 2-3 months for the majority of the swelling to be gone.
4. It will take 9 + months for the scars to “mature” (soften and lighten). Continue with the anti-scar silicone gel strips for at least 3 months.
5. Once breast shape is attained move to a highly supportive underwire bra. During high impact or strenuous exercise use a “double “ sports bra to prevent sagging of the breasts.
6. Enjoy your new body!

Summary

The “Mommy Makeover” is a term often referred to as a combination of breast and abdominal procedures usually consisting of a Breast Augmentation, Mastopexy, and Abdominoplasty (tummy tuck).

It also has one of the highest satisfaction rates of all Cosmetic Surgery. I hope these suggestions make your recovery a little easier as you reach your aesthetic goals.

Cost/Fees

The fees are based on the anesthesia used (local vs sedation or general anesthesia), the facility (minor surgical suite, outpatient operating room or hospital setting) and if combined with other procedures. All pre and post-operative care is included.  Some preoperative laboratory analysis may be required (usually covered by your medical insurance).

Conclusion

The most important factor to consider is seeking the opinion and services of a skilled, experienced and Board Certified Plastic Surgeon who are experts in “Mommy Makeover” techniques. The Imagine Plastic Surgery team uniquely provides the full array of both non-surgical and surgical alternatives to thus filling our motto of “One Goal, Many Options”. For more information, call and schedule a consultation.