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How to prepare for your surgery

Pre-operative appointment

On the day of your pre-operative appointment:

  • We will review your procedure in detail with you. 
  • You will also be provided with a post-operative appointment for follow-up after your surgery.
  • At this appointment, we will provide you with all of the after-care instructions as well as necessary medication prescriptions. 
  • We will ensure we have received your lab testing, which may include EKG and/or chest x-ray. 
  • We will address any questions and concerns you may have. It is a good idea to read over the procedure consent prior to this appointment so any questions that you may have can be addressed at this appointment.  

What medications will I be prescribed after surgery?

  • Narcotic medications may cause constipation. Ensure you have adequate (>25 grams/day) of fiber in your diet and drink at least 64 oz. of water daily. You may also wish to take an over-the-counter stool softener such as MiraLAX or Colace once or twice daily.
  • Blood thinners will need to be cleared by your surgeon. 
  • You can alternate your narcotic medication with Ibuprofen 600mg every 6 hours and/or Gabapentin 300mg three times a day.   Take ibuprofen with food to protect your stomach from irritation.
  • You will be given a prescription for pain medication, which should be obtained prior to surgery. If you are prescribed medications that contain acetaminophen (Tylenol), it is important that you not exceed 3500 milligrams per day. Do not drive, operate heavy machinery, or make important decisions while taking narcotic pain medications.
  • You may be prescribed an anti-nausea medication (Ondansetron), which can be taken as needed If you have a history of nausea or vomiting after anesthesia. 

Before prescribing any narcotic medications, we are required to check the Texas controlled substance history database (Texas Prescription Monitoring Program). If you currently have a pain medication contract with another physician or are currently on narcotic medications, we will have to coordinate your medications with that physician.

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What should I do or not do before the day of surgery?

Please do not:

  • Smoke (cigarettes, vape, or pipe) or use any nicotine products 4 weeks prior to and after your surgery. Smoking and nicotine greatly impair healing, which can cause an increased risk for infection and complications, such as delayed incisional healing or wound opening, which leads to worse scarring. 
  • Expose yourself to secondhand smoke, as this can also cause wound healing problems. If you use nicotine products, you will need to stop 4 weeks prior to surgery. You will also need to undergo a nicotine test prior to surgery to ensure that it is out of your system.
  • Drink alcohol before or after your surgery (until cleared by your surgeon). In addition, please do not drink alcohol while taking pain medication, as this can have serious and life-threatening side effects.
  • Do not take blood thinners such as Advil, Aleve, Naproxen, Fish Oil, Garlic, CoQ10, Omega 3,6, Motrin, Excedrin, Ibuprofen, Aspirin, medications for arthritis or any medication that contains these medications for ten days prior to your surgery and two weeks after.
  • Do not eat or drink anything after midnight the night before your surgery.

What to expect on the day of your abdominoplasty?

On the day of surgery do not take the following blood pressure medications with generic names that end in “-pril”, “-sartan” before your surgery. If you are on metformin, you will be asked to not take it on the day of surgery.
Your plastic surgeon will meet you in the pre-operative area to go over any last-minute questions or concerns you may have. Dr. Shah or Dr. Farber will make preoperative markings on your body and perform extensive checks with careful attention to detail to ensure you receive the highest quality of care. You will meet the anesthesiologist and their team, as well as the members of our plastic surgery operative team.

What to expect during your abdominoplasty?

Your procedure will vary depending on several factors; however, the first step of most abdominoplasty procedures is to make an incision across the lower stomach, just above the pubic area. The length of the incision will depend on the amount of skin and fat to be removed.

Next, the surgeon will separate the skin from the underlying abdominal muscles and remove any excess tissue. In some cases, the surgeon may also need to reposition the belly button. Once the surgeon has removed all the excess tissue, they will close the incisions with stitches or staples.

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What are some tips for a smooth recovery from my abdominoplasty?

In order to ensure your recovery is as fast and smooth as possible, we recommend that you prepare prior to your surgery. Some things you can do include:

  • Prepare a sleeping area that is easy to get to. For example, set up a couch downstairs so you will not need to use stairs to get to your sleeping area. 
  • Keep your toiletries close by and prepare food ahead of time. 
  • Arrange for someone to be with you the first night after surgery.
  • You may receive your post-operative medications at your pre-operative appointment. You should pick up these medications prior to your surgery.
  • If you’re having an outpatient same-day procedure, you will be released to go home the same day and will need someone to drive you home.
  • Review your post-surgery instructions given to you at your pre-operative appointment

If you have a history of nausea or vomiting after anesthesia, please let us know. We can prescribe anti-nausea medications and take extra steps to prevent nausea and vomiting after surgery.

What medications will I be prescribed after my abdominoplasty surgery?

After surgery, you may experience some discomfort. The goal of pain medications is to reduce pain; however, they may not remove pain completely. A good measure for if you need more pain control is that you should be able to take a deep breath without severe pain. Do not wait until your pain is unbearable to take the next dose of pain medication, as it will take longer to get your pain under control again.

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What medications will I be prescribed after surgery?

  • Narcotic medications may cause constipation. Ensure you have adequate (>25 grams/day) of fiber in your diet and drink at least 64 oz. of water daily. You may also wish to take an over-the-counter stool softener such as MiraLAX or Colace once or twice daily.
  • Blood thinners will need to be cleared by your surgeon. 
  • You can alternate your narcotic medication with Ibuprofen 600mg every 6 hours and/or Gabapentin 300mg three times a day.   Take ibuprofen with food to protect your stomach from irritation.
  • You will be given a prescription for pain medication, which should be obtained prior to surgery. If you are prescribed medications that contain acetaminophen (Tylenol), it is important that you not exceed 3500 milligrams per day. Do not drive, operate heavy machinery, or make important decisions while taking narcotic pain medications.
  • You may be prescribed an anti-nausea medication (Ondansetron), which can be taken as needed If you have a history of nausea or vomiting after anesthesia. 

Before prescribing any narcotic medications, we are required to check the Texas controlled substance history database (Texas Prescription Monitoring Program). If you currently have a pain medication contract with another physician or are currently on narcotic medications, we will have to coordinate your medications with that physician.

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How long will I need to continue my pain medication?

We prescribe pain medications for recovery after surgery but do not prescribe long-term pain medications and do not do more than one refill for any pain medications.

If you have pain that is beyond what is usually anticipated for your surgery and there is no surgical reason that can be found, we will help by referring you to one of the many pain management specialists that we work with.

How do I care for my surgical site?

You may shower 48 hours after your surgery. Do not scrub the incisions. Let the water run over them and gently dab them dry afterward. Gauze should be applied over the surgical site daily as needed for light drainage. Do not immerse your incisions in baths or hot tubs until at least 2 weeks after surgery or when cleared by your surgeon. After your surgery, you will be placed in an abdominal binder or a compression garment. You should always wear the compression garment except when showering for the first 6 weeks.

How do I care for my drains?

Sometimes, it is necessary to place a drain after surgery. The purpose of a drain is to remove excess fluid from the surgical area. Empty the bulbs and measure the output whenever the bulbs are half full or at least twice a day. You will be given a sheet to record how much is coming out of the drains. Bring this sheet to your follow-up appointment. In general, drains remain in place until there is less than 30mL (1oz) out of the drain for two days in a row.

At what point should I seek medical care?

Please call if you have the following signs/symptoms:

  • Temperature greater than 100.5 F
  • Bleeding or pus draining from the wound site. If you have bleeding, apply direct pressure to the area for 20 minutes
  • Increasing pain that is not controlled on oral pain medications
  • Increasing redness or size at the surgical site
  • Your drain is not holding suction
  • If your incisions come apart
  • Any other concerns
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For non-emergency questions:

  • During business hours (8 AM – 4:30 PM), call (210) 658-3555.
  • After hours and on weekends/holidays: call (210) 658-3555, and you will be forwarded to the on-call surgeon.

If you are having any serious problems or symptoms, such as difficulty breathing or chest pain, call 911 or proceed to your nearest emergency room.

Follow-up clinic appointment:

Your follow-up appointment will be scheduled at your pre-operative appointment prior to surgery. If you need to change your appointment time or date, please contact our clinic at (210) 658-3555.

Will my activity be restricted after my abdominoplasty?

After your surgery you should not carry out any vigorous activity: no pushing, pulling, bouncing, housecleaning, yoga, running, or heavy lifting greater than 5 pounds. Until your follow-up appointment, avoid activities that raise your blood pressure or heart rate. You are encouraged to walk around, and you can climb stairs after surgery. Please make sure you are doing some light activity daily and do not stay sedentary for long periods of time. 

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