Leading Up To Surgery
Medication & Supplements
Stop taking Aspirin, products that contain Aspirin, and all other supplements two weeks before surgery. This includes:
- BC or Goodies powders
- Fish oil
- Weight loss medication
- Vitamin E
- Herbal supplements
- Meal replacements or protein shakes
Please make sure to get your prescriptions filled prior to your surgery date. You will be expected to bring your prescriptions with you the day of surgery.
The pain medication that is prescribed can cause constipation. You can start prevention as early as two days before your surgery by taking Colace, or Activia yogurt. After your surgery, you can have things like MiraLAX or Milk of Magnesia, but these should not be taken before.
If you become ill or have to postpone your surgery for any reason, please notify us as soon as possible.
Day Before Surgery
You will receive a call and email the day before your surgery with instructions regarding where and when to arrive.
This will include instructions regarding medications.
Day Of Surgery Instructions
Food and Drink
Do not eat anything after midnight the night before your surgery.
- You can brush your teeth, but do not swallow any toothpaste or liquid.
- Do not consume candy or gum.
- You may drink water or Gatorade (any flavor except red) up to four hours before your surgery.
- Do not drink coffee or tea day of surgery.
Do not wear jewelry or make-up to your surgery appointment. Wear loose, comfortable, and warm clothing. A top that zips or buttons up is preferred. Please wear glasses instead of contacts if applicable.
A responsible adult must take you home. You will need someone to stay with you for the first night after surgery.
Note: If you are a minor, a parent or legal guardian must accompany you.
Fingernails must be short. If polished, it must be clear
No Taxi Cabs, Lyfts, or Ubers as your transportation home.
If you need transportation/help after surgery, the team at Metro’s other women, https://www.metrosotherwoman.com/raleigh-nc, have helped our patients with care, housekeeping, dog walking, taking children to soccer practice, and everything in between.
Sweat or pajama pants are preferred. Please no yoga pants/leggings.
What to expect
Once you arrive in our surgery suite, the clinical staff will discuss the details of your procedure and ask you to sign an informed consent. If applicable, you will take a pregnancy test prior to surgery.
You will speak with your anesthesia provider prior to your surgery. They will go over your history with you one last time before we get started and tell you what to expect when you are in the operating room.
From there, your surgeon will come in, discuss the procedure, and create his markings before we get started.
After Your Surgery
What to Expect Physically
You can expect a little pain and discomfort, as well as some swelling and bruising on your breasts and surrounding tissues. If you had liposuction under your armpit, you may notice bruising that travels down your sides and soreness on your sternum and ribcage.
You will have areas of numbness especially at your incision line. More than likely, your nipple will be numb the days following surgery. If this is the case, there is still a good possibility that the sensation will return.
You may feel a burning sensation at your incision line post-operatively. This will subside after about 24-48 hours.
You can expect a little pain and discomfort, as well as some swelling and bruising to the abdomen and flanks. The liposuction may have bruising that travels down your legs and the tops of your thighs. You will have swelling in your pelvic region. You will have areas of numbness, especially at your incision line. This will gradually improve over several months.
Your abdomen will feel very tight and you will not be able to stand up straight. This can be true up to 10-12 days after surgery, but we want you to start trying after your first post-operative appointment.
It may be more comfortable for you to be on your back with your head and knees elevated with pillows.
What to Expect Visually
Your breasts may appear very round and the skin tight and shiny with an upside-down appearance. It may take months for your breasts to assume a more relaxed and normal shape.
Your incision line will go around your areolar and then down in a straight line your breast in a lollipop shape. There is always a possibility that there will be an incision under your breast that looks like an anchor. Your surgeon will explain the likelihood of this during your consult.
You may experience a small amount of bloody drainage at your incision site. You can use panty shields or sanitary pads, which are held in place by your bra, for drainage. This usually subsides in the first two to three days after surgery.
You will have steri-strips and paper tape applied over your incision sites. Please leave these in place.
If you had liposuction, you will have an incision in your armpit. This will be covered with gauze and paper tape, which can be changed as needed.
The first thing you will see is the garment. You will either be wearing a panty girdle (specific to abdominoplasties) or a compression garment that extends from your upper waist to your knees.
Directly beneath your garment, you will see a dressing over your incisions. This will include gauze, pads, and foam tape. Please remove them all prior to showering, except the paper tape that is directly on your incision.
You will have an incision to your lower abdomen that extends from hipbone to hipbone and an incision around your bellybutton.
Note: If you are having a “mini” abdominoplasty you will not have the incision around your bellybutton.
You may see bloody drainage on your dressing and garment. This usually subsides two to three days after surgery.
Note: Your abdomen will be very swollen and have areas that look indented, tight, and or bunched up. Please know that these areas resolve, but it takes months for this to happen.
You will have compression stockings on after surgery. Please leave these in place until you take a shower to help with circulation while you are not moving around as much as you normally would be.
You are going to have to take it easy after this surgery, especially the first week or so. Please make sure to make a conscious effort to move around throughout the day. We want you to get up at least every couple of hours while you are awake to help blood circulation.
For the first 2-3 days after surgery make sure to cough and deep breath (5-10 deep breaths) every 2 hours while awake. When coughing you may need to hold a pillow to your abdomen to help with pain. This will help ensure that your lungs are fully expanding.
We will provide a bra for you to wear after surgery. If it feels better without it, you can leave it off.
Do not wear an underwire or push-up bra for six weeks after your surgery.
You are allowed to take a shower 48 hours after your surgery.
- Please leave the tape applied directly to the site in place.
- The incision area can get wet, but do not wash it directly.
- After your shower, gently pat the incision site dry.
You can clean your bellybutton with cotton swabs and hydrogen peroxide, but please do not do this more than once a day.
Do not run or do any type of exercise that would cause your breasts to bounce excessively for two weeks after your surgery.
Avoid core and chest specific exercises until six weeks after surgery.
Wear your garment at all times, except when showering. If you need to clean it, wash the garment in cold water and dry on a low setting.
We will provide you a different garment called a “Yummie Tummy” at your first post-operative appointment. You need to wear some type of compression for the first six weeks after surgery.
Please ask your surgeon or nurse directly regarding your restrictions due to the differences between under and over the muscle implant placement.
You can clean your belly button with just soapy water. Be gently as your clean in and around it, pat dry after each shower.
Rapid Recovery Instructions FOR IMPLANTS
Start your exercises 24 hours after surgery.
This applies to patients whose implants are placed under the muscle.
Slowly lift your arms straight in front of you above your head. Hold your hands above your head with your arms straight for 10 seconds then slowly bring your arms back down. Do this three times for each set. After your shower, pat your incision sites dry but leave the tape in place.
Do a set of three arm raises every 20 minutes while you are awake for the first three days.
You are going to have to take it easy after this surgery, especially the first week or so. Please make sure to make a conscious effort to move around throughout the day. We want you to get up at least every couple of hours while you are awake to help with blood circulation.
For the first two to three days after surgery, make sure to cough and deep breath (five to 10 deep breaths) every two hours while awake. When coughing you may need to hold a pillow to your abdomen to help with pain. This will help ensure that your lungs are fully expanding.
This is a way to keep your muscles limber and loose. Think of it like running a marathon. After a long run, it is important to keep your muscles loose and limber so they don't tighten and become painful. We are doing the same thing with your pectoral muscles with these two exercises.
You can place ice packs to the upper and lower part of your breasts to help with swelling and pain. Use for 30 minutes on then 30 minutes off to prevent frostbite.
Do not use heating pads to help with pain. This could cause a burn.
Resume your normal activities as you feel comfortable. If it hurts, don’t do it. If it doesn’t, it is ok to do.
You may take up to 1000mg of Tylenol (2 tablets of Extra-strength Acetaminophen or Tylenol over-the-counter) and 600mg (3 tablets of 200mg over-the-counter) Ibuprofen in between pain medication doses to make it easier to move around.
If you experience lower back pain, use the muscle spasm/relaxant prescribed for this pain.
Stop taking aspirin, products that contain aspirin, and all other supplements two weeks before surgery.
Do not use alcoholic beverages while taking pain medication.
You will be prescribed five different medications.
- Pain medication: Oxycodone
- Take one to two tablets every six hours, as needed for pain.
- Anti-nausea medication to be taken prior to surgery: Zofran or Ondansetron
- Take four tablets one hour prior to your surgery.
- After surgery take one tablet every six hours, as needed for nausea.
- Anti-nausea medication for extreme nausea: Phenergan or Promethazine
- Take one tablet every four to six hours, as needed for extreme nausea.
- Note: This may cause drowsiness
- Muscle Spasm/Relaxant: Carisoprodol (Soma)
- Take one tablet every eight hours, as needed.
- Note: This may cause drowsiness
- Please start the day AFTER surgery and follow the instructions provided on the prescription.
When To Call The Office
Call the office if you have a fever over 101 degrees, experience any sudden increase in swelling (especially on one side), or notice redness around your incision sites (especially if it’s warm to the touch).
Frequently Asked Questions
How long do I have to take off work?
How long does the procedure last?
About four hours
How long will I have to be in recovery?
At least 45 minutes
When can I drive again?
You can drive when you are no longer taking pain medication and feel comfortable driving again. Always consider that you would need to be able to react in case of an emergency.
When can I start exercising again?
You can start exercising about three to four weeks after surgery. Avoid core exercises for six weeks after surgery.
Can I sleep on my stomach after surgery?
You can sleep on your stomach as long as it doesn’t cause you discomfort. Generally this will happen after you are able to stand up straight without pain.
When can I get in a pool/beach/lake?
You can get in a pool, beach, or lake six weeks after surgery.
When can I wear a normal bra again or go shopping for a new bra?
Wait until six weeks after surgery. We would not recommend doing this earlier due to restrictions and healing.
Do I need to buy a bra for after surgery?
After surgery, you will be given a loose-fitting bra, called a Coobie bra. If you would like multiple options, you can buy more bras like this. Do not wear bras with underwire or push-ups until six weeks after surgery.
Can I go to a tanning bed or get spray tanned after surgery?
You can get a spray tan two weeks after surgery, but make sure your incision line is protected or covered. We do not advise patients to go to the tanning bed until six weeks after surgery.
What can I do for scar care after surgery?
Continue to wear the steri-strips/tape until your surgeon says you can remove it. After the tape has come off, you can use a scar gel of your choice. We would recommend a product that contains silicone, like Scaraway. This is the only thing proven to support scar improvement.
How long does the swelling last?
You will have the most significant swelling within the first six weeks of your surgery. After this you may notice that you are more swollen in your lower abdomen in the evening. This is normal and will continue to improve for the following months.
How long until I can stand up straight again?
It can take longer for some people, but most people are standing upright around 10-14 days after their surgery.
Will I have drains?
We perform drainless tummy tucks in this facility.