How Much Pain Will I Experience Post Op

By Jerome Edelstein, MD

Abdominoplasty is one of the most extensive cosmetic surgery procedures for the body. A full tummy tuck typically involves many components including, removal of excess skin, muscle tightening, liposuction and stretching the remaining skin tightly to pull it down into position. Though it is impossible to predict how each person will feel after their procedure, keeping in mind the extent of work to be done will help you prepare and understand what to expect without being unnecessarily anxious.

Post-procedure discomfort will depend on two factors; the pain tolerance and subjective experience of the individual patient, and the extent of the procedure performed. Just as each patient is unique, tummy tuck procedures can vary in detail. Liposuction performed during the procedure will add additional sensitivity and bruised sensations post op. As well the extent of the incision – from mini to circumferential lift – will involve differing lengths of an incision. Diastasis repair or hernia repair will create a tight, pulling sensation which many patients report as bothersome but more annoying than painful. This tight sensation does dissipate dramatically in the first week and throughout the first month after surgery.

Immediately after a tummy tuck procedure, the abdomen is relatively numb due to long-acting anesthetic injected into the tissues. This will take between 12-24 hours to gradually wear off and strong, oral pain medication is to be taken regularly during the early post-op phase as well, keeping discomfort to a minimum. The area surrounding and just above the tummy tuck incision often stays numb for a relatively long time. It could be weeks or months until feeling regenerates in this area. That means that typically, any pain or aching sensation which patients report is felt in the upper abdomen and sides- where nerves are intact and functional. If liposuction was performed at the upper abdomen and/or flanks, this area may be tender for the first 1-2 weeks and mild bruising may appear.

Muscle tightness and spasms are also sometimes reported. It may take up to four weeks for muscle spasms in the abdomen to ease and sometimes this sensation worsens with long periods of sitting or standing, as this engages core muscles.

Depending on the amount of skin laxity you had prior to surgery, the tightness of your frontal skin may be significant while swelling is also at its peak. Inflammation is usually the most extreme within the first 3-5 days after surgery and the majority is resolved by 3 weeks post op. By that time the tissue tightness will relax considerably. By roughly 10 days post op, most people report that discomfort is gone. A “pins and needles” sensation related to nerve regrowth is often reported during recovery, though patients describe it as tolerable.

A relatively new method of pain control in cosmetic surgery is the pain pump. This is a small device used to directly infuse pain medication into the tissues after a tummy tuck procedure, as needed.

It is recommended that you consider your own pain tolerance when planning a tummy tuck. How did your experience compare to the average for other procedures or injuries? Have you experienced other surgical procedures and what was your healing process typically like? It is usually recommended that you allow two weeks off of work to recover at home and ask for help with any strenuous work. Your plastic surgeon will be able to describe your surgical plan and recommend ways to prepare, as well as minimize discomfort, as much as possible post op.