Tummy Tuck Recovery: Busting the Biggest Myths

Dr. G (00:02):
You are listening to another episode of All the B's with me, Dr. G and my scrub tech Bri. Okay. We are back with another episode of All the B's. Technical difficulties ensued, but we're here and we're going to talk about tummy tuck recovery because there are over a hundred thousand tummy tucks a year performed a year, which is a lot actually, but people hesitate on having it done. And the number one reason is usually they're worried about recovery. And recovery is a concern. You don't want to do surgery if you haven't planned for your recovery for sure, but you can go down the rabbit hole on TikTok and social media and Google and here are all these recovery nightmares or horror stories and it might deter you from what's doing an operation that is very successful and also is the only thing that's going to solve certain problems. So we're going to walk through what recovery looks like today and go from there. But first we're going to discuss celebrity news.

Bri (01:06):
The most important stuff.

Dr. G (01:07):
The most important stuff. So I can't believe this story is still happening, but the Nancy Guthrie, Savannah Guthrie drama,.

Bri (01:18):
We've been having the nurse in the, or update us throughout the case to see what is happening because the fact that she's still missing is crazy.

Dr. G (01:26):
I know. And now there's so many ups and downs and

Bri (01:32):
I just don't, none of it makes sense.

Dr. G (01:36):
No.

Bri (01:37):
Where did she go?

Dr. G (01:38):
I don't know. And now that it's been going on for so long, to be honest, I'm afraid that we're never going to know, unfortunately why you would have some weird masked person show up at your house and get rid of your cameras is beyond me or disassemble

Bri (01:55):
Out of all the people to target. I mean, that's obviously pretty premeditated, right?

Dr. G (01:59):
Yeah. Or yeah. I mean it just doesn't make any sense. I don't know. Make it make sense.

Bri (02:06):
Maybe we do all this later. Bring her home. How do you get a full woman out of her house? I don't even know all the background details, but .

Dr. G (02:14):
Yeah, they don't either. So that's part of the problem.

Bri (02:18):
I don't understand.

Dr. G (02:19):
I would like to do say that nothing makes me feel the lack of humanity then when you have people who have nothing to do with the crime are sending ransom notes in.

Bri (02:31):
See, that's crazy.

Dr. G (02:33):
That's next level. Honestly.

Bri (02:34):
That's so dumb.

Dr. G (02:36):
How are you think that's going to work out is beyond me?

Bri (02:38):
Yeah,

Dr. G (02:39):
Just think two steps ahead and think, I haven't actually kidnapped this person, but I'm going to ask for money anyway because they're not going to try and track me down

Bri (02:49):
And now make everyone believe that I'm the kidnapper and put all those resources toward you and not finding her.

Dr. G (02:56):
What could possibly go wrong.

Bri (02:58):
Yeah, that person needs some time.

Dr. G (03:01):
It's multiple people. I think multiple people done this.

Bri (03:04):
Oh, more than one.

Dr. G (03:05):
And they had multiple, that was just one person, several ransom notes and I don't think any of 'em panned out. So just goes to show you people are,

Bri (03:13):
That's crazy.

Dr. G (03:15):
Amazing.

Bri (03:15):
And then how do you know what's real and what's not real? Now it's making it even harder to try and find her, but where are you this little old lady? Where are you going to find her now? I know. It's just

Dr. G (03:32):
It's very, very unfortunate. Alright, well moving on to something less dark is maybe Ashton Kutcher who can't escape plastic surgery speculation. I was like, who was talking about him in the first place, but

Bri (03:49):
No one. The last time we talked about him, it was actually not us. But wasn't he involved in some

Dr. G (03:56):
Weird scandal truck? Like Oh no, he was

Bri (03:59):
That seventies show.

Dr. G (04:00):
Yeah, the guy who got convicted of rape. He was friends with him and they tried to stand by cover for him or something. It didn't go well. Yeah, so I think he's on a new show is what my sister informed me. Yeah. So he's coming out with a new show, which I think is why his name's circulating again, another Ryan Murphy project. It has a bunch of people in it.

Bri (04:25):
Well, that's exciting.

Dr. G (04:25):
Allegedly. But I feel like this is a PR stunt. He doesn't look like he had plastic surgery. I'm not really sure what the, he looks the same.

Bri (04:33):
I love how they say he looks older than his younger self. Of course he does. He looks like he is aged appropriately. I know. I don't really know.

Dr. G (04:43):
He looks well maintained. I'm not really sure what, it seemed like an opportunity to discuss at one of the most common procedures in men in plastic surgery is rhinoplasty. That's really what

Bri (04:56):
And he doesn't even look like he had a rhinoplasty. No. If anything, he does look like he's got some sculptra on its cheeks and a very prominent chin, but that's about it.

Dr. G (05:04):
Yeah, the speculation was all related to his nose and I don't believe it

Bri (05:10):
Still looks a little crooked from here, so I don't believe that he had a rhinoplasty here.

Dr. G (05:16):
I concur. Okay, well moving on. I thought it was funny, we talked about this in the, OR again, bad bunny in the grass people.

Bri (05:28):
I am just so bummed I wasn't a grass person. Honestly. They got paid like a thousand bucks, $2,000 over eight days just to be grass. I could have done that. And people are selling their grass costumes for 10 grand or something online.

Dr. G (05:46):
I heard. Okay. So I read the article, I had a little bit of interest, somebody who is a mom I know locally from PB who put out on Facebook that her son was one of the grass people. And I was like, oh, that's hella cool. How fun to be on the football field for halftime. But then it's also funny, you didn't do anything. You just stood there and people thought they were going to dance or something. But then I guess at rehearsals, the grass costume weighed so much that people passed out immediately. It was hot and you're in this cage thing and it was a whole thing.

Bri (06:21):
I feel like they could have made that very light and mobile. It's just grass.

Dr. G (06:27):
My understanding is that it was a little last minute because bad bunny wanted multiple set pieces and the NFL was like, no, because you're going to destroy the turf and so you have to limit it to this many. And so the way to get around that is to have people come out and pretend to be grass instead of putting out grass stages.

Bri (06:47):
Genius. Genius. So I mean every time we talked about this in the OR our anesthesiologist thought it was bad, baby, and he kept messing up bad bunny bad baby. And then he'd be like, big baby. And we're like, no, no,

Dr. G (07:01):
Just stop talking. Yeah, the fact that he didn't know who bad bunny was is he's astounding.

Bri (07:08):
He's cut. You can't work here anymore.

Dr. G (07:12):
I mean, even if you didn't know his music, it was part of the conversation from the time he got announced as a Super Bowl halftime guy. But I really think he had blinders on because all he could see was Seattle Seahawks, which is his team.

Bri (07:27):
Yeah, that's all he talked about. Seahawks, Seahawks, Seahawks Seahawks.

Dr. G (07:32):
Everything else was just background noise to be honest.

Bri (07:35):
That's like every day in the OR.

Dr. G (07:37):
But I treated him after a hella long day in the OR yesterday with playing an actual bad baby song. So it was like there is a bad baby just

Bri (07:46):
He walked out shortly after and he was never seen again.

Dr. G (07:49):
In his Gucci flip flops. Oh my God.

Bri (07:53):
That's a whole other conversation.

Dr. G (07:55):
Okay. Alright. And then one last, because we're going to probably end up talking about this as it progresses, is the Justin Baldoni, Blake Lively. Oh

Bri (08:06):
Yeah. Nothing got settled in court, right?

Dr. G (08:08):
Shocker.

Bri (08:09):
It's honestly crazy. I can't believe it's still going on.

Dr. G (08:12):
Well, their trial date isn't set until May now, but they were supposed to meet for arbitration or mediation or,

Bri (08:19):
I don't even know what they're fighting over at this point,

Dr. G (08:24):
But it was funny because they got pics of them going in and out of the courthouse. So Justin was looking all chill, came with his wife, he was very gracious to the crowd. He was hamming it up and then Blake was all, I didn't see the pictures. Oh yeah, there's photos.

Bri (08:42):
Where's Ryan?

Dr. G (08:43):
He was not there. He had a smooth courthouse.

Bri (08:47):
Justin's wife really helps him out

Dr. G (08:50):
A lot. And then she just looks, Blake Lively, just looks pissed.

Bri (08:53):
She's promoting her haircare brand and

Dr. G (08:55):
She also looks kind of annoying, but he was yucking it up with the crowd and she was like, no comment.

Bri (09:03):
Wow. I just can't. They just need to both stop.

Dr. G (09:07):
They really do.

Bri (09:09):
This is so dumb. The movie's over.

Dr. G (09:10):
Every time they release more stuff, it just makes it look like originally they were like, we're going to be so close and this is going to be so amazing and we're going to be best friends and this is the best. And then something turned and now they're like hate each other with a passion. That's just crazy.

Bri (09:33):
It sounds like a bad breakup.

Dr. G (09:35):
I can't remember if we mentioned that one of our patients had met Justin.

Bri (09:39):
Oh yeah. Oh no. Wait, somebody, I thought it was somebody like a PA student or something and she was like, we were in the airport.

Dr. G (09:46):
No, it was one of our patients.

Bri (09:47):
Oh really? Yeah, and she's like, I saw him and I was, oh, I was talking to him and he was so hot and my boyfriend was, she was like, my boyfriend was over there. And I'm like,

Dr. G (09:57):
And he was super, super nice and he continued the conversation. He went on longer chatting with her than she would've imagined. And I was like, that's awesome.

Bri (10:05):
Yeah, a hundred percent would've texted my boyfriend, don't come back, don't come over here.

Dr. G (10:10):
Please go to the bathroom right now and stay there. Stay until I tell you otherwise. So she said he was really, really cute. Who else? Just saw somebody in real life and was like, oh, they were, wait, how do I forget that? My daughter ran into Tom Brady in the elevator in New York City and for the longest time has argued with my sister who is a huge Tom Brady fan ride or die through all his drama. I'm always like, what a cheater. But anyway, he is attractive. I'm not going to dispute that. But anyway, my oldest daughters always claims that he's not attractive, he's a cheater, whatever. It's overrated. And she had to let us know that she ran into him in real life and she was like, oh, actually retract all of that. He is quite gorgeous in person.

Bri (11:01):
She changed her tune real quick. We just need to see people in person. I feel like half of it's their personality and the way they carry themselves and he just probably walks in and he's like, he's tall. I'm Tom Brady.

Dr. G (11:13):
Yeah, yeah. There's some probably energy there. Main character energy if you will.

Bri (11:19):
A hundred percent.

Dr. G (11:19):
And then the only reason it's coming across my Gen Z kids is radar is because presumably a rumor to be dating Alex Earl. So that's a whole other

Bri (11:29):
A hundred percent. There's no way.

Dr. G (11:31):
Whatever.

Bri (11:32):
He just got really, his face got really gaunt or

Dr. G (11:36):
Yeah, she said he was a little skinny, but still a big imposing guy.

Bri (11:40):
We need to eat a cheeseburger, but for Tom Brady.

Dr. G (11:44):
Okay, so let's talk about some tummy tuck related news.

Bri (11:50):
Not as fun as Tom Brady, but no tummy tucks.

Dr. G (11:53):
Okay, so this teen mom, I don't know if you can qualify as a teen mom if you've had six or seven kids already.

Bri (12:04):
I love these because they have literally been teen moms for the last 20 years and they will never not be known as the teen moms. She had her kids back. I remember watching this back when I was a teen mom and I was pregnant at 17 and I would literally watch them. She had already had her kids and that was what, 13, 14 years ago?

Dr. G (12:24):
Yeah. I'm like, how are you a teen mom? You're like 42,

Bri (12:27):
Right? That's all she's ever going to be known for. Yeah, she's had a gazillion kids.

Dr. G (12:32):
So she shares graphic pics, which I thought was funny because her graphic pics are her with an oxygen.

Bri (12:40):
Why does she have a nasal cannula on it? What looks like at home?

Dr. G (12:43):
I know. I don't know. Teen moms are just not like us.

Bri (12:47):
Drain and her drain, which is very standard for every tummy talk.

Dr. G (12:50):
Everyone's like, it's a bloody drain. I'm like, that's a drain. Calm down.

Bri (12:54):
And of course, and a lot of the time we do lipo with our tummy talk. So with that you just have a lot more fluid that comes out.

Dr. G (13:01):
Yeah, I would say backup to that shot of protein. That's probably the most important takeaway from all of this. Drink your protein guys prehab with some protein post hab with some protein for all that I might mock her dramatic. This is a very important PSA. This is going to help you recover. You need protein to heal. And I know protein's on a mad kick in general. People love to get their macros and their protein, but when you have surgery, it really is important.

Bri (13:32):
Yeah,

Dr. G (13:32):
It's a building block.

Bri (13:34):
And I know I've touched on this before, but for some reason, myself included, when I had surgery I was like, oh, I'm not going to eat. I'm going to be skinny for this time. I'm on pain meds and I'm not hungry and I'm sleeping. And that is just not the way to do it. No, you're not going to heal it as efficiently as if you have protein.

Dr. G (13:50):
Yeah, don't Krispy Kreme and McDonald's it you want to eat good nutritious food, but yeah, don't starve yourself here.

Bri (13:59):
Actual nutrients.

Dr. G (14:00):
Yes, actual nutrients. So yeah, I feel like she had maybe a breast reduction and a tummy tuck and it's not even clear what her regret is to be honest.

Bri (14:12):
It kind of seems like the recovery is more what she's suffering through.

Dr. G (14:18):
But she has, oh, she's 32, sorry.

Bri (14:21):
She also had, I love how they said they have tubes coming out of her nose, tubes hooked up to her stomach, blood scene.

Dr. G (14:29):
She talks about mutilating her body. I would say the seven kids probably mutilated your body.

Bri (14:35):
I think the one thing with tummy tucks is the scar is a very large scar. It's not like a C-section scar. It goes hip to hip. It is essentially a very big recovery.

Dr. G (14:49):
She's in that slump right after surgery, which is not uncommon where you start thinking over everything again and maybe having some regret and it's just because you're clearing the anesthetic, you're taking pain medication, you're feeling swollen and you're sore and you're uncomfortable. And that's a normal, I feel like that's just a normal emotional rollercoaster of having major surgery, which it sounds like she did. She did breast reduction, she did 360 lipo, which is lipo everywhere and a tummy tuck. It's a lot of surgery and you have to give yourself time to recover. And she chose to do it over the holidays it sounds like, which is also super common because you have more time off. But then if you really are one of those people who lives for Christmas, then you're going to be sad. You're going to miss out on a lot. It just happens. It just depends on,

Bri (15:41):
You're not going to feel great in three days.

Dr. G (15:43):
No, yeah. You're not making it to Christmas parties. So if that's going to stress you out, then maybe pick a different time. If you would love to opt out of all the Christmas shenanigans, then that's a good time to have surgery because you can be peace out. I can't do Thanksgiving's another popular time. Then you're like, yeah, don't have to make Thanksgiving. Have a week off. Yeah. Dinner. So you get off of that. If you think of it as something that's more of a responsibility or a chore, if you love doing it, then yeah, you don't want to opt out of that. So I think that was really part of it was that she wasn't, she's like, I miss Christmas with my fiance, blah, blah, blah. I wasn't as present. Of course, whatever. You're recovering. So

Bri (16:31):
Sit and hang out. The recovery is not easy. And I feel like if you go in with the mindset that the first week or two is going to be hard, a tummy tuck probably is on the longer end of recovery is compared to anything else.

Dr. G (16:43):
I agree. Especially when you do it with lipo. It just feels like you were

Bri (16:47):
Hit by a bus.

Dr. G (16:48):
Yes. But you have to give yourself time to, I think for people, I'm imagining with her, I think she has seven kids. I'm imagining with her kids, you're somebody who's on the go all the time and it is probably mentally hard to just stop, do nothing.

Bri (17:07):
Yeah. You really have to take this time. You're not going to be letting your dogs out and picking up your children from the ground and doing all these things. You're going to most likely barely be moving the first week or so.

Dr. G (17:21):
You need to pour yourself a glass of water.

Bri (17:24):
I thought you were going to say wine, and I was like, yes.

Dr. G (17:25):
We're going to get to that with the Jessica Simpson story. Yeah, you just want to be getting up and taking care of yourself a little bit. You want some help. Somebody needs to help you and you certainly are in no position to be taking care of other people.

Bri (17:42):
I feel like the biggest thing that we've done in our office, our office is the tap block. We had all these patients that would have to come up in a wheelchair and they couldn't move the whole first week. And ever since she started doing the tap block, we haven't had a single patient ask for a wheelchair. They all come up, they do preemptively get walkers and stuff and they say that helps a lot, but they're still, they're up and they're moving. They're coming up. Not one single person. And I think that's been a huge game changer as far as doing tummy tucks is people are so much, I'm not going to say you're comfortable, but so much more comfortable than they were before you started doing those.

Dr. G (18:20):
Right. And I think that's, yeah, because we're blocking the nerves in the abdominal wall before, I mean we'll do the liposuction part of the back and flanks and then put you on your back and then we do the block before I do anything else. So before I start any incision or any actual surgery. And that helps kind of keep you numb during the procedure and for a little bit afterwards. And I think that really does help. If you don't get all those nerves firing with the initial incision, then it really helps the next few days that takes the edge off

Bri (18:57):
And you're moving. You're not just laying in bed, you're going to start healing a little bit faster. It's good for you to be moving.

Dr. G (19:04):
So I do think the tap block is definitely a game changer. I think everyone's different too. I know people who maybe work out a lot or really have a strong core that can sometimes hurt more than someone who never flexes their core doesn't do and is mostly loose skin. If you have a really, really wide separation that rectus diastasis where your six pack muscles are really spread out, bringing all that together in one shot can be uncomfortable. For sure. So

Bri (19:34):
Speaking of a diastasis repair, I know we have a lot of patients that ask about, do I need this? Do I not need this? Who needs a diastasis repair? And what actually is it?

Dr. G (19:45):
So almost any woman that's had kids would benefit from it. It is something that happens as your abdominal wall stretches out with pregnancy and then shrinks back down. There is fascia that connects the two rectus muscles and it gets stretched and it's just connective tissue. And so once it stretches out, you can't will it back together. So you can contract the muscles together and pull everything together, but that tissue in between is just stretched out. And so in surgery, I stitch that back together and sometimes it's more prominent on below the belly button. Sometimes it's more prominent above the belly button, but either way, you need to sew the whole thing from where your little breastbone starts to your pubic bone because if you just do half of it, the other part will bulge out. It doesn't work that way. So you have to do the whole thing from stem to stern. I say, and that hurts. That hurts that those muscles are still attached to your rib cage and still attached to your pubic bone. And so they pull back a little bit and it's a little jarring to have them pulled together. We're not cutting through the muscle like you do in an abdominal surgery or in a C-section, but I think it's the stretch part that's uncomfortable for patients. And I tell people it's probably a little worse than a C-section because you have the baby to distract you after a C-section so you're otherwise occupied with whatever's going on.

Bri (21:17):
And a huge fear of patients is that they're just going to rip everything you sewed up,

Dr. G (21:24):
They don't want to cough and you do want to splint. I tell 'em to just take a pillow and hold it when you cough or sneeze or laugh at least for those first couple weeks and it'll make you feel better. You don't want to strain going to the bathroom so and we make sure you have stool softeners so you don't get constipated. And then usually by four to six weeks, then you can start doing strength training and you're not going to hurt your repair. But I do have patients who are super stressed about it for a long time and I'm like, no, no, no, you're good. It's not going to open back up at three months or something like that.

(21:57):
Once you've healed, you've healed so you can get pregnant again. If that's an issue, I don't recommend it. You'll probably stretch everything out. Again, it's a slow stretch over time, but you can, you're not going to have an issue with the pregnancy if you get pregnant after having a tummy tuck, which hopefully teen mom has figured out before she went through.

Bri (22:18):
No more babies.

Dr. G (22:19):
Yeah. Maybe seven kids is good. I feel like one of them was a set of twins or something. I'm like, girl, yeah, there was no nothing but surgery was going to solve whatever her issues were. I'm sure she had a stretched out abdominal wall. And you get to that point where people will ask you if you're pregnant, when are you due and you're not pregnant. Your belly's a little stretched out and it really is. Those patients are the most gratified after getting that corrected. I don't know why people ask that question. Crazy.

Bri (22:54):
And then there isn't mini adominoplasty which you do perform.

Dr. G (22:58):
Oh yeah. So you could do

Bri (22:59):
But no repair, diastasis repair. Yeah.

Dr. G (23:02):
I think, well,

Bri (23:03):
Who's a good candidate for that one?

Dr. G (23:05):
About 10% of people are a good candidate for that one. And Jessica Simpson, which is our next little celebrity tummy tuck person who opened up having complications after she started with a mini tummy tuck, and I've seen this a few times. Mini tummy tuck is a faster recovery. I'm just removing the lower skin skin from the lower part of your abdomen and not doing a diastasis repair, not taking anything around the belly button. So it's really for people who just have a little bit of excess skin in their lower abdomen. And I would say about 10% of people are candidates. So you think you're going to, I don't know. If you really need a tummy tuck, then you should just get it. And I've had a few patients who did the mini, even though I recommended the other, and then circle back around for the regular, or if you have any extra skin or skin laxity above your belly button, again, you really need the whole thing.

(24:09):
The mini's not going to do it for you because now the lower abdomen's going to be tight and the upper abdomen's going to be a little bit loose relative. So it's very rarely employed, but it can be a good option in the right patient is all I'll say about that. And most people do need that diastasis repair. Very few people, either you haven't had kids or I don't know. I don't do a diastasis repair. I don't like to do 'em in men because they tend to blow it out. They have a lot more, I don't know, intraabdominal pressure. That's where they put their fat. It just isn't a great operation in them unless they're really, really massive weight loss. But most women benefit from a diastasis repair anyway, so that's the mini tummy tuck, which sounds like Jessica Simpson had, I think she points out a couple of things about being prepared for surgery because she had originally was having issues I guess with alcohol. She was drinking a lot and

Bri (25:14):
That comes with children.

Dr. G (25:17):
And so she had two kids and she's well documented having massive weight changes right in the public eye. She gains weight, everybody scrutinizes her. Then she goes through this amazing transformation and then blah, blah, blah. And her babies were born back to back. So she was scheduled for a mini tummy tuck and she was told to cancel the procedure because she had elevated liver enzymes due to excessive alcohol consumption, which you and I know we've canceled people for, had to cancel. This is interesting because she says she went through the surgery anyway, the

Bri (25:55):
Doctor let her do it, even with elevated liver enzymes?

Dr. G (25:58):
Yeah, it's wild. So she did okay, even though, I mean you can get away with it. I just think it's a bad idea. If you have elevated liver enzymes, maybe we should figure out what's causing that. And if it's alcohol, then we recommend that you're not drinking for a couple weeks before surgery. And certainly right after surgery, when you're mixing all those medications, alcohol can thin your blood if you're drinking enough alcohol that it's affecting your liver's ability to do its job, which is to metabolize things to clot blood, to detoxify you. I mean, that's crazy to not deal with that first. But it sounds like she didn't have a complication after it. She just wasn't happy with the results, which is

Bri (26:50):
Yeah, the scarring.

Dr. G (26:52):
Well, she has a scar and she didn't get what she wanted. She probably needed the full tummy tuck. So usually it's like you have an expectation of full mini tummy tuck gives you mini results. I'll just put it that way. And if you want full results, the mini tummy tuck's not going to get it if you're a candidate. So I think that's kind of what happened is she had a mini, she was already told not to do it anyway. Did it got away with it. Didn't have any so-called complications. Her only complication was dissatisfaction. Right.

Bri (27:26):
Yeah.

Dr. G (27:27):
And so she went on,

Bri (27:28):
Well, she said she got, let's see here, colitis. And then she was in Cedar-Sinai for nine days and then they talked about needing a blood transfusion,

Dr. G (27:37):
But that was after her second tummy tuck surgery. So then she had the actual surgery. It doesn't really say whether she figured out her alcohol consumption or not for that one. Yeah,

Bri (27:49):
She said she cut down, Might have to stop.

Dr. G (27:55):
Yeah. And then she got colitis, which is an extremely, extremely rare complication. And it doesn't, I mean, we can only go based off what she told us. I don't know why you would get colitis after a tummy tuck. It's true, true and unrelated perhaps. But either way, she was sick and in the hospital and nothing's being, so I've had patients get COVID after a tummy tuck, which sucks. I had another patient who had appendicitis within a month of having a tummy tuck, which also sucked. So I feel like that could be getting colitis True, true, unrelated. But now you have to go to the or again, someone's going to make little tiny incisions everywhere. You're still trying to heal from the tummy tuck. It's no bueno

Bri (28:42):
Just a bummer.

Dr. G (28:43):
And it's rare, but you can't predict those sorts of things. So it sounded like she had colitis, which combined with trying to recover from a tummy tuck made her miserable. And she ended up in the hospital for nine days, which is a lot, and almost had a blood transfusion, which also, I'm not really sure

Bri (29:03):
What, none of that sounds fun. Healing and dealing with all that.

Dr. G (29:06):
Right.

Bri (29:07):
That's why it's good to just wait until your blood work looks good.

Dr. G (29:12):
Yeah, she recovered. She did fine. But yeah, it was a much bigger deal than she had planned on. And I do remember with my patient that got appendicitis, it sucked twofold because she had taken her sick time from work to get the tummy tuck, and she had just gone back to work and then she got sick with appendicitis and had to, she was in the hospital.

Bri (29:40):
I always say your sick days are not for being sick. They're for vacation, and then when you're sick, you just still have to come to work. That's just the way it works.

Dr. G (29:48):
You can't go to work with appendicitis.

Bri (29:51):
I thought I had appendicitis last week, so

Dr. G (29:53):
Yes, you did.

Bri (29:54):
I did. I was like, this is going to be really inconvenient if I needed out this weekend, I was convinced

Dr. G (30:01):
On Valentine's Day weekend. Yes, that would've not been cool. So preparing for tummy tuck surgery is like everything else. You want to be optimized. That's what we want for our patients. We don't want to take somebody who's already a little sick. Certainly if you have a chest cold, we're not going to put you under anesthesia if your nutrition isn't up to par, if you're actively on a GLP one, if you have a cigarette hanging out of your mouth. Those are all reasons not to proceed. You need to kind of reassess your goals, and we want you to be part of the recovery plan and an active participant in your surgery. And so I would have to tell Jessica nicely that we need to see normal LFTs before we go to surgery. And if I was willing to let it slide, Dr. Abraham would be like, absolutely not, because you don't want to be responsible. What if she has a reaction to the anesthesia or something like that, and you're like, oh, well, we did have those elevated liver enzymes to start with. It's crazy.

Bri (31:08):
Which was documented in her chart, but it's fine. It's fine. So what do you tell people that I know a huge concern is scarring. What do you tell the patients about the scar?

Dr. G (31:23):
So yeah, I mean the trade-off for most of the surgery I do is an incision. So you have to be okay with the incision. Do we put it really low? Yes. Is it hidden in most bathing suits or bikinis? Yes. I'm going to go very low. It's usually below wherever your C-section scar is to give you an idea of low, if you have one. But it is a scar. It's not going to magically disappear. It will fade with time. I think the worst time for the scarring is at that four to six week point, and then usually at three months, it's still pretty visible and then it's going to continue to fade over one to two years. And everyone's a little bit different in terms of how fast that healing process is. If you have dark or ethnic undertones, the scar is usually darker brown than the surrounding tissue and fades to white over time.

(32:14):
And if you're more Caucasian, then the scar is pretty bright pink and fades with time. We do everything possible to make sure that the scar lays as thin and flat as possible, closing in layers, offering to use special stereo strips or tape to try and enhance the wound healing there, doing scar cream afterwards, lasering the incisions at a month, two months, and three months to get the collagen to lay down as nice as possible. Those are all things we do to sort of make sure that the scar looks as best as possible. And I think now we're starting to enter that world of medical tattooing or scar camouflage. So I think that's going to be an option for patients as it becomes more and more mainstream where patients can choose to have the scar after it's matured, tattooed to match their surrounding skin, which would be lovely.

Bri (33:14):
It looks great. I've seen, I follow a couple Instagrams and it changes so much,

Dr. G (33:21):
Which is awesome because back, I don't know, 15, 20 years ago, tattoo artists were not willing to tattoo scars. There was just a kind of an immediate concern that tattooing over a scar, it wasn't going to pick up pigment the same way. And so they would avoid tattooing over scars. And then people were brave enough to try to tattoo nipple aerial or reconstruction for breast reconstruction patients and realize that you could successfully do it. We could make a fake areola. 3D tattooing became popular. And then we had patients that were like, oh, I had my mastectomies or reconstruction after mastectomy, and they were tattooing an entire bra or this elaborate tattoo over their scars. And so I think over time it's been more and more acceptable to tattoo over scars, and now we're getting to the point where you can do it to match your own

Bri (34:21):
Versus the patients who I know have gone and got an actual big giant tattoos across their stomach, you don't really have to do that anymore. You don't have to get something you don't want down there

Dr. G (34:33):
To distract from the incision. That being said, there was a period in time where they wouldn't even do that because they didn't want a tattoo across the scar. So that was kind of the next evolution, and now they're like, oh, we can just tattoo pigment into either make it lighter or make it darker. So they

Bri (34:50):
Also kind of do with stretch marks I've seen.

Dr. G (34:52):
Yeah,

Bri (34:53):
I don't really know how that works, but I've seen it and it looks really good.

Dr. G (34:56):
Yeah, I think when stretch marks are a different color, different color, we can do better with that than when it's just the skin is really thin. It's hard to make that better. But yeah, I think you have to give yourself time with healing. You can't go out and tattoo it immediately. So like I said, your scars going to continue to mature for up to a year to two years, but then you have options.

Bri (35:20):
Yeah, I think when I reached out to somebody in Vegas that I saw to get my mastopexy scars tatooed, they said you have to be at least six months out, which I would wait at least a year, but six months is usually the general healing time. So tell me about the cat's butt hole. Just kidding.

Dr. G (35:40):
Oh, the belly button.

Bri (35:41):
The belly button. So many patients come in and they're like, what do you do with my belly button? Do you just chop it off?

Dr. G (35:47):
Yeah, that's true. So belly button is, we make a little incision around your belly button and leave it attached to the abdominal wall, and then we make a little incision where it is when we pull down that tissue and bring it out through that incision. And I like to do kind of an upside down U and take that U part and tuck it in so that it looks more like a natural belly button instead of just a concentric circle when it's all healed. The cat's butthole, if you will.

Bri (36:18):
I just heard somebody called a cat butthole one time And it's just stuck with me ever since.

Dr. G (36:23):
Yeah, that's a telltale sign of a tummy tuck. And so we try to create a natural belly button so that doesn't happen. But that was a standard way of doing it. But to kind of circle back to recovery, people are mostly in pain for, I would say the first two weeks and not really pain, just discomfort. You're kind of stooped over because we are bending you in half or what I call the relaxed beach chair position to bring that tissue down and get it tight and we can barely get you closed in the or, which is crazy because then a week later it feels like it relaxes and by a couple of weeks you can stand up straight again. So all of those things are interesting to see how resilient skin is. The first 24 hours are hard. A lot of times we leave a Foley catheter in for our patients, so they're not struggling to get up to pee. And then we see you post-op day one and get that catheter out. And then the first week to two weeks are probably where you're the most sore. And then usually by two weeks people are feeling pretty good.

Bri (37:37):
And you're going to probably have a drain the first, what, five to seven days or so?

Dr. G (37:43):
Yeah.

Bri (37:43):
So that's all totally normal. We also have had some patients who have all rented, you can rent a, what is it? The couch.

Dr. G (37:52):
Oh, like a recliner.

Bri (37:53):
So they were like, yeah, a recliner. A couple actually have done it now and like they just drop it off for two weeks and they sit in it downstairs if they just have a couch and they don't want to go upstairs to their bedroom. And I was like, that's genius. That is smart. So that might also be something to look into is Yeah, just rental, recliner rental.

Dr. G (38:11):
Because nobody wants that in your house permanently. So yeah, I tell patients if you don't do that and you're in bed, you're going to prop your knees up with pillows and prop your back up with pillows that you're kind of always in a V. You can sleep on your side. Really, the people that are on the losing end of this are those who are stomach sleepers. You're not going to be able to do that for a little bit. But yeah, I think if you're staying on top of your pain medication, you're staying hydrated, you're getting good nutrition, those first two weeks will go by pretty quickly. And maybe we tell people, plan some Netflix shows or books you need to read or something to kind of keep you occupied during that time so you can enjoy the recovery part

Bri (39:00):
If you're just planning ahead I think is so important. If you're get meals delivered, make sure your husband knows, or whoever you if you have kids to help cook for the kids. Just planning, I think, in general, and just knowing for that two weeks in that emotional roller coaster that you're like, what did I do? Or you're like, I can't move. I can't help with anything. Just got to let it go ahead of time. Yeah, just know it's going to be a little uncomfortable. Plan your meals plan where you're going to sleep. Just get everything situated.

Dr. G (39:37):
Yeah. And then, yeah, because it's kind of one of those things where you'll walk through the house and in my house, I have three girls, there's always hair ties or something on the floor or sock. Just you're going to have to keep walking.

Bri (39:50):
Yeah, don't pick it up. Don't feel like you need to clean and do everyone's laundry in the dishes. You're just going to have to plan for some help.

Dr. G (39:59):
Yeah, I would say that's the, and you can meal prep it. You can. Like I said, there's ways of thinking about these things in advance so that the recovery isn't as overwhelming. Just make it create your little nest at home and then tell everybody to go do what they need to do. They're all very, your family will be more independent than you think

Bri (40:23):
They will.

Dr. G (40:24):
They can figure it out.

Bri (40:25):
They can do it. But also don't sit in the chair for two weeks. You got to get up and walk.

Dr. G (40:32):
Yeah, you have to move around. We do want you to move around because that is important for circulation in your legs. It's important just for your breathing. The more you get up and take deep breaths, all of those things will help help your recovery as well. So you're not going to lay in bed for two weeks or whatever Cardi B claims to have done or whatever.

Bri (40:53):
Yeah, don't do it. Just get moving.

Dr. G (40:56):
Yeah. You should get moving. You're not stuck in bed for weeks and you shouldn't can start to stand straight up at about four to six weeks you'll be able to do it. And I've had people start cardio, like cardio at two to three weeks. Technically you could, but not lift anything heavy for four to six weeks. But you can start walking and in the right compression garment slowly start moving your body. People are different though. Some people will wait longer to go back to exercise, and some people will go back sooner than probably they should. But as long as you're not lifting anything heavy, then that's fine.

Bri (41:41):
And how long would you suggest somebody probably or approximately take off of work after having, I feel like one big thing is people are always end up taking off a little bit longer than anticipated. They'll be like, Oh, I'm only taking a week off. And I'm like, you should take a little bit more time off.

Dr. G (41:58):
Yeah. I mean, I think two weeks off is probably the right amount. Unless you're in a job where you're lifting and doing stuff, then you need to take more time off. But I would say definitely for the average person, two weeks off is good. And if you feel amazing and you want to go back to work before then go for it. But I think having the expectation that you're going to be out for two weeks is the most reasonable. I feel like the people who could maybe get away with going back sooner or those who work from home.

Bri (42:27):
Yeah, that's true. Unless you work from home, they take no time off.

Dr. G (42:29):
Yeah. Just turn that zoom camera off and do what you got to do.

Bri (42:34):
Have someone help you.

Dr. G (42:36):
Yeah, just bring the laptop over, do your work. Go. I love that. Yeah. I think that's

Bri (42:41):
Save your sick time for when you're actually sick. Oh wait, no.

Dr. G (42:47):
No.

Bri (42:47):
Save your sick time for when you actually go on vacation.

Dr. G (42:50):
Yeah. Use your sick time for something else. But I think if you're a nurse or a physician or a hairstylist, you're going to need to take some time off. Those are jobs where you're standing all day and you really need to, I've had patients that have been in those professions, and if you can take two weeks off and then go back to work with limited, knowing that you're not going to be lifting things and you're going to be tired if you're standing all day is a reasonable expectation. And same goes for those who are stay at home moms. A lot of what your job is, is driving little people around and that you also want to take two weeks off of. And same goes for pets, like large dogs and all that stuff. Just make sure you have the help you need for two weeks.

Bri (43:38):
I feel like that's kind of a common thing is people with dogs or so forth, they're like, oh, I tripped over my dog, or I tripped over the rug. Or being cognizant of all of that is helpful when you're recovering. Don't put a rug where you're walking or move your rug or

Dr. G (43:56):
Yeah, you're going to go slow. Just take it slow. I think that's the most important thing. And I think by I would say six months, you're usually back to normal and don't even think about having the surgery anymore. So I think,

Bri (44:14):
Yeah, it's a very rewarding surgery.

Dr. G (44:17):
Yes.

Bri (44:17):
Yeah.

Dr. G (44:19):
When you look at the before and afters, you're like, yes, those are game changing.

Bri (44:23):
Yeah. It's insane. It really is.

Dr. G (44:26):
And we are seeing more and more of it because people are losing weight on GLP ones, and so they're that loose skin and you can't get rid of that any other way than excision. Yeah.

Bri (44:36):
Unfortunately not.

Dr. G (44:36):
Yeah. I think if you have more questions about tummy tuck, if it's the right surgery for you, what your specific question is about recovery, then let us know and the chat, and we'll get back to you.

Bri (44:52):
We will get back to you. I feel like we should do a cheers or something.

Dr. G (44:57):
Oh yeah. We didn't even mention our new mugs, our merch.

Bri (45:00):
We have on our Meet me at the cabin heated rivalry shirts. I don't know if you heard any of that. I didn't talk, brother.

Dr. G (45:09):
We're going to the cottage is a quote. I dunno what cabin she's going to.

Bri (45:13):
I'm still working on finishing my coffee. We had a really long day yesterday.

Dr. G (45:18):
But get in loser. We're going to the cottage shirts. Yes. Because still,

Bri (45:23):
Now that we know all about hockey

Dr. G (45:25):
Yeah. Everything there is to know. Yes. Another thing that we like to tease our anesthesiologist about.

Bri (45:31):
Yeah. He loves it. Loves it.

Dr. G (45:33):
So we're going to scrub in.

Bri (45:35):
And scrubbing out.

Dr. G (45:37):
Okay. If you're listening today and have questions, need info about scheduling, financing, reviews, or photos, check out the show notes for links. Restore SD Plastic Surgery is located in La Jolla, California. To learn more about us go to restoresdplasticsurgery.com or follow us on Instagram @restoreSDplastic surgery. If you enjoyed this episode, please share it and subscribe to All the B's on YouTube, apple Podcast, Spotify, or wherever you like to listen to podcasts.