Roderick P. Zickler, M.D.
Dressings may be removed at 48 hours, as it is unlikely there will be any drainage from the incisions after that. Once dressings are removed, no further dressings should be necessary.
Empty the drains daily or more frequently if needed. They will be removed when drainage from each drain is less than 30 cc (below the bottom line on the drain tube). If there is any drainage around the drain tube through the skin, it probably means the drain is clogged. It can be cleared by “stripping”. Support the tube where it exits the skin gently with your fingers to keep it from pulling, then with your other hand pinch the drain completely closed, and draw it away from the skin creating a small suction vacuum for a distance of approximately 4 to 6 inches and repeat this process. You should probably see a dark purple plug move through the drain, followed by clear or pink fluid. The drainage from around the skin will stop. Please call Dr. Zickler if you need to do this or wish further instructions, or if this does not work.
Abdominal binder or thigh length girdle should be worn for two weeks with removal as needed for washing or bathing. The binder can be tailored with a pair of scissors if you wish. If an abdominal binder is being worn, a cotton T-shirt or silk camisole worn under the binder will help prevent abrasion to the skin from the rough surface of the binder. Nothing needs to be worn beneath the girdle.
Position and activities can be as much as tolerated. I would recommend that the first day after surgery sitting up in bed with feet dangling toward the floor is the bare minimum of activity. It will be better if you can get up to a chair. Early ambulation, even if it is just a few steps of walking around the room is preferable. The earlier you are able to walk (even a small amount) the less likely you are to get blood clots in your calf veins. You should keep the white TED hose on for at least 3 or 4 days until ambulation is normal and there is no remaining leg swelling. You will be most comfortable in the early days flexed at the waist with extra pillows behind your back and under your knees. You can position yourself in bed any way that is comfortable. When you begin to walk, you will probably also be stooped at the waist. As the abdominal skin stretches and relaxes, you can gradually straighten up as your body tolerates.
Any activity that you feel you can comfortably do, can be done without restriction. In general, expect the first three days to be bed to chair type activities. At one week, most people will be walking upright. Usually it will be at least two weeks before you are ready to resume working.
We advise against driving while you still require narcotic pain medication because this affects your judgment and your ability to drive. Similarly, pain at your incision might affect your ability to drive safely. It is recommended that you not drive until you are pain free and a safe driver.
Diet can be whatever you like. Generally the first night after surgery people may feel queasy from the anesthesia. If you were nauseated in the Recovery Room a prescription for anti-nausea medication has been given and will be helpful. Even if there is no nausea the first night after surgery, a very gentle diet with things like liquids or perhaps soup and crackers would be recommended. The following day, once all signs of nausea have passed, you can resume a normal diet. Narcotic medication can be constipating, as is lack of activity. Drink plenty of fluids and add fiber to your diet to help prevent constipation. A mild laxative may be necessary on the third or fourth day after surgery. You do not necessarily need to have a bowel movement until then.
If there are any questions or problems or concerns, please call Dr. Zickler’s office at 423/968-2732. This activates a 24-hour per day, 7-day per week answering service. I would much prefer to hear about anything, even if it is trivial rather than hear about this later when it is too late for anything to be done. Certainly, if there are any concerning signs or symptoms such as fevers, redness at incision lines, irregular appearance of the wounds or unevenness of swelling, please let me know. I would be happy to check you anytime in the postoperative period, however, we generally schedule the first visit at 5 to 7 days after surgery so that sutures and drains can be removed at that visit.
Cosmetic Surgery Associates
Bristol Professional Park, Suite 205
350 Blountville Highway
Bristol, Tennessee 37620
Toll Free 1-800-231-3335
Fax (423) 968-7530