A Year Post-Op: What I Want You to Know About a Tummy Tuck and Muscle Repair

I’ve mentioned before in passing that I had a tummy tuck (technical term: abdominoplasty–which makes the surgery sound more serious…and more accurate honestly) and a muscle repair. It’s not something I just scream to the world because people like to assume the tummy tuck did all the work and that I just let a surgeon fix my body/get me in shape/take all the fat off. And don’t get me wrong, the tummy tuck DID do amazing things for me (they removed 5.5 pounds of EXCESS SKIN, y’all!), but it didn’t make me lose 95 pounds. No, changing my eating habits and going to the gym did that. I like to think that it accentuated my hard work, but it was/is my hard work.

The ONLY difference in these two photos is the 5.5 pounds of skin the doctor removed. Isn’t it crazy what was hiding underneath the extra skin?! (I went on to lose another 37 pounds after the pictures on the right.)

The picture on the left is of me at my heaviest. I lost 53 pounds (the two top left pictures are me after that weight loss) BEFORE my tummy tuck. The picture on the right is of me after I lost a total of 95 pounds around nine months post-op. You can see itty bitty ab muscles forming!

Now, I went into the surgery pretty blind. I have a close family member who had one about fifteen years ago and I asked questions, but I realize now I didn’t even know WHAT to ask!

So here’s what I think you may need to know if you’re considering a tummy tuck in the future.

  • A tummy tuck is NOT just a tummy tuck.

Sometimes it can be. It COULD just be the removal of excess skin. But that’s actually pretty rare. Most women–dare say 85%, if I had to guess–also need a muscle repair (because of diastasis recti–ab muscles that didn’t close after pregnancy or weight loss or something similar).  There are four types of diastasis recti: open (muscles split apart kind of around the belly button), open below the navel, open above the navel, and the most severe kind: completely open (meaning your abdominal muscles are split apart from the top of them to the very bottom). Because I never halfway do anything, mine of course was the most severe. I had a FIVE-INCH separation down the length of my entire abdomen (caused by my swelling from preeclampsia with MM–I gained 19 pounds in 3 days with her and it gave me crazy amounts of stretch marks and ruined my abs). My split was so bad that when I was pregnant with Lawson I could do a kind of half sit-up and if I held it for 30 seconds or so he would move his head and stick his head up through my abs (he was breach the whole time)–I’m sure he thought it was the coolest thing ever. But y’all, that is one serious ab split! And that, dear friends, is where the hard part comes in.

What they do for a tummy tuck and muscle repair is cut you kind of like a csection, but all the way across (my incision is 22″ long), fold/pull all your skin up to the tip/top of your abdominal muscles and repair (i.e.: stitch) the abdominal muscles back together. After the muscle repair they do liposuction on your flanks (sides) to even it out, and then they pull the skin down to make it taut and cut off any excess skin (remember, I had 5.5 pounds of excess skin removed!), they’ll cut out your belly button and reattach it in the middle of your new stomach. They insert two drains on either side of your mons pubis (the front part of your hoo-ha; these get removed 1-2 weeks after surgery usually). There are tons of videos online showing this procedure, but I didn’t look at them before my surgery. I didn’t want to see it (still don’t. Ick.).

So as you can see it’s not “just” removing the skin. It took right at three hours for mine, which is an average amount of time. You’re put completely under, but because insurance doesn’t cover it (so every single minute you’re there you are being billed) you do it as outpatient surgery and leave the surgery center/hospital after an hour or so in recovery.

  • Wait. If you have a medical problem (like diastasis recti) why doesn’t insurance pay for it?!

Great question. And I didn’t even think about turning my surgery into insurance since I thought it was purely cosmetic. I didn’t realize the severity of my muscle split (because I had so much excess skin covering it) until my first post-op appointment with my doctor. And he probably didn’t mention it at my consultation appointment because plastic surgeons (in general) hate dealing with insurance. Since my surgery one of my friends has had a tummy tuck and had a similar abdominal tear and her insurance paid for basically all of it. You live and learn, I guess. As far as cost: in Atlanta it cost $10,100. I’ve met some women who have gone to foreign countries like the Dominican Republic, Columbia, or Mexico (to name a few) and their surgeries have been as little as $3,000. I didn’t feel comfortable (actually, it didn’t even cross my mind) with anything but American medical care, but that’s just me.

  • What’s the recovery like?

I’ve had a lot of surgery in my life. Easy stuff like my tonsils out and my wisdom teeth removed. Semi-easy stuff like two csections. Medium stuff like two ovarian cancer surgeries (10″ incisions both times). Hard stuff like a breast reduction (went from a J-cup to a D-cup). Very hard stuff like a kidney surgery with a stint and drain (12″ incision).

I say all that to tell you, I understand pain. I understand recovery. But y’all. Y’ALL. If you get nothing out of this entire post understand this clearly: this surgery (really meaning the muscle repair) is the hardest surgery I’ve ever had. I would say it’s like ALL my surgeries COMBINED. I am not exaggerating in the slightest.

The first two or three days I remember nothing. It was all a blur of pain. For the first fourteen days I slept on the couch. I stayed on the couch 99.9% of the day. I was unable to get up on my own. I was unable to shower on my own. I was unable to get to the toilet on my own. I was on pain medicine around the clock. From day 15-20 I made a lot of improvement and could take a shower by myself, put on my own clothes, and sit up on the couch. By 21 days post-op I was 75% again and driving (still spending 50% of my time on the couch). By 28 days I was 90% again and could pick up my 20-pound son (yes, I couldn’t lift anything even for one second that was over five pounds for 28 days and it hurt my heart wanting to pick up my nine month old but not able to; I didn’t realize that part of the recovery until right before I was wheeled back to surgery).  I was able to go grocery shopping again and return to a normal lifestyle. By the six-week mark I was 100% and back at the gym (low impact; regular workouts I waited until 8 weeks post-op). I did my tummy tuck at the beginning of my summer break so I had nine weeks before I had to go back to work. If I had to guess when I could have gone back I would say three weeks would be the absolute minimum (and I would have been exhausted at the end of the day), but by four weeks I would have been okay.

  • What else should I know about post-op?

Swelling. Because of your extensive incision they cut through your lymphatic system so your fluid collects in your abdomen after surgery until it reconnects. It’s like you grow in girth as the day goes on from the fluid buildup. You could start out first thing in the morning with a size 6 waist, for instance, and end up with a size 12 waist by 8pm, especially if you’re outside in the heat or working out. That’s why it’s important to wear a compression garment after surgery. Some women just wear light Spanx, some women wear the tightest faja they can squeeze themselves into. I wore something in the middle (mine was from Leonisa). I stopped swelling right at six months (which is average; I’ve met some women who continue to swell past the one-year mark and I can’t even imagine the frustration) and stopped wearing my garment then as well.

  • This is a pretty intense surgery. Are there any complications?

Yes, unfortunately. And of course I got one of them. I can’t speak for all complications, feel free to google them if you dare, but I can tell you about mine. When I went for my one week followup appointment (let me stop here and stay: I do NOT like at all that I did not see my surgeon for an entire week; I also do NOT like that I was instructed to NOT touch my bandages at all. I was told not to shower, not to touch any bandages or change them) I had what looked like scabs on the front of my incision–about 5″ or so across. It was necrosis. That’s a fancy word for “tissue death”. Don’t google it. Trust me. It’s “common”, relatively-speaking, when you have an area that has a lot of scar tissue (I had two c-sections and two ovarian cancer surgeries in that area already). At my two week post-op the doctor used tweezers and pull the scab-like thing off and underneath was a hole. This is called wound tunneling. It goes hand-in-hand with necrosis. It took 63 days for my incision to close.

There is so much I’m leaving out. Like, how my plastic surgeon told me I had an infection and refused to ever use the word “necrosis” (scared of a lawsuit/documentation on his record) and told me to clean it with peroxide twice a day and gave me crazy strong antibiotics–which is 100% the WRONG treatment (and necrosis is not an infection and does not need antibiotics). How I ended up having to go to a wound clinic for five weeks and use Santyl to get rid of the yellow slough, how I had to pack the hole twice a day (wet-to-dry dressing) with Dakins solution-soaked stringy gauze (with a very long Q-Tip, ewww), how I had to use medical grade honey and cover it with bandages, how they had to measure it every time I went to the wound clinic to make sure the depth was getting shallower (again, ewwww) and how they had to cut around and inside the hole with a scalpel to make it bleed to stimulate healing (again, EWWWWW). I could go on and on. It was a lot. I’m glossing over it. If you want to see pictures of my wound healing I can show them to you–I’m actually really proud of what my body was able to do, but I don’t want to gross people out. But please know that if you found this post and are suffering from necrosis I am here for you and will help you in any way I can.

  • Wow. A tummy tuck is a lot different than I thought! So would you recommend it?

Yes. 100%. I know I just went through how hard and painful it was, but once the recovery period was over–I would say honestly about three months post-op–I was so happy I did it. And I still am. The surgery repaired my torn apart body (something no amount of exercise could ever touch) and it removed excess skin. And y’all, that skin removal changed my very being–it makes me get teary-eyed just thinking about it. I started doing yoga last August. I never did it before because I was horrified to think about if my shirt rode up during a pose and someone saw my tummy. And just a couple of nights ago I was doing a pose and a good 10″ of my skin was showing and I did not care at all. I go to Zumba and sweat and sometimes I even wipe my face with the hem of my shirt and I don’t care that my stomach shows. I even wear bikinis (something I hadn’t done since I was 12 until late last summer)! The surgery has pushed me to physically challenge myself (I had lost 53 pounds prior to surgery and another 42 pounds afterwards). It has changed my life.

If you have any questions please feel free to comment or even email me at twougaalums (at) bellsouth {dot} net and I will answer them. Hope you all have a great weekend–I’m going to the mountains with some of my favorite sorority sisters for our annual girls’ weekend and I can’t wait!

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5 Responses to A Year Post-Op: What I Want You to Know About a Tummy Tuck and Muscle Repair

  1. rachel June 2, 2017 at 8:23 am #

    Thanks for your transparency with this! It’s hard to know what to ask. My best friend had the procedure a few years back, but her recovery wasn’t as scary as yours sounds! I wonder if that’s because hers was just to remove excess skin? She has never had children so she didn’t have to go through that extensive muscle repair. I remember her telling me she doesn’t even remember the first few days because of the pain meds haze, but she was able to go to a wedding after two weeks.
    I would love to have this, but I’m like you, I have a procedure and you can go ahead and bet on complications. I had a hole in my second c-section incision. Probably not as bad as yours, but my doctor also did the right thing, sounds like yours didn’t.

  2. Natalie June 2, 2017 at 2:42 pm #

    YES! If it was “just” skin it would be like an easy c-section (but with no getting up in the middle of the night or having to feed a baby with your body, haha!!).
    Yeah, my plastic surgeon had zero knowledge of wound care (he’s a double board certified plastic surgeon so he’s great…as long as there are no complications)…so glad I found the wound clinic at my local hospital! 🙂

  3. Mary Ann Hawthorne June 2, 2017 at 3:24 pm #

    I had my tummy tuck, skin removal, and muscle repair at the end of April. Like you, I had 5.5 lbs of skin removed too.

    I was so glad to read your story and found myself nodding in agreement at almost all of it. I had my share of complications too–a hematoma that had to be surgically irritated at two weeks post op and now an infection in the hole where the second drain was, which my surgeon pulled today.

    But I completely agreee with you in that I would absolutely do it again. The results are SO worth it.

  4. Mary Ann Hawthorne June 2, 2017 at 3:27 pm #

    I also forgot to mention, that I was extremely fortunate and my insurance covered not only my skin removal, but the tummy tuck and muscle repair as well.

  5. Gayl kirkpatrick June 2, 2017 at 6:54 pm #

    Natalie, thank you for being honest describing your experience ! You look fantastic and I know it took a lot of hard work to get there. You are inspiring and encouraging?

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