Plastic surgery restores form and function through reconstructive procedures, cosmetic enhancements, and body contouring.
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The Brazilian Tummy Tuck is performed under general anesthesia. This ensures the patient is completely unconscious and feels no pain. A board-certified anesthesiologist monitors vital signs continuously throughout the procedure.
To prevent deep vein thrombosis (blood clots), sequential compression devices are placed on the legs to keep blood moving. The operating room is kept sterile and temperature-controlled. The patient is given intravenous antibiotics before the incision to prevent infection.
The surgery begins with precise markings. The main incision is placed very low on the pubis, allowing the scar to be hidden by underwear or bikini bottoms. The length of the incision depends on the amount of excess skin, but typically runs from hip bone to hip bone.
A second incision is made around the belly button to free it from the surrounding skin. The surgeon carefully navigates around the preserved lymphatic vessels and Scarpa’s fascia during the initial entry.
Unlike traditional methods, the Brazilian technique often starts with or integrates extensive liposuction. The surgeon uses a cannula to suction fat from the entire abdominal wall, the flanks, and the back. This thins the tissue flap and defines the waist.
This step is crucial for the “Brazilian” look. It sculpts the muscles and curves before the skin is even lifted. The use of VASER or power-assisted liposuction helps gently break up fat without damaging the connective tissue web.
Once the skin is lifted to the level of the ribcage (creating a tunnel), the surgeon addresses the muscles. The rectus abdominis muscles are sutured together using strong, permanent stitches. This repairs the diastasis recti.
This step flattens the internal abdominal wall and narrows the waistline. The surgeon may also place sutures in the oblique muscles to further cinch the waist and enhance the hourglass effect.
The operating table is flexed (bent) to bring the patient’s chest and knees closer together. This relieves tension on the skin. The surgeon then pulls the loosened skin flap down and removes the excess tissue.
The closure is performed in multiple layers. First, the Scarpa’s fascia is sutured, then the deep dermis, and finally the surface skin. This layered closure relieves tension on the visible scar, promoting finer healing. The belly button is brought out through a small slit and sutured into its new position.
After surgery, the patient is moved to the recovery room. They are placed in a semi-fowler position (bent at the waist) to protect the incision. An abdominal binder or compression garment is applied immediately.
Nurses monitor pain levels and vital signs. Patients are encouraged to take deep breaths to clear their lungs. Once stable, usually after a few hours, the patient is discharged to the care of their designated escort.
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The first two days are the most uncomfortable. Patients must maintain a flexed posture at all times, even while sleeping or walking, to avoid pulling on the muscle repair. This is often called the “walker’s hunch.”
Pain is managed with prescribed narcotics and muscle relaxants. Patients are instructed to walk short distances around the house every few hours to promote circulation, but otherwise, rest is the priority.
If drains were placed, the patient must empty the bulbs and record the fluid output daily. Drains prevent fluid buildup under the skin. The Brazilian technique often allows for drainless recovery or very short-term drainage.
Patients are taught how to strip the tubing to prevent clots. Keeping the entry sites clean is essential to prevent infection. Drains are typically removed in the surgeon’s office once output drops below a safe threshold.
Swelling is significant and expected. It peaks around day 3 or 4. The abdomen will feel tight and stiff. Bruising may extend to the hips and thighs due to gravity.
The compression garment helps control this swelling. Patients are advised to limit sodium intake to prevent water retention. Arnica montana or bromelain supplements may be recommended to accelerate bruise resolution.
The pain from a tummy tuck comes from two sources: the skin incision (burning) and the muscle repair (deep ache/cramping). Muscle relaxants are often more effective than narcotics for muscle pain.
Some surgeons use a long-acting local anesthetic injection (like Exparel) during surgery, which numbs the abdomen for the first 3 days. This significantly reduces the need for opioid medication and improves early mobility.
Patients can typically shower 48 hours after surgery, provided they have clearance regarding their drains. They should not soak in a bath. The incision is usually covered with surgical glue or tape (Steri-Strips) that remains in place for weeks.
Keeping the incision dry and clean is paramount. Patients are instructed to pat the area dry gently or use a hair dryer on a cool setting. No ointments or creams should be applied to the incision unless directed.
While walking is encouraged immediately, strenuous activity is restricted. Patients cannot lift anything heavier than a gallon of milk for the first few weeks. This protects the muscle repair from tearing.
Driving is prohibited while on narcotics and until the patient can react quickly without pain (usually 2 weeks). Returning to an upright standing position happens gradually over 7 to 14 days as the skin relaxes.
The Brazilian Tummy Tuck typically takes between 3 and 5 hours. This is longer than a standard tuck because of the extensive liposuction and detailed contouring involved.
It depends on your surgeon’s specific technique. Many Brazilian Tummy Tucks are now “drainless” due to the preservation of the lymphatic system and use of quilting sutures. If used, they usually stay in for 3 to 7 days.
You will need to walk bent over for the first week to protect the repaired muscle and the skin closure. Most patients can gradually stand fully upright by day 10 to 14. Forcing it too soon can widen the scar.
It is considered one of the more uncomfortable cosmetic surgeries due to the muscle tightening. However, modern pain management with long-acting numbing shots (Exparel) makes it much more manageable than in the past.
You can start light walking immediately. You can return to cardio around 4 weeks. However, you must avoid any core exercises (crunches, planks) or heavy lifting for 6 to 8 weeks to allow the muscles to heal fully.
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