This is a very interesting question and I’m intrigued by the different answers! In my practice I apply the compression garment the day after surgery to minimize circulatory compromise on blood vessels that are in spasm, a normal protective reflex to tissue “injury” compounded by the effect of epinephrine in the injected lidocaine. After confirming ideal capillary refill the next day, I apply the binder.
I believe that the binder helps stabilize the tissues and minimize shearing or shifting of the flap as it fuses back to the underlying muscle. This is critical in the first 8 days or so since too much movement of these tissues will delay the fusion or adherence, which is critical in the prevention of seroma. Clearly, compression decreases swelling too, which leads to greater comfort in most patients.
Much more comfortable compression such as Spanx can be used as early as 2 weeks from tummy tuck surgery. While no one has proven that the final outcome (especially healing problems and seroma?) are different with or without compression, I find that it is so much more comfortable for my patients that a large number continue to wear some type of gentle compression well beyond the usual 6 weeks recommended by so many plastic surgeons. (Gregory J. Stagnone, MD, Dallas Plastic Surgeon)
Tummy tuck compression garments
I have been in practice for over 20 years and I am a huge fan of tummy tuck compression garments following a tummy tuck. ALL of my patients wear the garment for 4 weeks. The main reason is that the compression garment will result in more even healing because fluid accumulations are less likely to form.
My standard protocol for the garment is for the patient to start wearing it immediately following surgery.
They are asked to wear it continuously for 2 weeks. You can take it off to shower, but that is about it. Then, after 2 weeks, you can wear the garment only half of the time – either during the day or at night.
During my career, I have seen the difference that a compression garment makes in tummy tuck results. It’s great, and can only help you. More details can be found in the reference link. (Ricardo L. Rodriguez, MD, Baltimore Plastic Surgeon)
It is recommended that you wear the binder for the first week until your tummy tuck drains are removed. (Mel T. Ortega, MD, Miami Plastic Surgeon)
I ask patients to wear a compression garment for four weeks postoperatively assuming that they have not had a seroma after tummy tuck. (Christopher J. Davidson, MD, FACS, Wellesley Plastic Surgeon)
You should wear your garment for 4-6 weeks. I recommend to my patients that they should wear the compression garment for 4-6 weeks. (Jhonny Salomon, MD, Miami Plastic Surgeon)
I ask my patients to wear a binder for 2 weeks after a tummy tuck if I haven’t repaired their muscle. If I did a muscle repair, I have them wear it for 6 weeks. It takes 6 weeks for scars to form and develop sufficient strength to hold the repair together. Until then it’s just the sutures and they can break.
The binder is there to remind the patient to be careful, and it’s a back up support device in case they forget and try to strain themselves. (Martin Jugenburg, MD, Toronto Plastic Surgeon)
Every surgeon has a routine that you will be advised to follow after your tummy tuck. Normally the binder is not worn past four weeks. Some patients feel more comfortable wearing the garment for a longer period of time. You will not be harmed if you wear the garment longer than one month.
It is very important to pay close attention to how your binder/garment fits. You should adjust it several times per day in order not to get any unwanted permanent lines. (John J. Edney, MD, Omaha Plastic Surgeon)
Tummy tuck compression garments serve several purposes after an abdominoplasty. Compression reduces swelling and bruising, improves support, and helps decrease fluid accumulation. In my practice I recommend patients wear the tummy tuck compression garments constantly for 2 to 4 weeks. However, the garment may be taken off to shower or to be washed. It is best to ask your surgeon how long you should wear your garment. (Saeed Marefat, MD, Washington DC Plastic Surgeon)
Most of my patients will wear an abdominal binder and/or a panty girdle (Spanx) for up to 6 weeks after a tummy tuck. The abdominal binder will help support the abdominal muscles and take the tension off of the muscle repair. Most patients say it helps to support when they laugh or cough better than the girdle.
The Spanx type of girdle will help better with swelling in the lower pubic area, but is usually not as supportive as the binder for the muscles. The girdle is easier and more comfortable to wear under work clothes.
A lot of patients will wear both girdle and binder for 6 weeks to get even more compression of the abdomen. (Stanley Castor, MD, Tampa Plastic Surgeon)
There is some debate and variation among plastic surgeons about the use of binders and compression garments. While some surgeons have their patients wear such tummy tuck compression garments for many weeks, others do not believe in their use at all.
In my practice, I have patients wear their binder for a week after the drains are removed. Some patients do elect to wear them longer, as they like the supportive feeling. However, I do not believe that the binders are essential after this point.
The role of the binder or any other compression garment is to provide a light pressure to minimize fluid build up in any potential space that is created from the surgery. The body is always in a delicate balance of absorbing fluid that leaks from our small blood vessels. After surgery, more fluid leaks due to the inflammation, and the body is less able to absorb it. This normalizes after some time.
While compression garments are potentially helpful during this recovery phase, there are also some downsides. An overly tight garment, or one that is allowed to have creases, can create irregularities of the skin which can be permanent. In addition, the tightness of the garment can be uncomfortable for some patients.
The bottom line for my patients is that for tummy tucks with liposuction, the binder is used for a week after the drains. For lipo alone, a garment is used for only a week if at all. (Jeffrey Rockmore, MD, Albany Plastic Surgeon)
This is a question best answered by your operating plastic surgeon. He/she is ultimately responsible for the outcome of your surgery; we should respect his/her postoperative instructions and not manage them online. (Tom J. Pousti, MD, FACS, San Diego Plastic Surgeon)