Before surgery: what to prepare
Stop aspirin, ibuprofen, naproxen, and blood thinners 10–14 days before. Stop fish oil, vitamin E, ginseng, ginkgo. Smoking and vaping must stop at least 4 weeks before (6–8 weeks is the safer standard for combined procedures) and through 6 weeks after, abdominal flap necrosis risk is among the highest of any cosmetic procedure with nicotine. Most surgeons require BMI under 30 to bundle these procedures because the cumulative VTE and wound-healing risk above that threshold is meaningfully higher than the individual procedures alone. Discuss any hormonal birth control or hormone replacement therapy with the surgeon at least 4 weeks before surgery; many protocols pause hormonal contraception in the weeks around surgery to lower clot risk. Buy the tummy binder the clinic specifies, front-closing surgical bras, button or zip tops only. Set up a recliner or wedge pillow for sleeping. Stock easy meals and stool softeners (constipation from pain medication is common and worth managing proactively). Arrange substantial home help for the first 2 weeks; many patients arrange for a family member to stay. If your last pregnancy was less than 6 months ago, wait, abdominal muscles haven't returned to baseline.
The day of surgery
Mommy makeover is performed under general anaesthesia, runs 4–7 hours depending on the combination, and usually requires 1–2 nights in hospital. You wake up with a tummy binder around the abdomen, surgical bra on the chest, drains in both the abdomen and sometimes the breasts, a urinary catheter for the first day, and significant pain that is managed by IV medication. Standing fully upright is impossible because of the abdominal tightness; you walk hunched over for the first week.
Days 1–3: peak swelling
Pain is significant, often described as one of the more challenging recoveries in cosmetic surgery because of the abdominal muscle plication. Take prescribed medication on schedule. Walking is the single most important thing you do in the first 72 hours: target 5–10 minutes of walking every 2 hours while awake, not just toilet trips, to keep blood moving and reduce clot risk. Sequential compression devices are usually fitted in hospital and, for higher-risk patients (BMI over 30, history of clotting, longer surgical time), the surgeon may continue pharmacologic prophylaxis (low-molecular-weight heparin) for several days. The binder should be snug enough to support the abdomen but never so tight it restricts deep breathing or compresses the groin, both increase rather than reduce clot risk. Sleep in a recliner or with the bed bent at the hips and knees, do not lie flat. Drain output is recorded and reported.
Week 1: stitches out, bruising fades
Drains come out at day 5–10 once daily output drops below the threshold the surgeon specifies. Sutures (where external) at day 7–14. Walking improves from hunched to slightly bent. Office work from week 2–3 for desk jobs only; nothing requiring lifting or reaching. Abdominal binder and surgical bra worn continuously. Pain dropping but still moderate.
Weeks 2–4: back to public
Walking near upright by week 3. No lifting above 2–3 kg through week 6. No abdominal exercise, no chest exercise, no running. Scars are pink and at their most visible around week 2–3 then begin to fade. The abdomen is still significantly swollen and feels firm.
Months 2–3: swelling resolves
Swelling drops dramatically and the new abdominal and breast contour becomes clearly visible. Scars continue to fade. Light exercise expanding to include low-intensity cardio (walking, stationary bike) by week 6, low-intensity core work by month 2–3 once cleared. Sensation across the lower abdomen is reduced and slowly recovers over months.
Months 6–12: the final result
Final shape and size by month 6 with minor settling and scar maturation through month 12. Scars are noticeably faded by month 6 and continue to mature through month 12. The horizontal abdominal scar (low, hidden under underwear or swimwear) is permanent but pale and well-concealed by month 12 for most patients. Some reduced sensation across the lower abdomen below the umbilicus is common and is frequently permanent because the surgery transects cutaneous nerves during flap elevation; what you have at month 12 is essentially what you keep. Pregnancy after a mommy makeover is possible but undoes the surgical work and is medically discouraged for at least 12 months.
Red flags: when to call the clinic
Call the clinic the same day for: fever over 38.5°C after day 3, sudden firm painful swelling in the abdomen or breasts, pus or yellow discharge from any incision, increasing redness, skin at the incision edges that turns dusky white or black, sudden change in drain output (large increase or sudden stop), or shortness of breath. Go to an emergency room immediately for: shortness of breath combined with chest pain (rule out pulmonary embolism, risk is highest of any cosmetic procedure for the first 2 weeks because of abdominal muscle work and reduced mobility), one-sided leg swelling and pain (deep vein thrombosis), or sudden severe abdominal pain that is different from baseline. Constipation past 5 days despite stool softeners and walking warrants a clinic call (to rule out ileus). Routine mild constipation, asymmetric swelling, and reduced sensation across the lower abdomen are not red flags.