Latest / Alabama The Beautiful: The Eastern Shore Cosmetic Surgery Podcast / What Tummy Tuck Recovery Really Looks Like, Week by Week

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What Tummy Tuck Recovery Really Looks Like, Week by Week · Alabama The Beautiful: The Eastern Shore Cosmetic Surgery Podcast

• Dr. Gardner (00:00): I've had patients go back to work in a week after a mommy makeover. Now, they were working from home, so all they had to do was get on a Zoom call or answer phone calls. And so yeah, they could do that within a week as long as I say, look, it's fine as long as your head's not messed up, meaning you're not on narcotics or anything that's going to alter your reality to the point where you're saying weird stuff on your Zoom call and you get fired. Announcer (00:27): You're listening to Alabama the Beautiful. Kirstin (00:30): I'm Kirstin Jarvis and I'm here with Alabama cosmetic surgeon, Dr. Vincent Gardner. Hey, Dr. Gardner. Dr. Gardner (00:37): Hey Kirstin, how are you? Kirstin (00:38): Good. Today we are going to talk about life after a tummy tuck. Dr. Gardner (00:44): Great. Kirstin (00:46): A tummy tuck is a bigger recovery than most people expect and a huge life change. So we want to know the honest truth from the day you wake up from surgery until about six months later. Dr. Gardner (00:58): Yeah. So I mean, there's a lot to cover there and obviously we'll go through it. Tummy tuck, one of the most common procedures that we perform as cosmetic surgeons, we do lots and lots of them. Sometimes we combine it with breast or other areas for a quote mommy makeover. But yeah, it's one of the most requested procedures that we do. So we can get into that. We'll get into the nitty gritty. Kirstin (01:21): Okay. Let's talk about the first week. So we're going to talk about drains, the hunch, and what really happens that first week. So what does the first week involve? Dr. Gardner (01:34): Let's talk about drains first. When we elevate the flap, meaning the abdominal skin and subcutaneous tissue, we do that for a couple of reasons. One, so we can expose the underlying muscles. Basically, the muscles that we're going to plicate are the rectus muscles and they're your six pack muscles. So we want to plicate those because a lot of times they get spread apart during the process of the baby developing in the uterus enlarging. It has to make room. And so one of the things that we do is we will sew those muscles back together, bring them to the midline, which will allow patients to do crunches and actually start to see some improvement in their tone of their abdominal wall. But we also do it because we want to free up that skin from the belly button all the way up to the breast plate so we can pull it down and tighten that skin and subcutaneous tissue over the muscle repair. (02:33): So we leave drains in that space and we do that because that is a potential space where fluid can collect. And much like if you were to skin your elbow, fall and skin your elbow on the concrete, you're going to weep fluid from that wound. And so you're going to weep fluid internally. And if that fluid has nowhere to go, it will build up and cause what's called a seroma or a fluid pocket. So what we do is we add drains for a short period of time to evacuate that fluid while the body recovers and those areas quit weeping. And so typically we like to leave drains in for one week, sometimes two, and occasionally if somebody's being a little stubborn, we might have to leave them longer than that, but we try to get them out in the first week or two. And really when they come out is determined or dictated by the amount of fluid that's coming out. (03:25): And so that's an individual thing. The other thing during that first week, you talked about maybe being kind of hunched over and the reasoning behind that is we are pulling everything very tight because we want to get the best result for the patient. So when we're actually doing the procedure, if the patient's laying flat, we will actually bend them up about 20 to 30 degrees and we resect the skin after we have bent them up. And so that can be really tight. And again, the whole point is to give you a great result. And if we don't pull it tight, you might end up with some skin laxity. And so our goal is to try to get it tight. So some people feel the need to kind of walk hunched over because they feel like if they stand up straight, they're going to pop their stitches and everything's going to come apart. (04:12): I've never seen that happen, but I understand the concern because it feels tight and patients feel like they're going to rip something or tear something, but never happened. All right, what else? What am I missing? Kirstin (04:26): Compression? Dr. Gardner (04:27): Compression. So we put compression on you at the time of surgery or right after the case. Why do we do that? Well, when we do these procedures, what's going to happen is you're going to swell. Doesn't matter where we operate, arms, legs. So if we're doing an arm lift or a thioplasty, you're going to swell. So we're going to put you in compression. Compression is going to add some external compression to help decrease the fluid collection and the weeping that happens naturally after these procedures, or for that matter, any procedure that's done, you're going to have some swelling and some local inflammation and that's your body trying to heal the wound. And so my best analogy would be that if we were at a high school gymnasium and I asked you to run from one side to the other, you could easily run from one side to the other. Kirstin (05:17): Well, I don't know if I could. Dr. Gardner (05:20): But if we filled that gymnasium up with five feet of water and then I said run from this side to the other, it would take you a long time to get from one side to the other because you're wading through the water. And so that's my analogy for swelling is that if you've got a lot of fluid within the tissues, things just don't tend to work optimally, meaning that white cells, macrophages, red cells, all the things that we need to try to get to the area of the injury, and that's what surgery is, it's a controlled injury, to get to the area of injury to start the healing process, it has to wade through that water. So if we can minimize the swelling by removing fluid with drains and some compression. Now again, compression is a good thing, but not too much compression. If you have too much compression, you can essentially choke things off and cause more problems than you are actual helping. (06:21): So the appropriate amount of compression is good. We want firm, but not too firm. And then the other thing I like to do is I like to tape incisions and we will put some either like a glue or a silk or some sort of mefix type tape, a porous tape that if you have some drainage, it can easily come through the tape. But the tape is important because what it's doing is keeping those two wound edges together. And if we can keep those pulled together, what's going to happen is you're going to have better healing because when an incision is on tension and it's pulling apart, what happens is your body will realize that there's tension there and it's going to start adding more and more collagen to the incision and it's going to thicken and you're going to get a thick scar, but you're also going to get a widened scar. (07:13): So an incision that heals under tension, you get a thick wide scar, an incision that heals with minimal tension, you're going to get a nice thin line. And so taping will help keep things pulled together and compression will help reduce swelling. And that combination is a great one-two punch for post-op healing. Kirstin (07:32): Okay. How much help does somebody with a tummy tuck need the first week at home? Dr. Gardner (07:39): Great question. Depends really on the patient. Some people I would say need more help than others. What does that mean? Well, obviously everybody has a different pain threshold. And so somebody who has a very high pain threshold, they may do better. They're just more stoic. They don't tend to hurt as much. But again, that's just hard to predict. Some people, they don't tolerate discomfort that well and so they may need more help. When I say help, the biggest thing is when you're getting up from a seated position, it might be uncomfortable. Why is that? Well, when you're rolling and trying to pull up, what are you doing? You're using your abdominal wall muscles. Well, we've just put big sutures in your abdominal wall muscles to pull them together and that's very uncomfortable for movement because if you think about it, we use our abs for everything. (08:30): Whether you realize it or not, you really do. That's part of the core. And so anytime you engage your core after a tummy tuck, it can be uncomfortable. So you might need some help as far as just general mobilization. When we talk to you about trying to sleep kind of bent up, that's why I love it when patients say, "Yeah, I've got the recliner ready." And that helps for a couple of reasons. One, it elevates their head a little bit, which is going to help with gastric emptying. It's going to help decrease swelling, especially if we did a concomitant breast procedure. The other thing it's going to do, it's going to elevate your feet. And we like feet to be up in the air because that helps with venous drainage from the ankle, getting that blood back to the heart so the blood doesn't pool in the legs because remember, what are the two things that cause problems post-op? (09:18): And traditionally we worried about blood clots and pneumonia and being up and walking helps decrease both of those risks. But sleeping in a recliner or sleeping with the leg slightly elevated, it's going to help decrease the pressure in the veins, which is going to allow for increased blood return to the heart and it's just going to help decrease those risks. Kirstin (09:39): And that first couple days, your muscles are going to be numb. So to get up and walk around your kitchen or walk behind your couch or whatever the case might be will definitely help in the long run. Dr. Gardner (09:52): Absolutely. And it's not, people think that they have to do exercise. It's not that at all. I mean, just getting up, meandering around for 10 minutes every hour is going to be very helpful. One, it keeps you kind of moving. It's that old, well, when you stop moving, you rest and we want you just kind of moving a little bit to help decrease that effect. The other thing is, remember every time we take a step, we're pumping our calves. And what do I mean by that? Let me try to show you. So when I put my foot up in there, every time I pump my foot back and forth by taking a step, I'm pumping my calf muscle. And by pumping your calf muscle, you are going to, again, actively pump or push that blood out of the veins back to the heart. It's going to decrease pooling in the legs, which is going to decrease your risk for a blood clot. Kirstin (10:47): Well, we send everybody home with compression socks, but let's see yours one more time. Dr. Gardner (10:52): All right. I know where this is going. Kirstin (10:55): Maybe you can tell our friends where to go. Oh yeah. Love it. Dr. Gardner (10:59): Yeah, compression, really important. You actually want to try to get a measured and fitted stocking if you can. We measured at the ankle, the widest point in the calf and the length. Just being in good compression, it should be tightest at the ankle, less tight as it comes up the leg. That's going to help keep that blood from pooling. And so it's very helpful. And the thing we didn't talk about was pain medicine and let's jump on that real quick. So post-op pain medication, we have been using this sodium blocker called Jornavix, and it has been a real good addition to our post-op regimen as far as for post-op pain. It's a non-narcotic, so we don't worry about constipation. That's the bad part or one of the bad things about narcotic pain medicine is that it tends to constipate people and that's a big problem post-op. (11:47): So we have a whole nother regimen just about not getting constipated because again, you throw a tender tummy from the muscle repair and then constipation on top of that and it's a disaster. So the best thing to do as far as treatment of constipation is to actively prevent it. And part of that is the pain medication. And this Jornavix, it's a scheduled medicine, which means you take it whether you're hurting or not, and it works fantastic. We really like that. And then we have some narcotic and some other medicine as backup or in addition to the Jornavix. So again, not pimping out for Jornavix, we don't have any stake in that, but I do think it's a good product and so I'm not shy about talking about it. Kirstin (12:34): Yeah. It seems to be really good for pain control and a lot of the other doctor's offices in our area, the orthopedics and even the dermatologists, everybody's kind of using it now. So it seems to be pretty good. Dr. Gardner (12:45): Yeah. Kirstin (12:45): All right. So let's talk about weeks two to four. When people can start standing up straight and walking a little more, when would you say is safe or when can people start walking up a little more straight? Dr. Gardner (13:00): Well, I mean, technically, as far as walking upright, you're not going to hurt anything if you do that in the first week. Having said that, it's probably going to be sore and a little more difficult, but by the second to third week, I would say most people are walking in a more of a standing position and they don't feel like they have to hunch over, but you're not going to hurt anything. But I do ask people to try to start slowly, if they're laying down, slowly kind of straightening that abdominal wall. Part of that is because if you don't, I've seen plenty of people, they come in and now they're complaining of back pain because they've been hunched over for a couple of weeks. So that's what I would recommend is start trying to work that range of motion, try to stand up straight. But again, the old adage is in surgery or post-op recovery, if it hurts, don't do that. (13:54): It's like, "Hey doc, it hurts when I do this." Okay, great. Don't do that. And again, we want you to kind of heal on your own time, but I do see people that I'm like, "Okay, you need to be a little farther along than you are. Maybe you're babying yourself a little too much." And that's okay too. Some people just don't know and they're afraid to challenge anything because they don't want to screw it up. And I love those patients because they're actually following the rules. But yeah. Kirstin (14:22): In week one, two, a little bit further than that sometimes, when people's drains come out, is that life changing? Dr. Gardner (14:31): Yes. So getting drains out is life changing. And I say that not because the drains really, they don't particularly hurt, but I would say getting them out frees them up. It's just one less thing to worry about. It's annoying. And I think just knowing that they're there can be kind of mentally bothersome to some people. But yeah, once we get the drains out, usually within that first week or so, most patients feel much better. Kirstin (14:58): Another thing about drain removal is we usually tell patients they can switch from the abdominal binder to a Faja at that point. And that feels so much better too, to get that sticking binder off your stomach and to be able to put on a compression garment instead just feels so much better. Dr. Gardner (15:15): Yeah, absolutely. Switching to the Faja can be great too. And so people are like, "What's a Faja?" Well, Faja is just a bodysuit, right? It's a Spanx type garment. You can get them in many different shapes and sizes and colors, and some of them will snap up the sides or they'll have the clasps and hooks like a bra does. Some of them will have that plus zippers. Some of them are a true Spanx type garment where you don't have any zippers or clasps and you just literally shimmy into it. Obviously when you have drains, it's going to be really hard to shimmy into something. So we use an abdominal binder for those first couple of weeks. And then once the drains are out, then we can switch to a Faja type garment. I always recommend that you get a couple of different garments and from a couple of different suppliers. (16:05): And the reasoning behind that is if you get two Fajas that are exactly the same, we always worry about compression points and stitching. And so the compression points and stitching, if they're exactly the same on two different garments, say you wear a garment and you swap it out every other day or every day to the new garment. Well, that's a good thing because they're going to have different pressure points because they're made by different companies and they're slightly different. But if you're wearing two of the exact same garments, which again, you can do, but you're going to have the exact same pressure points, exact same stitching. And so we worry more about that and it's not going to hurt anything, but I have seen where people, especially if they wear compression that's too tight in the same place over and over, you can get some contour irregularities caused actually by the garment. (16:55): So you just have to be careful with that. And then let's kind of talk about, we really didn't say much about massage. And when I say massage, I mean lymphatic massage because everybody hears the word massage and they're like deep tissue, hot stone, all that kind of stuff. Lymphatic massage is a very gentle process. I describe it and I kind of show them my hand. I said, look, lymphatic massage is literally just kind of rubbing along the skin. What you're trying to do is you're tenting open the lymphatic channels to allow that fluid to drain into the lymphatics. If somebody is being aggressive and rubbing, what you're going to do is actually cause more damage. So you want to be very careful with that. You want to make sure somebody, or if you're seeing somebody for lymphatic massage, that you're really getting a lymphatic massage. (17:46): It should be very gentle, very light, but on the same note, you should notice quite a bit of improvement because you're going to have fluid mobilization. They should be massaging towards lymph basins or lymph nodes and that's going to allow for decompression. And if I hear somebody and they're like, oh, it was really rough and it just made things worse, then they probably did not get a lymphatic massage. For patients that get a true lymphatic massage, most of them are like, oh my gosh, my swelling is so much better and I've only had one or two massages. Kirstin (18:17): What's your feelings on people watching YouTube videos or TikTok videos and doing a little lymphatic massage at home? Dr. Gardner (18:25): Good question. I would have to see the videos. I think it can be okay. What I typically would recommend is that maybe try, and again, I don't know that the massage therapist or the lymphedema specialist will allow this, but most of them will. I would say that if your spouse or whoever your caregiver is, they go with you and kind of watch how they do the massage, then that can be helpful. At my old practice, we had a massage or lymphedema specialist and they did lymphatic massage and part of that job was for them to help train the family in how to do the lymphatic massages. And I think they can be very helpful and if you have somebody that's capable and willing to help out, then that's great. As far as videos go, it's like anything else out on YouTube, you get good and you get bad stuff. (19:15): And so as long as it's good content coming from somebody who's credible and knows what they're doing, it's probably a good thing. Kirstin (19:23): Let's talk about showering, sleeping, getting up and down off the couch, out of the bed. When does that stop being like a whole production? Dr. Gardner (19:36): Good question. Probably has to do more with the individual than anything else. I mean, I see patients that are super motivated. They're like, "I do not want to miss work. I'm going to get back as quickly as I can." And then I see other people that are like, "Yeah, I can take as much time off as I want. I'm not trying to rush things." And they'll tend to take things a little bit slower. Again, there's nothing right or wrong about that. It's just some patients are more motivated to get back faster and that mindset is worth its weight in gold. If you set yourself up mentally, talk positive things to yourself, you're going to do so much better. But if you're constantly saying, "I'm hurting, I'm miserable, I hate this, this is terrible," you're going to do terrible. If you're constantly telling yourself, "This is awesome. I'm going to look so great. Man, I'm doing great." And just be positive with yourself, it really makes a difference mentally. And we know that that really does affect your recovery. Kirstin (20:36): Fully agree. Awesome. Okay. The six week mark is usually when people tend to start feeling back to normal and start to get back to their daily lives. When can folks drive, go back to work, pick up their kids, physically pick up their kids? What's that look like? Dr. Gardner (20:58): So the biggest holdup and delay with all that is that muscle repair, that rectus muscle repair, the rectus plication. And the reason we don't like you to do any heavy lifting, straining or vigorous activity for six weeks is because of the last thing we want to do is pull or pop stitches that's going to allow those muscles to separate. If you will allow them to scar in and really heal, and when I say scar, scar just means that they heal together and they're firmly attached, they're not going anywhere. And usually if you'll give yourself six weeks to recover, you'll do great. It doesn't mean you can't do anything for six weeks, but I don't want you to really challenge that by doing any heavy lifting, straining, or vigorous activity. But six weeks, and that's probably why people feel that way because I think mentally we set them up, "Hey, in six weeks, you're going to be back." Kirstin (21:48): You're free. Dr. Gardner (21:49): Yeah. And it doesn't mean go out and try to lift the gym at six weeks. It means you ease back into exercise, you start back, get back to your daily routine, and you tend to do really well. But yeah, I say six weeks is that cutoff point and it really has to do more with me not wanting you to try to challenge that muscle repair before it's ready. Kirstin (22:11): So at this practice, we see most all patients at the six week mark. What do their scars tend to look like at that point? Dr. Gardner (22:20): If they have been following the rules using either the MeFix tape, which is the scar tape, and I like for patients to use the mefix or the scar tape for the first six to eight weeks. After that, or I like for you to switch to the silicone tape. But if you do those things and you wear good compression, most people, their scars are actually going to look pretty nice. Now, I will say there are certain people that they just don't scar well no matter what we do. And when I say that, what do I mean by that? Well, I mean that they may spit sutures, they may just have more irritation, and for some reason, some people have issues with scarring. And it could be a genetic thing where you tend to lay down more collagen and you do it, your mom's done it or your dad's done it and you just make a thicker scar. (23:12): But again, we try to mitigate that with taping and compression. If you do that and follow the rules, you'll tend to do well. When you say a spitting suture, what does that mean? It just means that for whatever reason, you're having some issues where some of those little superficial stitches are placed underneath the skin. And what can happen is you'll get kind of a red spot on the incision and usually sometimes it'll even open up, look like a little pimple and we'll get a little piece of old suture and pull it out with some tiny little tweezers. And then once we get the old stitch out, then it tends to heal up nicely. And sometimes you'll get a couple of those and we have to kind of remove those sutures. And once we do that, it usually heals. But that's what spitting suture means. It doesn't mean you're actually spitting out your mouth, but it just means that you're having some issues with the sutures at the incision level. Kirstin (24:06): And it's super common. It doesn't mean that anything's infected and it literally feels like a zit, like just something kind of poking through your skin. Dr. Gardner (24:13): Yeah. It's more of an annoyance than anything else, but some people do get kind of freaked out about it because they think you're right that, oh my gosh, this is infected. There's a problem. It's rare to have that. Doesn't mean that statistically we will see some people with some infections and some wound problems, but the good news is it's a minor, very minor number. Kirstin (24:33): Yeah. Okay. So what about month three through six when people start to get their shape, swelling mostly subsides at that point? Dr. Gardner (24:47): Yep. So I always tell people if we're doing concomitant liposuction, which we do in a lot of cases, now I'm doing a case tomorrow where the patient has lost all of her weight, we're not doing any liposuction, we are just removing skin. And for that patient, the recovery will be easier because when we do liposuction, and sometimes we're doing what we call lipo 360, where we're doing full back lipo, then we flip you over, we lipo the front, the flanks, and then we do the tuck. Well, in that situation, you're just going to take longer to heal because liposuction, we're damaging the tissue to get the fat out. And when I say damaging, it's going to heal and it heals very nicely, but it takes some time. And so you're going to have that inflammatory process and it's going to take three, four months, sometimes up to six months for what I call the microscopic swelling to go down. (25:43): The macro or the big swelling tends to go down in the first three to four weeks, but that what I call microscopic or tiny swelling or small swelling will tend to hang around up to six months and it will gradually get better. And so that's why over that four to six month mark, you start to see patients really kind of come into what's going to be their final result. And it's just a waiting game, but it also, I ask you, eat right, heavy on the protein, light on the carbs, make sure you're taking good multivitamins, vitamin D, B12, zinc, all the things that you need to really heal. And if you'll do that, again, set yourself up for success and you'll do really well. Kirstin (26:30): Also on the protein, we should, I guess, highlight that it's not just that we want you to maintain your great results, but protein is going to help with your, I don't know, tissue healing, I guess. Is that what I'm looking for? Dr. Gardner (26:42): Tissue healing. Remember, protein's the building blocks. And not only that is if you want the best physique, which again, people are trying to get their body back, eat protein. And why is that? Well, protein helps build muscle. And so if you're active and you're working out, I'm not talking about bulking up and trying to compete on stage, but I'm talking about if you want to build muscle, muscle burns more energy at rest. And so you actually burn more calories the more muscle you have. And so again, if you'll eat lots of protein, it'll help healing your wounds and it'll help building and toning muscle, which is going to help you in turn burn more when you're at rest. Kirstin (27:30): What about the numb patch of skin around your incision? When do you get feeling back in that area again? Dr. Gardner (27:38): That is super annoying. And think about it like this. So if we're making our incision here, what's going to happen is all of this has been cut. And so when we make that incision from hip to hip, all this drainage has nowhere to go. And so it kind of sits there. So that's why you get some swelling right here, but also we've cut all of these nerves and so it gets kind of numb and tingly right here. And over time, that is going to come back. It doesn't matter where we make that incision. When we used to do old strip hair transplants, we would make an incision from ear to ear and people would be numb back here on the top of their head for six to nine months. And eventually that comes back, but it is super annoying. Same thing on the belly. It just kind of feels weird and looks like, "Hey, it's not my skin." But eventually those nerves kind of find their way and most people will get the majority of that back. It just takes time. Kirstin (28:40): Yeah. What have you heard patients say about how their clothes fit or their confidence level or just how life has changed after a tummy tuck? Dr. Gardner (28:53): Tummy tucks, again, are life changing. And you say, "Well, it's not cancer. You're not curing cancer." Well, you're right, but you would be amazed at how patients respond because again, just to go to the before and after gallery, if you do that, you're going to understand why patients have such a dramatic reaction to a tummy tuck because it doesn't matter. You can do a million crunches a day. You're never going to get a six pack of abs unless we pull those muscles back together. Now doing crunches actually will do something. The other thing is that skin laxity from your belly button to your breastplate, that loose skin, you cannot tighten that up. I don't care again how many crunches you do, you're just not going to get improvement. But if we sew the muscles together and we pull all that down and free up underneath it, we're going to get a nice result. (29:48): And so we're going to accomplish what unfortunately you can't accomplish in the gym. Just like with my massive weight loss patients, I see people that have lost over 200 pounds and Getting rid of that extra skin, getting rid of those love handles. If it's a breast or a chest, we're getting things back where they belong. It's life changing because all of a sudden you see yourself different in the mirror. I've had plenty of patients who, when they look at themselves in the mirror, say they've lost 200 pounds, they see all this hanging skin or this loose skin and they say, "Well, gosh, I look like I'm a candle that melted." But once we can remove that skin, and the same thing happens with a tummy tuck with somebody who's just had kids, they see themselves differently. At least that's what they tell me. Anyway, that's why I think it's such a great procedure. (30:41): Plus the fact that we can combine it with other procedures, breasts, other parts of the body and do it all at the same time as a quote mommy makeover. It's a great procedure. Kirstin (30:51): I was trying to find a picture of myself. I'm going to quit looking, but I cannot even tell you. I've been slender and smaller my whole entire life, but my kids completely wrecked my whole abdomen. Seriously, a tummy tuck made all the difference. It was amazing. Dr. Gardner (31:08): Yeah. Kirstin (31:08): Okay. So for a mom or somebody who's lost a significant amount of weight or anybody else that is just looking to tighten things up, and if they want to know whether it's worth the downtime, what is the honest trade off? Is it worth the six weeks off work or the six weeks not being able to lift your toddlers? Dr. Gardner (31:28): So here's what I would tell you. I don't know anybody that necessarily takes six weeks off. Now, I'm not saying people don't, but most people want to know when can I get back to work? Well, I've had patients after the first week, and we didn't talk about driving, so let me address that too. I've had patients go back to work in a week after a mommy makeover. Now, they were working from home, so all they had to do was get on a Zoom call or answer phone calls. So yeah, they could do that within a week as long as I say, look, it's fine as long as your head's not messed up, meaning you're not on narcotics or anything that's going to alter your reality to the point where you're saying weird stuff on your Zoom call and you get fired. But if you're mentally okay and you're taking the Journavx and you feel good and you want to get out and do things, it's fine. (32:23): So everybody heals at their own pace, but I have patients within a couple of weeks get back. But yeah, that's just different for everybody. But let's talk real quick about when can you drive? So the key there is I don't like for you to drive that first week, but prior to driving, you have to be off any kind of narcotics, benzodiazepines, muscle relaxers, anything that's going to alter your mentation and could affect you driving for at least 24 hours. The other thing you have to do, and what I request that you do is get behind the wheel of your car with it turned off, pretend a little kid pulled out in front of you on a bicycle, practice slamming on the brakes, look right, look left, make sure that you're completely unencumbered or undistracted by any pain or discomfort. Because if you can't slam on the brakes, like if you try to slam on the brakes and it just hurts and you're like, oh my gosh, I don't think I can do that, then you shouldn't be driving. (33:18): And it's a common sense thing. Don't do anything that's going to endanger you or the public. And so once you can do that and you've proven that to yourself, then I think it's okay to drive again with the caveat that you're off any kind of narcotic benzos, muscle relaxers, anything that messes with your head for at least 24 hours. The other thing is what you don't want to do is go out and get into a car wreck, end up in the ER, have them check your urine and they're like, oh my gosh, you're positive for narcotics. Well, suddenly that innocent fender bender, now you're in the middle of something and you're the one on the hook because they found something in your urine that shouldn't be there and you're like, well, but I took this or that. So anyway, just don't put yourself in that situation and please don't endanger anybody else. So just be smart about driving post-op. Kirstin (34:13): Okay. Do you have a burning question for Dr. Gardner or me? You can leave us a voicemail on our podcast website at alabamathebeautifulpodcast.com. We'd love to hear from you. Thanks, Dr. Gardner. Dr. Gardner (34:26): Thanks, Kristin. Kirstin (34:27): Go back to making Alabama Beautiful. Dr. Gardner (34:29): All right. Announcer (34:32): Got a question? Leave us a voicemail at alabamathebeautifulpodcast.com. To learn more about Eastern Shore Cosmetic Surgery, go to easternshorecosmeticsurgery.com. The commentary in this podcast represents opinion and does not present medical advice, but general information that does not necessarily relate to the specific conditions of any individual patient. If you enjoyed this episode, please share it and subscribe to Alabama the Beautiful on YouTube, Apple Podcast, Spotify, or wherever you like to listen to podcasts. Follow us on Instagram @easternshorecosmeticsurgery. Alabama the Beautiful is a production of The Axis, T-H-E-A-X-I-S.io.