Myomectomy is a surgical procedure performed to remove uterine fibroids while preserving the uterus. It is a common treatment for symptoms like heavy bleeding, pelvic pain, or pressure. After the procedure, many individuals notice significant abdominal swelling, often called a “swelly belly” or “myomectomy pooch.” Achieving a flatter abdomen following surgery requires patience, following medical guidance, and incorporating specific recovery strategies. This path involves managing initial inflammation, optimizing nutrition, and safely rebuilding core strength over time.
Managing Initial Post-Operative Swelling
Abdominal swelling is a normal response to the surgical trauma of a myomectomy. This immediate distention is caused by internal inflammation, fluid retention, and the body’s healing processes reacting to the uterine incision. The most noticeable swelling typically peaks in the first few days and gradually subsides over the first four to eight weeks post-surgery.
Proper rest and restricted activity are the primary methods for managing early inflammation. Avoiding heavy lifting or straining is paramount, as excessive abdominal tension can aggravate the surgical site and prolong swelling. Physicians advise against lifting anything heavier than a few pounds for the first four to six weeks, depending on the type of myomectomy performed.
Some surgeons may recommend a medical-grade compression garment or abdominal binder to provide gentle support to the recovering tissues. This external pressure can help minimize fluid accumulation and increase comfort while moving, but its use must be approved and guided by your physician. Effective pain management is also important, as uncontrolled pain can lead to muscle guarding and tension, worsening the feeling of tightness and swelling.
Diet and Hydration for Reducing Abdominal Bloating
Beyond surgical inflammation, internal abdominal bloating from gas and constipation contributes significantly to post-myomectomy distention. Anesthesia, pain medication, and reduced activity often slow the digestive system, making dietary focus crucial. Increasing daily water intake is the simplest and most effective strategy, supporting bowel regularity and overall healing.
A diet rich in easily digestible fiber prevents constipation, which can strain the abdominal muscles and surgical site. Incorporating foods like whole grains, cooked vegetables, and fruits with the skin on helps maintain soft, regular bowel movements. Limiting foods known to produce excessive gas, such as carbonated beverages, cruciferous vegetables, and certain beans, minimizes internal distention.
Protein intake is a component of the recovery diet, providing the necessary building blocks for tissue repair and wound healing. Sources like lean meats, eggs, dairy, and legumes should be included to support the body’s repair work. Reducing sodium and processed foods is advisable since excessive salt intake leads to systemic fluid retention, contributing to abdominal puffiness.
Safely Reintroducing Core Strengthening Exercises
Resuming exercise requires strict medical clearance, typically at the six- to twelve-week mark, depending on the surgical approach and individual healing. Rushing core work risks injury, including developing a hernia at the incision site. The initial step is gentle movement, such as short, frequent walks, which promote circulation and prevent blood clots without stressing the abdomen.
Once cleared for focused activity, the priority shifts to reactivating the deepest core muscles: the transverse abdominis and the pelvic floor. These muscles stabilize the torso and help draw the abdomen inward without putting pressure on the healing uterine scar. Initial exercises should be very low-impact, such as gentle pelvic tilts or focused deep breathing exercises.
The next phase involves a gradual progression to re-establish functional core strength, which is fundamental to achieving a flatter appearance. Examples include modified planks, where the knees remain on the floor, and gentle bodyweight exercises, avoiding traditional crunches or sit-ups initially. High-impact activities, heavy weightlifting, or exercises that cause the abdomen to bulge outward should be avoided for several months to ensure the integrity of the scar tissue.
Understanding Long-Term Recovery and Aesthetic Expectations
The journey to a fully recovered and flatter abdomen extends beyond the initial weeks of post-operative care. While the most dramatic swelling decreases within the first two months, complete internal healing and resolution of inflammation can take six months to a full year. The uterus and abdominal wall require this extended period to fully recover and settle.
The final appearance is influenced by the surgical approach; laparoscopic or robotic myomectomy results in smaller, less noticeable scars than an abdominal myomectomy. Regardless of the technique, the scar will mature and fade significantly over the first year. The “flat stomach” aesthetic results from consistent application of recovery principles: managing weight through healthy diet, maintaining core tone, and allowing the natural healing timeline to elapse.
A realistic expectation is that the body will feel and look different immediately after surgery, but relief from fibroid symptoms and a return to a more comfortable figure is achievable. Consulting with a pelvic floor physical therapist can be beneficial for customized guidance on safely rebuilding the deep core. Focusing on long-term health and consistent, safe habits provides the best aesthetic and functional outcome.