Stop nicotine and blood-thinning medications 4 weeks before. Optimise nutrition with adequate protein. Stop alcohol 3 weeks before. Begin sleeping inclined 2 weeks before. Pre-op blood work and imaging in week -2. Travel to Istanbul 2–3 days before surgery for consultation, marking, and anaesthesia review. The detail below is the full protocol.
Why preparation matters more than you think
The single biggest determinant of mommy makeover outcome — bigger than surgical technique, bigger than implant choice, bigger than recovery hotel quality — is patient preparation. Patients who arrive with optimal nutrition, off nicotine for 4 weeks, off blood-thinning medications, well-hydrated, and at a stable weight have substantially fewer complications and better final results than patients who prepare casually.
This isn't a mystery — the published literature is clear about this. What's harder is actually doing it. The protocol below is the same one given to every mommy makeover patient at Dr. Erdal's clinic, written so you can start it on your own.
Week -4: Stop and start
Stop: nicotine in any form
Cigarettes, e-cigarettes, vapes, nicotine gum, nicotine patches, snus, and chewing tobacco all contain nicotine. Nicotine narrows the small blood vessels in skin and subcutaneous tissue. After tummy tuck, the lower abdominal skin flap depends on a marginal blood supply that has to nourish a large area; nicotine pushes this from "marginal but adequate" into "marginal and failing," producing skin necrosis at incision edges.
The 4-week minimum is for the body to recover normal microvascular function. There is no shortcut. Cutting down is not the same as stopping. Switching from cigarettes to vapes is not stopping. The clinic will perform a urine cotinine test if there is doubt, and a positive test postpones surgery.
Stop: blood-thinning medications and supplements
The full list of medications and supplements that increase bleeding:
- Prescription: aspirin, clopidogrel (Plavix), warfarin, apixaban, rivaroxaban, dabigatran. Any prescription anticoagulant requires a perioperative plan agreed with your prescriber.
- Over-the-counter: ibuprofen (Advil, Brufen), naproxen (Aleve), high-dose vitamin E, high-dose fish oil (>2 g/day).
- Herbal: ginkgo biloba, garlic in supplement form, ginseng, ginger in supplement form, turmeric/curcumin in supplement form, St John's wort.
Paracetamol (acetaminophen, Tylenol) is safe to continue. If you have a chronic pain condition that requires anti-inflammatories, discuss alternatives with your physician 6+ weeks before surgery.
Start: nutrition optimisation
Protein is the single most important nutrient for surgical healing. Target intake is 1.2–1.5 g per kg of body weight per day — for a 70 kg person, that's 84–105 g of protein daily, distributed across meals. This is more than most people eat without intention.
- Add a multivitamin with iron and zinc.
- Vitamin C 500 mg daily for 4 weeks supports collagen synthesis.
- Avoid aggressive caloric restriction in the month before surgery. Even if your BMI is high, the time to lose weight is months earlier — the final 4 weeks should be at a stable weight on adequate calories.
- Hydrate: at least 2 L of water daily, more in the final week before surgery.
Week -2: Tests, training, and travel
Pre-operative blood work and imaging
Standard pre-op panel: complete blood count (CBC), coagulation studies (PT/aPTT/INR), electrolytes, liver function, kidney function, blood type and crossmatch, HIV/Hep B/Hep C screen. EKG and chest X-ray for patients over 40 or with cardiovascular history. Recent mammography (within 1 year) for breast cases. Glucose and HbA1c if there is a diabetes history.
Results are sent to the clinic in advance for anaesthesiology review. If anything is abnormal, this is the time to address it — not the day before surgery.
Begin sleeping inclined
After tummy tuck you'll sleep with your upper body elevated approximately 30–45° for 2–3 weeks. This reduces pressure on the abdominal closure and helps with swelling. Practise this position now using two pillows under your shoulders and head, or a wedge pillow. It feels unnatural at first; your body adapts in 4–7 nights. Going through this learning curve before surgery means the post-operative version is much easier.
Week -1: Final preparation
Logistics
- Childcare: arranged for at least the 10 days you'll be in Istanbul, plus 5–7 days after return for primary recovery at home.
- Help at home: someone to manage shopping, cooking, and household tasks for the first 7–10 days after return. Picking up children under 10 kg is restricted for 6 weeks.
- Meals: pre-cook and freeze 7–10 meals before flying. Soup, stew, casseroles, and protein-forward meals work best.
- Pharmacy: pick up any ongoing prescriptions in advance; most are sent with you to Istanbul.
Skin preparation
Mild antibacterial wash (chlorhexidine 4%) once daily in the evening, for the chest, abdomen, and surgical area, for the final 5 days. Avoid moisturiser, body lotion, or perfume on these areas in the final 48 hours.
Do not shave or wax the surgical area in the final 48 hours — micro-abrasions and follicle inflammation increase infection risk. The clinic uses sterile electric clippers immediately before surgery if hair removal is needed.
Day -3 to -1: Istanbul arrival
Most international patients fly to Istanbul 2–3 days before surgery. The breakdown is:
| Day | What happens | Time required |
|---|---|---|
| Day -3 | Arrival, VIP transfer to hotel, rest, hydration | Travel + transfer 1.5–2 hours from airport |
| Day -2 | In-clinic consultation, surgical marking, photography | 2–3 hours at clinic |
| Day -2 | Anaesthesia consultation, ASA classification, airway exam | 30 minutes |
| Day -1 | Final blood work, fasting protocol begins | Brief; rest day otherwise |
| Day 0 | Surgery | Hospital admission 2 h before; OR 4–6 h depending on combination |
Surgery-day morning
- Final shower with chlorhexidine wash. No moisturiser, makeup, deodorant, or perfume.
- Remove all jewellery (including wedding ring), contact lenses, dentures.
- Wear loose, comfortable, button-front clothing — slip-on shoes.
- Bring your phone, charger, slippers, a small overnight bag, your passport, and your insurance documents.
- Do not bring valuables. The hospital provides secure storage but minimise what you need.
- Last solid food at midnight. Clear liquids (water, black coffee, clear apple juice, weak black tea) up to 2 hours before scheduled operating room time. Nothing for 2 hours before.
The clinic transfers you to hospital approximately 2 hours before scheduled operating-room time. Pre-operative steps in the holding area: anaesthesia consent, IV placement, compression stockings, antibiotic prophylaxis, marking review, surgical timeout. You enter the operating room awake; anaesthesia begins there.
Istanbul packing list
Below is the complete packing list — what to bring, and (importantly) what NOT to pack because the clinic provides it:
| Item | Bring | Provided by clinic |
|---|---|---|
| Compression garment | — | Yes, custom-fitted |
| Surgical bra (post-op) | — | Yes, post-op |
| Wound care supplies for first 4 weeks | — | Yes, provided |
| Prescription medications (your normal regimen) | Yes | — |
| Pain medications post-op | — | Yes, prescribed by clinic |
| Button-front shirts (5–7 pieces, 2 sizes up) | Yes | — |
| Slip-on shoes / soft sandals | Yes | — |
| Comfortable pyjamas (2-piece, button or pull-on) | Yes | — |
| Reading material, audiobooks, headphones | Yes | — |
| Phone charger + adapter (Türkiye uses Type F) | Yes | — |
| Lip balm (anaesthesia is dehydrating) | Yes | — |
| Toiletries (light, no perfumes) | Yes | — |
| Snacks for hotel (high-protein, easy) | Yes | — |
| Wedge pillow for sleeping | — | Yes, provided in hotel |
| Reference photos of the result you want | Yes | — |
| Mammography report (recent, breast cases) | Yes | — |
| Passport, insurance, prescriptions list | Yes | — |
Common questions
What if I miss a step in the protocol?
Tell the clinic. Honesty is significantly better than concealment — the clinic can adjust the surgical plan or postpone the operation by a few weeks. Concealing nicotine use, recent ibuprofen use, or undisclosed medication is the leading cause of preventable surgical complications.
Can I take my normal vitamin/multivitamin?
A standard multivitamin is fine to continue. Discontinue high-dose isolated vitamin E, high-dose fish oil, ginkgo, ginseng, garlic supplements, and St John's wort 4 weeks before. Vitamin C 500 mg/day is encouraged — supports collagen synthesis.
What if I get a cold or infection in the week before?
Tell the clinic immediately. A current upper respiratory infection or any infection elsewhere in the body is a contraindication to elective surgery. The operation is rescheduled — typically 2–4 weeks later — at no additional cost.
What about menstruation timing?
Menstruation does not affect surgery and is not a reason to reschedule. Hormonal cycle phase has no clinically significant effect on outcomes. If you take hormonal contraception, continue normally — no need to stop.
Should I do special exercises before surgery?
Cardiovascular fitness is helpful — anaesthesia and recovery are easier in fitter patients. Walking 30 minutes daily for 4 weeks is the simplest intervention. Do not start a brand-new aggressive exercise programme in the final 4 weeks; it produces inflammation and fatigue that doesn't help.
