We get many questions about what activities are safe after Dr. Immerman performs a cleft lift procedure, and this page is meant to help clarify the instructions. In general, it is safe to go back to normal activity, but to be gentle with the incision, and keep it clean and dry. Especially in the winter, take extra precautions to avoid falling. Dressing instructions can be found on this page: https://www.pilonidal.com/dressings
But, if you would like more detailed activity instructions, continue reading.
We encourage sitting after surgery, and patients are encouraged to sit, even on the day of surgery. This will not stress the incision, and may actually help the incision heal by opening up the gluteal fold near the anus and allow air circulation. Most patients find that sitting on something firm is more comfortable than something soft. Soft furniture (like a sofa) allows you sink down into it which presses on the incision and is often more uncomfortable.
Some patients have a tendency to sit sideways, on one buttock, with the thought that it will be better for the incision. Actually, it is worse for the incision and is not recommended.
Dr Immerman does not recommend a coccyx cushion, and would rather that you sit on regular chairs. However, the goal here is not to cause pain, and if you find that a coccyx cushion is more comfortable, it is OK to use one.
It is OK to sleep in whatever position you find comfortable. It is safe to sleep on your back if that is what you like. Whichever position you use for sleep, just make sure the drain bulb is tucked under your clothes so it is not accidentally pulled out.
It really takes an incision six weeks in order to completely heal, and we do not recommend any contact sports during that time period. Nor do we recommend any activity with repetitive back and forth of the legs, such as jogging or biking for that same six-week time period.
Activities that do not have any risk of falling or contact with the incision are usually safe. Golfing, shooting baskets or batting practice are examples of things that are safe. However, any activity, especially in warm weather that causes excessive sweating should be followed by a shower, drying off thoroughly, and replacing the gauze between the cheeks.
There are no restrictions on bending. As for squatting – the normal kind of movements a person does on a daily basis are just fine. For example reaching for that bottom shelf of the refrigerator. But it is not a good time for exaggerated squatting as one would do with weightlifting, yoga, etc.
There is no restriction on lifting while standing. Dr. Immerman just asks that you be careful if lifting is done in such a way that the weight is being transmitted down the body to the incision, such as with a bench press. It is not a good time for sit-ups or leg presses.
This has to be looked at in the context of the information above. If you work at a desk job, you can return to work when comfortable. If your job puts you on your feet all day, that should also be safe any time.
But, jobs that are strenuous, involve exaggerated and prolonged squatting, or that present a possibility of falling or trauma to the incision, should be delayed for several weeks. Exactly how many weeks depends on the specific activity, and you will need to use your judgment based on the above information, keeping in mind that it will be fully healed six weeks from the operation, as long as no problems came up in the recovery period.
Dr. Immerman tries to make the recovery from the cleft lift procedure as easy as possible, and these restrictions should not upset your lifestyle to dramatically. If you are not a patient of Dr. Immerman, please understand that different surgeons have different activity instructions, and you should follow your personal surgeon’s instructions – especially if your surgery was not a cleft lift.