What is a tummy tuck?
Also known as abdominoplasty
Tummy-tuck surgery or abdominoplasty, can flatten your abdomen by removing loose, excess fat and skin and tightening muscles in the abdominal wall. It can also remove some if not all of the stretch marks in your lower abdomen. It is popular following pregnancy, massive weight loss or whenever a flabby abdomen with weak muscles impairs body contour. Most patients report improved self-esteem as a result of this procedure.
What are my options?
A personal consultation with your surgeon will determine the best option for you. Here are some different approaches:
In addition to the incision across the lower abdomen, a traditional tummy tuck involves an incision around the navel. Excess skin is removed, muscles are tightened and liposuction may be used to contour the abdomen. This surgery removes skin from above the navel down to the pubic area that has been compromised by pregnancies, genetic laxity or obesity.
A single incision is made in the pubic area, which will be placed as low as possible and can range from a few inches to the entire span of your abdomen. Through this incision, your surgeon will remove excess skin, tighten slack muscles and possibly use liposuction to further refine the area. The ideal candidate for a mini-tummy tuck has laxity and protrusion below the navel. A mini-tummy tuck is usually recommended for those who have always been in fairly good shape but cannot achieve their aesthetic goals with diet and exercise.
Extended or High Lateral Tension Abdominoplasty
If you have excess skin in the love handles or hips, your incision can be made longer to address this problem. The high lateral tension tummy tuck was one of the first procedures developed to address skin excess after significant weight loss or pregnancy. The technique uses a layer in the deeper tissue to support and maintain the repair. This procedure includes a tummy tuck in the front of the abdomen and transfers the lift over the hip to the side of the thigh to improve contour in this area, suspending and improving the hip and thigh. You can simulate the effect by grabbing the skin on the sides of your waist and pulling up as if you’re putting on a pair of pants.
Who is a good candidate for tummy tuck surgery?
A tummy tuck is a highly individualized procedure. You should do it for yourself, not to fulfill someone else's desires or to try to fit any sort of ideal image.
In general, you may be a good tummy tuck candidate if:
You are physically healthy and at a stable weight
You have realistic expectations
You are a nonsmoker
You are bothered by the appearance of your abdomen
How should I prepare for a tummy tuck?
In preparing for tummy tuck surgery, you may be asked to:
Get lab testing or a medical evaluation
Take certain medications or adjust your current medications
Avoid taking aspirin, anti-inflammatory drugs, and herbal supplements as they can increase bleeding
A tummy tuck may be performed in an accredited office-based surgical facility, licensed ambulatory surgical center or a hospital.
If your tummy tuck is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.
What should I expect during a consultation for tummy tuck surgery?
During your tummy tuck consultation be prepared to discuss:
Your surgical goals
Medical conditions, drug allergies, and medical treatments
Current medications, vitamins, herbal supplements, alcohol, tobacco, and drug use
Your tummy tuck surgeon will also:
Evaluate your general health status and any pre-existing health conditions or risk factors
Discuss your options
Recommend a course of treatment
Discuss likely outcomes of the tummy tuck and any risks or potential complication
The success and safety of your tummy tuck procedure depend very much on your complete candidness during your consultation. You'll be asked a number of questions about your health, desires, and lifestyle.
The consultation is the time to ask your plastic surgeon questions.
It's very important to understand all aspects of your tummy tuck procedure. It's natural to feel some anxiety, whether it's excitement for your anticipated new look or a bit of preoperative stress. Don't be shy about discussing these feelings with your plastic surgeon.
What are the risks of tummy tuck surgery?
The decision to have plastic surgery is extremely personal, and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications of tummy tuck surgery are acceptable.
You will be asked to sign consent forms to ensure that you fully understand the procedure and any risks.
Tummy tuck risks include:
Fluid accumulation (seroma)
Poor wound healing
Numbness or other changes in skin sensation
Skin discoloration and/or prolonged swelling
The recurrent looseness of skin
Fatty tissue found deep in the skin might die (fat necrosis)
Deep vein thrombosis, cardiac and pulmonary complications
Suboptimal aesthetic result
The possibility of revisional surgery
These risks and others will be fully discussed prior to your consent. It’s important that you address all your questions directly with your plastic surgeon.
What should I expect during my tummy tuck recovery?
Your doctor will discuss how long it will be before you can return to your normal level of activity and work following liposuction. After surgery, you and your caregiver will receive detailed instructions about your post-surgical care, including information about:
Drains, if they have been placed
Normal symptoms you will experience
Any potential signs of complications
Immediately after your tummy tuck
You may expect the following immediately after the procedure:
As the anesthesia wears off, you may feel dizzy, disoriented, and nauseated. These sensations should pass within a few hours, although some types of oral pain medications may cause these symptoms to recur.
If you return home the same day, you will need someone to drive you. Depending on the extent of the procedure, you may be required to spend a night or two in the hospital recovering from surgery.
Immediately following an abdominoplasty, expect your abdomen to feel very sore or tender. Any pain you feel can be controlled with pain medications.
Most tummy tuck patients require several days of bed rest, even if they return home the same day as their surgery.
Your incision site will be covered with a dressing to keep the area clean and protected. You will also be wearing a wide elastic compression garment to reduce swelling and provide support to the skin as it tightens. You will wear this garment for several weeks.
Depending on the extent of your abdominoplasty, you may have tubes in your incision to drain away fluid. You will be asked to empty the drains a few times a day and keep track of how much fluid comes out. Drains are usually removed from three to fourteen days after your surgery, depending on how much fluid is coming out.
If you have traditional sutures, these will typically be removed within the first week or two (absorbable sutures will not have to be removed).
Your surgeon should provide you with detailed instructions for managing your drains, changing your bandages, and showering during recovery. You will also be told whether you can put any ointment on your incisions to reduce discomfort.
Common side effects experienced by abdominoplasty patients include redness, bruising, and swelling. These effects usually subside in one to three weeks as your body adjusts to the new contours and the incisions heal.
Recovery time frame after a tummy tuck
Recovery from a tummy tuck procedure occurs over a period of six months or more. In the first couple of days, managing pain and avoiding complications is your top priority. The first week will be the worst, and you will still feel like you are recovering for about two to three weeks. After a few weeks, regaining mobility and fitness becomes important. After several months, you can start evaluating the aesthetic outcome of your surgery. It is important to remember that the time it takes to recover varies greatly among individuals.
The first few days after surgery, you should rest quietly. Remember, you must not take aspirin or certain anti-inflammatory medications. To prevent coughing and bleeding, do not smoke after your procedure. Do not drink alcohol for five days after surgery or while you are taking pain medication.
Arrange for someone to help you get around the house and help with your medication for at least the first two days after surgery.
Make sure you continue to have lots of help at home—this cannot be stressed enough. You'll be tempted to try to help around the house, but you won't feel like yourself for at least seven to ten days and you still shouldn't do any heavy lifting (such as picking up your children or baskets of laundry) for four to six weeks. If you have small children, you must put someone else totally in charge of their care for at least two weeks.
Follow your surgeon’s instructions carefully. The first two days are the most uncomfortable, so if you are instructed to take medications at certain times, stay on the schedule. Discomfort typically drops down to a "nagging" level by five to seven days.
You will likely go back for follow-up with your surgeon within five days. During this visit, your doctor can remove the drains. Swelling should subside within five weeks.
Call your surgeon immediately if you notice an increase in swelling, pain, redness, drainage, or bleeding in the surgical area, or if you develop fever, dizziness, nausea, or vomiting. Other red flags include shortness of breath, chest pains, and an unusual heartbeat.
You should be up and walking the day after surgery, although slowly. It is important to walk to discourage swelling and to prevent blood clots in the legs. However, avoid strenuous exercise for four to six weeks, because it can trigger unnecessary fluid retention in the treated areas.
Plan to take about two weeks off from work, depending on the physical demands of your job.
Make an effort to ease back into your normal routine gradually rather than all at once.
The recovery period is typically longest for patients undergoing a traditional abdominoplasty, rather than a mini-tummy tuck, and for those who are combining a tummy tuck with other surgical procedures.
Wearing your compression garment as directed reduces the likelihood of loose or sagging skin after an abdominoplasty. The compression garment also helps to control swelling, resulting in a shorter recovery period.