What is a tummy tuck?
Abdominoplasty, or tummy tuck surgery, is a cosmetic procedure that enhances the shape and appearance of the abdominal area by removing excess skin and fat and tightening the underlying muscles. The procedure is typically performed on an outpatient basis.
There are various techniques that plastic surgeons use for tummy tuck surgery, and the best approach will depend on the individual patient's needs and goals.
A standard abdominoplasty involves:
- Removing excess fat and sagging skin from the abdominal area below the belly button to just above the pubis
- Tightening the remaining skin and muscles, resulting in a flatter stomach
- Repositioning the belly button for a more natural appearance
Tummy tuck surgery is often sought by women who have experienced substantial weight loss or multiple pregnancies, which can lead to abdominal muscle looseness and excess skin.
The procedure can address these concerns by performing a combination of ab muscle repair, which brings the rectus abdominis muscles back together, and a panniculectomy, which removes excess stretched-out skin.
Liposuction is another option that some people choose to further contour the waist and flanks. However, there is some debate about the best timing for liposuction in relation to a tummy tuck procedure, whether it is before, after or during.
Liposuction can be performed safely and effectively as long as the surgeon takes measures to preserve the blood supply to the remaining abdominal skin during the procedure. This helps to ensure proper healing.
In some cases, the excess fat removed via liposuction may be transferred to the hips, a hybrid procedure sometimes referred to as an hourglass tummy tuck.
In addition to women, a growing number of men who have experienced significant weight loss are also opting for tummy tuck surgery to improve the appearance of their abdominal area.
What are the pros and cons of a tummy tuck?
- Tummy tuck surgery tightens and reshapes the waistline, resulting in a smoother, firmer and more shapely abdominal appearance.
- Surgery can eliminate or reduce the appearance of pregnancy stretch marks and other scars on the lower abdomen (c-section, hysterectomy scars, etc).
- You may experience relief or complete remission of lower back pain and urinary incontinence due to the restored strength and stability of the abdominal muscles.
- The effects of a tummy tuck are generally long-lasting but may be affected by significant weight gain or pregnancy.
- The surgery requires a considerable amount of time to recuperate, with at least two weeks of rest needed and the overall recovery process potentially taking anywhere from 3 months to a year.
- The procedure carries a reasonably high, 3% risk of complications (more details below)
- A tummy tuck leaves an enduring scar that is generally well-hidden and spans across the lower stomach from hip to hip.
- It is an expensive surgery that Medicare and private health insurance likely will not cover, although partial funding may be possible if the procedure includes hernia repair.
- Additional touch-up procedures may be required to enhance your results, particularly if multiple procedures were performed together during a mummy makeover.
Melon Tip: As a result of removing excess skin and fat, a tummy tuck may result in weight loss, though it is not a weight loss procedure.
How much does a tummy tuck cost?
Average Cost: $12,300
Range: $7,100 - $28,700
The cost of the surgery will vary based on the difficulty of your procedure, the skill and experience of the surgeon, the location of the clinic, and any other additional expenses.
Abdominoplasty is deemed an elective cosmetic surgery, so it is normally not covered by Medicare or private health insurance. However, some insurance policies may provide partial coverage if the operation includes the repair of a hernia.
Is a tummy tuck dangerous, what are the potential risks and side effects?
Tummy tuck surgery, also known as abdominoplasty, is typically considered safe when performed by a qualified plastic surgeon. Common minor side effects of a tummy tuck include swelling, bruising, and temporary numbness around the incision site.
Compared to other cosmetic procedures, this surgery has a higher complication rate.
In a 2015 study published in the journal Plastic and Reconstructive Surgery, the complication rate for tummy tucks was found to be 3%, higher than the average rate of 1.5% for other cosmetic surgeries. The most frequent major complications, side effects and risks of abdominoplasty are:
- Temporary blood clotting under the skin (Hematoma)
- Clear fluid build-up beneath the skin (Seroma)
- Blood clots (Thrombosis)
While rare, patients may encounter pulmonary thromboembolism, the formation of blood clots in the lungs. The use of intravenous sedation and tumescent anesthesia can help to minimize this risk.
Additionally, the risk of developing seromas and hematomas can be lessened through the use of the "Lockwood" technique, in which a larger amount of skin is left attached to the muscles, leaving less space for these fluids to accumulate.
Even though tummy tuck surgery has a very low mortality rate, ranging from 0.02% to 0.16%, it is still higher than the death rate of other cosmetic procedures. However, to put this in perspective, the mortality rate for selective C-section delivery is roughly 0.02%.
It is important to follow your surgeon's recommended guidelines for rest and activity. This is necessary to avoid prolonging the recovery period, causing additional scarring, or increasing the risk of requiring corrective surgery.
Nevertheless, some movement can help prevent the formation of blood clots, so be sure to discuss with your surgeon a safe plan for walking and other activities as you heal.
Is a tummy tuck worth the money?
Tummy tuck surgery consistently has a very high patient satisfaction rating, despite the high cost and lengthy recovery period.
This surgery is often sought out by mothers who wish to restore their body after pregnancy, many report being extremely pleased with the results, which can include improved body image and self-esteem.
Men who have had tummy tucks are also very satisfied with the outcome, with many describing the surgery as life-changing.
Tummy tuck surgery can also be a useful option for individuals who have undergone significant weight loss and wish to complete their journey by addressing excess skin and other issues left in the abdominal area.
However, satisfaction is not always guaranteed. Some people who have undergone the procedure have reported subpar outcomes, including complications, asymmetry or visible scarring. To increase the likelihood of a successful procedure, it is important to choose a qualified and experienced plastic surgeon who is board-certified and regularly performs tummy tuck surgery.
It can be helpful to research the surgeon's training and credentials by checking patient reviews and looking at before-and-after photos. A well-executed tummy tuck should produce a flat abdomen contour, a narrow waist, smooth skin, and no visible incision scars when wearing underwear or swimwear. Achieving these results typically requires careful planning and attention to detail during the surgery.
Who is a good candidate for a tummy tuck?
To be a good candidate for tummy tuck surgery, it is generally recommended that you are in good health and at a stable weight, as large weight fluctuations can affect the results of the procedure. You should also have excess skin in the abdominal area that causes the skin to hang when you sit upright.
Many surgeons recommend that you be within 4-7 kilogrammes of your goal weight before undergoing tummy tuck surgery. Many also refuse to operate on patients with a body mass index (BMI) of 30 or above due to concerns about an increased risk of complications.
Plastic and Reconstructive Surgery, the journal of the American Society of Plastic Surgeons (ASPS), published a study in 2019 that concluded that obese patients can safely undergo abdominoplasty, without an increased risk of complications versus non-obese patients. The study found that surgery in patients with a BMI up to 35 is safe when combined with a program from a dietician and a waiting period to ensure that the patient is achieving exercise and diet milestones.
However, other conditions such as advanced cardiopulmonary disease, cirrhosis, and diabetes can all increase the risk of complications and should be carefully considered before undergoing surgery. Specifically, it is important to obtain medical clearance before proceeding with such a procedure.
It is also important to stop smoking at least 2 weeks before the procedure and ideally 6 weeks in advance. Nicotine consumption restricts blood flow and can increase the risk of slow healing. Additionally, you should not smoke during the recovery period. If you are a smoker, this may be a good opportunity to quit the habit altogether.
Patients should also have realistic expectations regarding the outcomes of surgery. A tummy tuck is intended to flatten the stomach, but achieving a perfectly flat tummy is not always possible. In some patients, the cause of the belly protrusion may be mesenteric fat inside the abdomen. Even the best muscle repair and skin tightening may not result in a completely flat stomach if there is a large amount of mesenteric fat present.
How do you prepare for tummy tuck surgery?
Organise to have someone available to assist you during the first week after surgery. In the early recovery phase, a good assistant is essential. You will likely need help with simple tasks such as getting in and out of bed, using the toilet, showering and getting dressed. Most surgeons recommend not lifting anything for 6 weeks after the procedure, so it may be helpful to have a friend or family member staying with you, especially if you have children or pets at home.
After tummy tuck surgery, you'll be staying at home for quite a while, so stock up on food and supplies beforehand. Food-wise, make sure to:
- Fill your pantry with nutritious food like fruit, vegetables, and protein to help with recovery.
- If you have difficulty eating, protein shakes can help maintain hydration, fullness, and energy.
- Buy smaller containers of milk or juice, as you may not be able to lift larger bottles.
- Prepare meals in advance and freeze them for easy access.
Post-operative garments are usually provided by surgeons, but you may need extras, in case one becomes soiled. Below are some other supplies you should consider stocking up on:
- Hygiene pads to absorb any liquids that may leak from drains or incisions.
- Stool softeners can be useful in preventing constipation, which can be a side effect of pain medication. This will also help alleviate strain on your abdominal muscles during bowel movements.
- Compression socks can help improve circulation and prevent blood clots. It is common to be instructed to wear compression stockings for a short period of time after your surgery, and then to switch to socks with grip on the bottom for added stability during your recovery.
- A recliner or pillows to support the "beach chair" position can make it more comfortable to sleep. Many tummy tuck patients find it helpful to rent a recliner, but you can also achieve similar results by using pillows you already have to support your back and knees.
- An adjustable toilet seat riser can make it much more comfortable to use the bathroom, requiring less strain on your abdominal muscles. These seat risers are relatively inexpensive and can be a worthwhile investment.
- A lanyard or string to hold your drains can be helpful in keeping them out of the way while showering. Drains are usually stitched into place, so it can be difficult to remove them. Attaching them to a lanyard or string around your neck can help keep them secure and out of the way.
Other recommendations from surgeons include:
- Thoroughly clean your house before surgery to avoid the temptation of doing any cleaning or tidying afterwards.
- Use old sheets and towels during recovery to avoid ruining your best linens.
- Carefully read and follow all of your plastic surgeon's post-surgery instructions, and make sure your caretaker does the same. Properly following these instructions can help lower the risk of complications.
After a tummy tuck, it is normal to experience fluctuating emotions from depression (“why did I get this done?”) to elation (which may lead to over-activity). To help manage these mood swings, it can be helpful to have distractions on hand like books, video games, and movies. Having these activities to engage your mind can assist in navigating the emotional challenges that can come with surgery.
What happens during tummy tuck surgery?
The duration of a tummy tuck surgery can range from 90 minutes to five hours, depending on the complexity of the operation. The surgery is typically performed using general anesthesia, which allows the patient to be completely asleep during the procedure. However, it is also possible to undergo surgery using intravenous sedation and tumescent anesthesia, which may result in a quicker recovery. Discuss all available options with your surgeon before deciding on the best anesthesia for your procedure.
After the anesthetic is administered the surgery will start by:
- The surgeon will begin by making a horizontal incision in the lower abdomen, potentially with an additional incision around the belly button.
- The skin and underlying tissue will be separated from the muscles extending from the bottom of the sternum to the rib cage and possibly beyond.
- The skin is lifted to access and repair the abdominal muscles, which will be tightened and strengthened by suturing them together.
- The upper abdominal skin will be pulled back down and the pelvic tissue, including the vulva, will be pulled up to create a tighter appearance.
- A new entry for the belly button will be created in the midsection and secured to the abdominal wall
- Excess fat around the new belly button opening will be removed to give it an attractive "innie" appearance. If the original navel cannot be preserved, a tattoo can be done to create a natural-looking replacement.
- Excess abdominal skin is trimmed away to create a smoother surface.
- The remaining skin will be flattened and the incision will be closed with stitches.
- Surgical dressings such as gauze, tape or elastic bandages are applied to your abdomen.
- Surgical drains may be inserted to prevent fluid from accumulating around the incision during the healing process. The drains are clear plastic tubes placed in small incisions under the main surgical incision.
- You may be required to wear a compression garment to reduce swelling and support the abdominal area during healing. This garment should be worn 24 hours a day (excluding showering) for at least the first week after the surgery.
During a tummy tuck, most surgeons use dissolvable stitches on the internal layers of tissue, excluding the muscle repair aspect. If any stitches are used on the skin surface, they will be removed at the first follow-up appointment, a week after surgery.
It is common for doctors to remove all external sutures and staples on the third day post-op and all drains on the fifth postoperative day.
Melon Tip: An alternative to using drains is the "drainless tummy tuck," which employs a suture technique to reduce fluid accumulation. This method takes longer, has a higher risk of causing dimples and irregularities, though some patients report experiencing less pain with this approach.
How painful is a tummy tuck?
During tummy tuck surgery, you will be given anesthesia so you will not feel any pain. However, recovery from the procedure can be very uncomfortable, with many patients experiencing pain that feels like tightness in the stomach area. The intensity of the pain can vary from person to person, with some experiencing significant discomfort while others find it to be less severe than anticipated.
The pain is often caused by the stitching and tightening of the abdominal muscles that occurs during the surgery. Patients who have undergone a C-section prior have reported that the pain from a tummy tuck is similar, though the recovery is easier overall as they do not also have the added responsibility of caring for a newborn.
The initial days following abdominoplasty tend to be the most painful, but the discomfort usually subsides quickly. To complement taking prescribed or over-the-counter pain medication, doctors may also suggest these methods to reduce pain:
- A long-acting non-opioid numbing agent can be used to reduce discomfort during the first few days after a tummy tuck.
- The TAP (transversus abdominis plane) block technique involves injecting anesthetic into the ab muscles before the surgery is completed, this can further reduce pain at the site and reduce the requirement for pain medication, which has potential side effects.
- During the first few days post-op, local anesthesia (e.g. novocaine) can be delivered to the abdominal area with a pain pump. This can help lessen the intensity of pain when it is at its worst.
- To alleviate muscle spasms, which are a common side effect, as the abdominal muscles adjust to their new tighter state, some surgeons may prescribe muscle relaxants. These involuntary contractions can be uncomfortable and disrupt the recovery process.
Each surgeon has their own unique approach to managing pain following a tummy tuck procedure. Speak with your provider beforehand to understand their specific plan and to alleviate any concerns you may have about pain during recovery.
While it is impossible to completely avoid discomfort after the surgery, the desired results of the procedure often make the temporary pain worth it. Many patients are excited to see the improvements they have been hoping for and are willing to endure the discomfort in the short term.
How long does tummy tuck recovery take?
It is recommended to allow for at least 2 weeks of rest before returning to work and plan for up to 6 weeks of total recovery time before engaging in strenuous activity or exercise.
If you have the ability to take more than 2 weeks off work, it can be helpful to have extra time to recover and regain your energy.
Here is what to expect during recovery:
- After a tummy tuck, you can expect to experience severe post-operative pain, for which your doctor will prescribe pain medication. Your surgeon may also use pain pumps or long-acting numbing agents to relieve pain and hasten recovery.
- Swelling, bruising, and tenderness around the incision area is common, particularly during the first 3 days.
- Even if you are not motivated to, you should get up and move around a few times a day in order to improve circulation and prevent blood clots.
- It may take a week or two before you are able to fully stand up straight again, due to the considerable tightness across the abdomen. Patients have reported that the pain is similar to that of a C-section, while others have found a tummy tuck to be more uncomfortable. Ultimately, the pain is very comparable.
- You will need assistance for everyday activities during the first 5 days post-surgery and may require additional help during the following week in order to prevent unnecessary complications. The recovery process can be difficult, and you will likely need assistance with tasks like sitting, standing, and getting in and out of your compression gear to bathe.
- It is important to pay attention to your sleeping position during the first 2 to 3 weeks after surgery. Make sure to sleep on your back with your torso and head elevated to avoid putting tension on your incisions or stretching your abdominal tissues and muscles while they are still healing. Using pillows or sleeping in a recliner can help to elevate your upper body.
- The recovery process can also be emotionally challenging, and some patients may experience "tummy tuck blues”. It can be helpful to have a close friend or loved one who can provide emotional support and help you stay optimistic about the incoming end result.
- You may be able to resume your normal lifestyle within 2 weeks of the surgery, but it is important to gradually increase activity and not push yourself in order to preserve the results of the procedure and avoid unnecessary complications.
- It is recommended to avoid lifting heavy objects, including small children, for the first 4 to 6 weeks of recovery.
- It is recommended to wait until fully recovered before resuming sexual activity after a tummy tuck. Some doctors suggest waiting up to 6 weeks, while others advise waiting at least 2 weeks before taking a "passive" role.
How long does swelling last after getting a tummy tuck?
Abdominoplasty can result in swelling that may take up to 3 months to fully resolve. However, once the swelling has dissipated, you will be able to see the final results of the procedure.
How soon can you see results a tummy tuck?
Tummy tuck surgery can produce an immediately noticeable transformation in patients who had a large amount of excess skin and fat prior to the procedure. Still, swelling can mask the final results of the surgery.
While you can expect to see a significant improvement within a few weeks, it may take up to 3 months or longer for the full effects of the surgery to be visible
How long do results from a tummy tuck last?
The results from tummy tuck surgery can be very long-lasting, with some patients experiencing results that last up to 20 years or more. However, the longevity of your results depends on your lifestyle habits, such as maintaining a healthy weight through diet and exercise.
Additionally, the elasticity of your skin before surgery and natural changes that occur with aging can also impact the outcome. To help preserve your results, it may be beneficial to incorporate non-surgical body contouring treatments, like Emsculpt, into your routine in addition to maintaining a healthy lifestyle.
Does a tummy tuck leave a permanent scar?
Tummy tuck scars are typically located horizontally along the lower abdomen, from one side of the hip to the other. The scar is usually placed very low, just above the pubic region, making it easily concealable with underwear or a bikini.
While you can discuss the placement and size of the incision with your surgeon, it is possible that the scar may be bigger than desired. In cases where there is a large amount of excess skin, a vertical incision may also be necessary.
Try this test to estimate how long your tummy tuck scar will be:
- Sit upright and engage your ab muscles tightly.
- Grab any excess skin with both hands, beginning at your stomach and moving out towards your hips.
- The point at which you are no longer able to grab the skin is where your scar is likely to end
It is normal for tummy tuck scars to remain visible to some degree, but they will typically fade and become less noticeable over time. Your doctor will provide you with instructions on how to care for your incision in order to lighten the scar. They may also suggest using a scar treatment product, such as Biocorneum, to improve the appearance.
It is important to avoid putting excessive strain on the incision, through activities such as lifting, bending, and twisting, for a period of 4 to 8 weeks post-surgery. With proper care and precaution, the scar should eventually resemble a fine line.
Can you have a baby after a tummy tuck?
While it is considered safe to have a baby after undergoing tummy tuck surgery, future pregnancies may stretch the skin and muscles, potentially requiring revision surgery to fix.
If you are planning to have more children in the future, you may want to consider waiting to have a tummy tuck until after you have built your family. This can also bring additional benefits, a study published by the American Society of Plastic Surgeons in February 2018 found that abdominoplasty can help to alleviate back pain and urinary incontinence that may result from pregnancy.
How long do you have to wear compression gear after a tummy tuck?
The use of compression gear after surgery is debated among surgeons, with some recommending wear for a period of 3 to 6 weeks, while others do not recommend it at all or prefer a shorter duration.
It is suggested to wear the surgical garment provided by the doctor for the first 2 weeks after surgery, followed by the use of commercial compression gear, such as Lululemon, for an additional 4 to 8 weeks.
Specifically, patients may be placed in a binder immediately following the procedure, and then switch to compression gear at their first post-surgery appointment, typically one week later. The recommended wearing schedule may vary, but it is common for patients to wear the binder continuously, except when showering, for the first 3 weeks after surgery, and then only during the day for an additional 2 weeks. Some patients find it helpful to continue wearing the binder for a period of time after the drains are removed, around 10 days post-surgery, as they report that it feels more comfortable with it on.
Should you get lymphatic massages after a tummy tuck?
Lymphatic massages may be requested by some patients during the recovery process in order to encourage the flow of lymph fluids, which can help remove waste and toxins from tissues.
However, this is not a necessary treatment and it is important to wait until the body has fully healed before getting a lymphatic massage to avoid potential complications.
If you are considering a lymphatic massage, consult with your surgeon first to determine if it is appropriate for you.
Are there any alternatives to tummy tuck surgery?
If you are looking to address excess fat and loose skin around the stomach, as well as tighten the abdominal muscles, a full tummy tuck is the most effective solution. There is no other treatment that can provide the same comprehensive results. If someone claims a non-surgical treatment is equally effective, it is likely untrue or exagerated.
A mini tummy tuck, or mini abdominoplasty, may be an option for those mainly concerned with excess skin in the lower abdominal region. However, it is important to note that this procedure only addresses a limited area of the abdomen and the results may be more modest compared to a full tummy tuck. In fact, it may only be suitable for a small percentage of people, around 2%.
The Tummy Tuck belt is a compression garment that is supposed to help burn fat through a combination of a topical lotion and the body's own abdominal contractions, creating a "fat-burning effect." The make of this product claims that it can lead to a reduction of about 1 centimetre in the first week and 2.5 cm in 30 days, though they do not provide any medical evidence of such.
It is worth noting that, even if the claims about the Tummy Tuck belt are valid, the results it produces are likely to be much less effective than those achieved through plastic surgery.
Sources & Studies
Batac, J, Hamade, M, Hamade, H & Glickman, L 2019, ‘Abdominoplasty in the Obese Patient’, Plastic and Reconstructive Surgery, vol. 143, no. 4, pp. 721e726e, viewed 6 January 2023, <https://journals.lww.com/plasreconsurg/Abstract/2019/04000/Abdominoplasty_in_the_Obese_Patient__Risk_versus.13.aspx>.
Taylor, DA, Merten, SL, Sandercoe, GD, Gahankari, D, Ingram, SB, Moncrieff, NJ, Ho, K, Sellars, GD & Magnusson, MR 2018, ‘Abdominoplasty Improves Low Back Pain and Urinary Incontinence’, Plastic and Reconstructive Surgery, vol. 141, no. 3, pp. 637–645, viewed 6 January 2023, <https://journals.lww.com/plasreconsurg/Fulltext/2018/03000/Abdominoplasty_Improves_Low_Back_Pain_and_Urinary.13.aspx>.
Winocour, J, Gupta, V, Ramirez, JR, Shack, RB, Grotting, JC & Higdon, KK 2015, ‘Abdominoplasty’, Plastic and Reconstructive Surgery, vol. 136, no. 5, pp. 597e606e, viewed 6 January 2023, <https://journals.lww.com/plasreconsurg/Abstract/2015/11000/Abdominoplasty__Risk_Factors,_Complication_Rates,.9.aspx>.