Tummy Tuck

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.

When to Consider a Tummy Tuck

  • If you’ve got flab, stretch marks or excess skin in your abdomen that does not improve with diet or exercise.
  • If the shape of your abdomen has been affected by pregnancy or massive weight loss.
  • If you feel that your protruding abdomen is unattractive.
  • If your self-confidence is marred by your stomach contour.

Considerations

Pros

  • Tummy-tuck surgery will restore a flat tummy.
  • You will look better in clothes and swimwear.
  • You will have a more youthful-looking body.

Cons

  • You will have a scar (located in the bikini area).
  • Another pregnancy may influence surgery results, so it is best to wait until you’ve finished having children before undergoing this procedure.
  • Weight gain following abdominoplasty may negatively affect your surgery results.

These are the top three pros and cons to weigh when considering a tummy tuck. If you want to focus on what is unique to you, please consult with your aesthetic plastic surgeon.

Are you a good candidate for a tummy tuck?

There comes a time when you realize that efforts at dieting and exercise are yielding lower numbers on your bathroom scale but not changing the appearance of your sagging and protruding abdomen. The following are some common reasons why you may want to consider a tummy tuck:

  • Aging, heredity, pregnancy, prior surgery or weight fluctuations have left you with extra skin on your abdomen, abdominal muscle weakness, or both.
  • You do not smoke. Smoking slows down the healing process and increases the risk of serious complications during and after surgery. If you smoke, you must quit at least six weeks before surgery.
  • Your weight is stable. Slender individuals with extra fat and loose skin in the lower tummy are the best candidates; if you are generally obese, this procedure is not appropriate for you.
  • If you have a significant amount of intra-abdominal fat surrounding your internal organs, you may need to slim down before considering a tummy tuck.
  • You are physically healthy. You must be in relatively good physical shape to tolerate this procedure.
  • You are finished having children. The muscles that are repaired during an abdominoplasty can separate again during future pregnancy.
  • Internal or external scars from any previous abdominal surgery may also affect your candidacy.

If you are in good general health, have a positive attitude and realistic expectations, you are most likely a good candidate for this procedure.

How is a tummy tuck procedure performed?

In this surgical procedure, your surgeon will remove your loose abdominal skin and tighten up your abdominal muscles with sutures.

  • Your surgeon will mark your abdomen to indicate the location of the incisions, the center of your torso and the location of the repositioned navel.
  • A solution of lidocaine (a local anesthetic) and epinephrine (a vasoconstrictor that controls bleeding by constricting blood vessels) will be injected.
  • The primary tummy tuck incision will be above the pubic mound, from one hipbone to the other. In a full abdominoplasty, another incision is made around your navel. In a mini-tummy tuck, your surgeon will use a shorter incision.
  • The surgeon will loosen the skin from your abdominal wall to your ribcage and then place sutures in the fascia of your abdominal muscles to pull them into a tighter position. This is the muscle repair portion of the surgery.
  • After your abdominal muscles have been sutured, your surgeon will remove excess fat by liposuction or other methods. Your abdominal skin is then stretched down over your incision line and the excess skin is removed.
  • Next, your surgeon will mark the placement of your navel. Although the skin around your navel has been moved, the navel almost always stays in the same place. Your surgeon cuts a hole through the redraped skin and sutures it around your navel.
  • Your surgeon will use tissue glue, sutures, staples or Steri-Strips to close the incisions.
  • In a full abdominoplasty, the surgeon will often insert one or more drains to prevent fluid buildup, which can cause pressure on the incision. The drain is a clear plastic tube placed through a very short incision below the main incision, which leads out of the body to a small oval-shaped bulb. Each time you empty a bulb and before you close it again, you will be asked to squeeze it to help drain the wound.

The goal of your aesthetic plastic surgeon and staff is to help you achieve the best results and to make your surgical experience as easy and comfortable as possible.

What are my options?

A personal consultation with your board-certified aesthetic plastic surgeon will determine the best option for you. Here are some different approaches:

Full Abdominoplasty

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.

Mini Abdominoplasty

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.

What will my tummy tuck incisions and scars be like?

The incision for a full abdominoplasty usually runs from hipbone to hipbone, and may be in a V-cut or U-cut shape, so that the scar can be hidden in a bikini. Your surgeon will determine the shape and length of the incision based on your preferences and the amount of correction you need. You may also have an incision around the navel.

With a mini-tummy tuck, the surgeon can place the incision as low as possible; it can be hidden in the pubic bone area. The abdominal skin that is removed is below the navel, and there are no incisions around the navel. The length of the mini-tummy tuck incision will vary based on how much skin your surgeon removes.

With a high lateral tension abdominoplasty, scars are longer and often higher than scars in more traditional abdominoplasties and mini-tummy tucks. It is common not to excise the umbilical (navel) site, because not as much skin is removed centrally.

Your initial consultation appointment

During your initial consultation, you will have the opportunity to discuss your cosmetic goals. Your surgeon will evaluate you as a candidate for tummy-tuck surgery and clarify what approach is best for you. Understanding your goals and medical condition, both alternative and additional treatments may be considered.

You should come to the consultation prepared to discuss your complete medical history and answer the following questions:

  • Do you have any medical conditions or drug allergies? Are you being treated for any medical conditions?
  • Have you had any previous surgeries?
  • What are your current medications and vitamin and herbal supplements?
  • What is your current use of alcohol, tobacco and recreational drugs?
  • What is your history with any noninvasive cosmetic procedures?
  • What outcome do you expect from the surgery? What is your chief motivation in undergoing an abdominoplasty?

Your surgeon may also:

  • Ask you to look in a mirror and point out exactly what you would like to see improved.
  • Take photos for your medical record, using computer imaging to show improvements you can expect.
  • Evaluate your health status, including preexisting health conditions or risk factors.
  • Evaluate the elasticity of your skin.
  • Discuss your ideal weight, realistic weight and current weight and possibly suggest a weight loss program before surgery.
  • Discuss your plans related to future pregnancies.

Your treatment plan

Based on your goals, physical characteristics, and the surgeon’s years of training and experience, your surgeon will share recommendations and information with you, including:

  • An approach to your surgery, including the type of procedure or combination of procedures.
  • The outcomes that you can anticipate.
  • Your financial investment in the procedure.
  • Associated risks and complications.
  • Options for anesthesia and surgery location.
  • What you need to prepare for your surgery.
  • What you can expect to experience after surgery.
  • Show before-and-after photos of cases similar to yours and answer any questions.

Questions to ask your aesthetic plastic surgeon

We developed these questions to help you:

  • Make the most informed and intelligent decisions about your procedure.
  • Confirm that you have the right surgeon for your procedure.
  • Make your initial consultation as rewarding as possible.
  • Understand your options, potential outcomes and risks.

It is important for you to take an active role in your surgery, so please use this list of questions as a starting point for your initial consultation.

  • Am I a good candidate for a tummy tuck?
  • Are the results I am seeking reasonable and realistic?
  • Do you have before-and-after photos I can look at for the procedure I am undergoing?
  • Will my scars be visible? Where will my scars be located?
  • What kind of anesthesia do you recommend for me?
  • What will be the costs associated with my surgery?
  • What will you expect of me to get the best results?
  • What kind of recovery period can I expect and when can I resume normal activities?
  • What are the risks and complications associated with my procedure?
  • How are complications handled?
  • What are my options if the cosmetic outcome of my surgery does not meet the goals we agreed on?