Abdominoplasty (Tummy Tuck)

An abdominoplasty (tummy tuck) is a major procedure in which the plastic surgeon removes extra skin and fat from the middle to lower abdomen and tightens up the muscles of the abdomen. Patients who have a “large stomach” are typically very happy to have a flatter abdomen. However, this type of surgery leaves a scar across the lower abdomen; some scars go as far as from hipbone to hipbone, and some are smaller.

You should know that insurance usually does not pay for this procedure. Check with your insurance carrier to find out for sure.

Patients who are in fairly good shape, but feel they have extra fat or loose skin that will not respond to diet or exercise, are good candidates for this procedure. These can be women who have had multiple pregnancies, older persons or people who have had a gastric bypass procedure and whose skin has lost some of its elasticity. This surgery is not recommended for women who will be having more children or for people who plan to lose a lot more weight.

A flat stomach can reduce your clothing size and boost your self esteem, but you should discuss your expectations with your surgeon so that you can be more certain about the results you achieve.

Abdominoplasty is a very common cosmetic procedure, and patients typically are highly satisfied with the results. As with any surgery, there are risks such as infection or blood clots. Poor healing can cause a patient to have a heavier scar, which may require a second operation. Patients who smoke can increase the risk of these complications and delay healing.

When you first visit the cosmetic surgeon, he or she will examine your abdomen and determine where the fat is located, examine your skin tone and talk about your expectations for the procedure.

Some patients have most of their fat below the belly button. If so, the surgeon can perform a less complicated procedure called a “partial abdominoplasty” or a “mini tummy tuck,” which usually can be done on an outpatient basis. Some patients have liposuction in combination with the tummy tuck to remove fat deposits from the thighs and hips while the tummy tuck is being performed. Sometimes liposuction alone is enough to reduce the size of the abdomen.

Before surgery, patients must quit smoking for about two weeks (and also not smoke for at least two weeks after), avoid tanning the abdomen, and eat and drink normally (no dieting). All of these factors influence the ability to heal.

This surgery is done with the patient under general anesthesia or under local anesthesia with a sedative so he or she is very sleepy and relaxed – an occasional pulling sensation may be felt, but no pain. It takes anywhere from two to five hours depending upon the extent of the surgery. A partial abdominoplasty takes only an hour or two.

There is a long incision just above the pubic area and going up to the hip bones. There’s another incision to release the navel from the tissue around it. In partial abdominoplasty, the incision is much shorter and the navel might remain where it is – but sometimes it may be pulled into a long, thin shape as the skin is tightened.

Extra skin is removed; a new hole is cut for the navel and then stitched in place. Sometimes a tube or drain is inserted into the incision to drain extra fluid. This is removed in a day or two. It is common not to be able to stand up straight for a while, but patients should start walking as soon as possible. The abdomen will be swollen and uncomfortable, but pain medication is available to help with this. Stitches typically are removed in about five days. There may be deeper stitches under the skin with small strings coming through; these are removed in two to three weeks. The abdominal dressing comes off, and the surgeon may ask you to wear a support (a small girdle-type undergarment) for a while.

Most patients can return to work after two weeks, although some people take three or four weeks. Walking should be encouraged, as it will help the patient feel better and heal faster. No strenuous exercise should be undertaken until the doctor approves it.

Many patients feel as if their scars look worse for two to six months after surgery. This is normal; it can take up to one year before they flatten out and look lighter. They’ll never go away but are not visible under clothing or even most bathing suits.

For patients who follow a balanced diet and exercise regularly, the results can last a long time.

Making an Appointment

For a consultation with a Washington University cosmetic surgeon, please call (314) 362-4452.

Disclaimer: The photos on this website are of models, not actual patients.