Tummy Tuck (Abdominoplasty)
What is a tummy tuck?
A tummy tuck is surgery to correct a loose or flabby abdomen or belly. A tummy tuck, also called abdominoplasty, involves removing excess skin and fat, and tightening weak or separated muscles. Many people seek a tummy tuck for cosmetic reasons to create a firmer, flatter abdomen. Others need a tummy tuck to remove excess skin after significant weight loss.
A tummy tuck is a major surgery with serious risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all your treatment choices before having a tummy tuck.
Types of tummy tuck
The types of tummy tuck include:
Complete or traditional tummy tuck treats the entire abdomen by using a large hip-to-hip incision and another incision around the navel. Patients who require significant fat removal and restructuring of the abdominal wall need this type of tummy tuck.
Partial or mini tummy tuck treats only the lower part of the abdomen below the navel using small incisions. This type of tummy tuck is appropriate for patients who suffer mainly from loose abdominal skin and excess fat that is concentrated below the navel.
Other procedures that may be performed
Your doctor may perform other procedures in addition to a tummy tuck. These include:
Belt lipectomy, or body lift, to remove loose hanging skin from the waist down
Breast surgery to lift sagging breasts
Buttock augmentation or lift to improve the appearance of the buttocks by lifting and tightening the skin or using implants or fat injections to add fullness and roundness to the buttocks
Liposuction to remove excess fat
Thigh or arm lift to remove sagging skin on the thighs and arms
Why is a tummy tuck performed?
Your doctor may recommend a tummy tuck to remove loose, sagging skin or excessive fat on the abdomen. This often occurs as a result of significant weight loss, pregnancy, heredity, aging, or a prior surgery.
Your doctor may only consider a tummy tuck for you if other treatment options, such as diet and exercise, have been ineffective and if you are seriously unhappy about the appearance of your abdomen. Ask your doctor about all of your treatment options and consider getting a second opinion.
Who performs a tummy tuck?
A plastic surgeon performs a tummy tuck. Plastic surgeons specialize in correcting physical defects that affect a person's appearance or ability to function.
Traditional tummy tuck involves making an incision across the bottom of your abdomen, from hip to hip. Your surgeon will also make an incision around your navel. Your surgeon will remove excess skin and fat and tighten your abdominal wall by securing muscles together with stitches. Surgery involves repositioning your navel, pulling the remaining skin to its new position, and closing your incisions.
Partial tummy tuck involves making a small horizontal incision below the navel. Your surgeon will remove excess skin and fat through this smaller incision. Your navel does not require repositioning with this procedure. Unlike a traditional tummy tuck, this procedure is usually an outpatient procedure.
Your doctor will advise you on which procedure is best for you and how long you need to stay in the hospital or surgical center based on your diagnosis, age, medical history, general health, and possibly your personal preference. Learn about the different procedures and ask why your doctor/surgeon will use a particular type of procedure for you.
Types of anesthesia that may be used
Your surgeon will perform your tummy tuck using either general anesthesia or regional anesthesia.
General anesthesia is a combination of intravenous (IV) medications and gases that put you in a deep sleep. You are unaware of the procedure and will not feel any pain. You may also have a peripheral nerve block infusion in addition to general anesthesia. A peripheral nerve block infusion is an injection or continuous drip of liquid anesthetic. The anesthetic flows through a tiny tube inserted near your surgical site to control pain during and after surgery.
Regional anesthesia is also known as a nerve block. It involves injecting an anesthetic around certain nerves to numb a large area of the body. You will likely have sedation with regional anesthesia to keep you relaxed and comfortable.
What to expect the day of your tummy tuck
The day of your surgery, you can expect to:
Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.
Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. Your care team will give you blankets for modesty and warmth.
Talk with the anesthesiologist or nurse anesthetist about your medical history and the type of anesthesia you will receive.
A surgical team member will start an IV.
The anesthesiologist or nurse anesthetist will start your anesthesia.
A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgery as they happen.
The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and your recovery until you are alert, breathing effectively, and your vital signs are stable.
What are the risks and potential complications of a tummy tuck?
As with all surgeries, a tummy tuck involves risks and possible complications. Most tummy tucks are successful, but complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.
General risks of surgery
The general risks of surgery include:
Anesthesia reaction, such as an allergic reaction and problems with breathing
Bleeding, which can lead to shock
Potential complications of a tummy tuck
Potential complications of a tummy tuck include:
Changes in skin sensation or color that may be permanent
Poor wound healing
Recurrent loosening of the skin requiring additional surgery
Skin or tissue death
Temporary or permanent change in skin sensation
Reducing your risk of complications
You can reduce the risk of certain complications by following your treatment plan and:
Avoiding future weight gain or loss
Discussing any desire for future pregnancy with your doctor
Following activity, dietary and lifestyle restrictions and recommendations before your procedure and during recovery
Informing your doctor if you are nursing or if there is any possibility that you may be pregnant
Not smoking because smoking decreases wound healing
Notifying your doctor immediately of any concerns, such as bleeding, fever, or increase in pain
Taking your medications exactly as directed
Telling all members of your care team if you have any allergies
How do I prepare for my tummy tuck?
You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome.
You can prepare for a tummy tuck by:
Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.
Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), blood tests, and other tests as needed.
Maintain a healthy weight before the surgery through a healthy diet and exercise plan
Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.
Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and help the healing process.
Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. Your doctor will give you instructions for taking your specific medications and supplements.
Questions to ask your doctor
Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments.
It is also a good idea to bring a list of questions to your appointments. Questions can include:
Am I a good candidate for a tummy tuck? Are there any other options for treating my condition?
What type of tummy tuck procedure do I need?
How long will the surgery take? When can I go home?
What restrictions will I have after the procedure? When can I return to work and other activities?
When can I shower after tummy tuck surgery? How should I care for my incisions?
How will I look after surgery?
What kind of assistance will I need at home?
How should I take my medications?
How will you treat my pain?
When should I follow up with you?
How should I contact you? Ask for numbers to call during and after regular hours.
What can I expect after my tummy tuck?
Knowing what to expect after a tummy tuck can help make your road to recovery as smooth as possible.
How long will it take to recover?
You will stay in the recovery room after surgery until you are alert, breathing effectively, and your vital signs are stable. You may have a sore throat if a tube was placed in your windpipe during surgery. This is usually temporary, but tell your care team if you are uncomfortable.
You may be wearing a compression garment similar to a girdle when you awake from surgery. You will likely have swelling and bruising. The compression garment will help reduce swelling and aid the shrinking and tightening of the skin. You may also have small drains under the skin to help drain excess blood or fluid. Swelling and bruising should subside within a few weeks.
You will still be drowsy from sedation or anesthesia, so you will need a friend or family member to drive you home and stay with you the first night. For a traditional or complete tummy tuck, you may need to stay in the hospital for one to two days.
Recovery time varies depending on the procedure, type of anesthesia, your general health, age, and other factors. Most people return to normal activities and light exercise six weeks after surgery. You may need to avoid strenuous activity for as long as three months. Full recovery takes four to six months.
Will I feel pain?
Pain control is important for healing and a smooth recovery. There will be discomfort after your surgery. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes because it may be a sign of a complication.
When should I call my doctor?
It is important to keep your follow-up appointments after a tummy tuck. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:
Change in alertness, such as passing out, unresponsiveness, or confusion
Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery. It is not necessarily a sign of a surgical infection. However, you should follow your doctor's specific instructions about when to call for a fever.
Inability to urinate or have a bowel movement
Pain that is not controlled by your pain medication
Unexpected drainage, pus, redness or swelling of your incision
How might a tummy tuck affect my everyday life?
The new appearance of your abdomen or belly may give you increased satisfaction with your appearance and increase your self-confidence. Surgeons caution that it is important to be realistic about how much a tummy tuck may improve your self-image. Talk to your surgeon about what a tummy tuck can and cannot do for your overall appearance and self-image.