Abdominoplasty (also known as a tummy tuck or TT) is surgery to remove the excess skin and fat on the abdomen that may accumulate after pregnancy, obesity, or age. In a full abdominoplasty, abdominal muscles that may have become stretched out or lax over time are tightened. An abdominoplasty is not a simple procedure and you must be aware of the risks and postoperative care and recovery time that will be needed.
First and foremost, you must be in good health and not have any active diseases or serious pre-existing medical conditions. You also must have realistic expectations of the outcome of your surgery. Discuss your goals with your abdominoplasty surgeon so that you have an understanding about what can realistically be achieved with tummy tuck surgery.
You must be mentally and emotionally stable. An abdominoplasty requires patience and stability to get through. There is sometimes a lull or depression after surgery and this low period can develop into a more serious issue if you are already depressed.
If you are a woman, you probably should wait until you are finished having children before having a tummy tuck, since the skin and muscles can get stretched out again. If you are considering losing weight, you should wait until after you've reached your desired weight. You may need additional surgery to remove the excess skin if you lose more weight, which would mean that the money spent on your abdominoplasty would be wasted.
There is no "normal" age or time in one's life to have an abdominoplasty, but it is most often done after a woman has given birth and does not plan to have more children, or after someone has lost all the weight he or she intends to lose.
An abdominoplasty consultation involves talking with the surgeon and telling him or her what you want to achieve through tummy tuck surgery. The surgeon will also examine you. You can show photos of yourself when you had a flatter abdomen and the two of you can discuss what is and isn't possible with an abdominoplasty. You also have a chance to look at before-and-after photos of other tummy tuck patients of that plastic surgeon.
A full tummy tuck is usually performed under general anesthesia.The surgeon makes an incision across the lower abdomen just above your pubic bone and pubic hair. This incision may go from hip to hip, but it is usually placed so that it will be hidden by a bikini bottom. Then, skin and fat is separated from the abdominal muscles up to the bottom of the rib cage. An incision is made around the belly button to loosen the skin and detach it from the belly button. Most frequently, excess skin and fat below the belly button is removed.
In a full abdominoplasty, the fascia and rectus abdominus muscles are tightened by folding the fascia along the centerline of the abdomen. This tightens the muscles and abdominal wall. The skin above the belly button is pulled down toward the pubis and sutured into position as the incision is closed. A new hole is made in the skin to suture around the belly button.
Usually, one or two drains are placed under the skin under the incision to allow fluids to drain from the site for a few days. These drains are usually placed through small incisions above your pubic bone. The drains are plastic tubes that end in plastic bulbs that look sort of like grenades. The bulbs are emptied regularly and are squeezed before they are reattached to the tubes so that there is a bit of negative pressure that helps with the drainage of fluid.
There are several different techniques for abdominoplasty, most of which differ in the amount of tissue that is removed and the shape and placement of the incision. Most abdominoplasty surgeons try to place incisions in the most inconspicuous area whenever they can, but sometimes this is not possible. Discuss this with your surgeon beforehand. Some surgeons go completely horizontal and straight across with their incisions, some use a V shape, and others follow along the bikini line. In my opinion, an incision following the bikini line is the best since the scar can be easily concealed, but your body's needs will determine the incision placement for you.
You are usually able to walk after abdominoplasty surgery and you will be encouraged to do so. You should take a short walk three or four times a day for a few minutes each time. You will most likely not be able to stand completely straight and you may be a bit hunched over for several days. The skin of your abdomen may feel tight. You may be instructed to remain bent over a bit for the first 4 to 5 days after surgery. This posture might cause some back spasms and discomfort, so ask your surgeon about muscle relaxants.
If drains have been inserted, they are usually removed 4 days to 2 weeks after tummy tuck surgery. You should take it easy for at least 2 weeks after surgery. Take it easy, but walk a bit every few hours every day. You will be told to wear an abdominal pressure garment for several weeks after your surgery to hold everything in place while you heal. This is a girdle or a band that fits around your abdomen and holds everything in place during healing.
Some swelling and bruising are normal, but the amount varies from person to person. Recovery from tummy tuck surgery may vary depending on the person and the surgery type.
The amount of pain with an abdominoplasty is quite variable. Some people report a moderate amount of discomfort and some say it is more intense. But there will be some pain. Your surgeon can give you a prescription for pain relievers.
This is not a scar-free surgery. In fact, scars may be quite severe depending on the amount of skin needed to be removed, your body's ability to heal, whether you scar well, the skill of your surgeon, and the technique used. Most surgeons try to use techniques that leave a scar that can be covered by a standard bikini. Be sure to discuss the tummy tuck incision types, techniques and placements with your surgeon at your consultation. Ideally, having no scar would be wonderful, but that isn't possible – yet.
Yes, there will be some swelling after tummy tuck. Abdominoplasty is serious surgery and, depending upon the case, a lot of tissue is removed, so some swelling is inevitable. Swelling should subside within in a few weeks.
Abdominoplasty takes a long time to heal completely. While the drains are in, you should rest in bed or on a couch, but get up to walk frequently. You may be told to wear a compression garment, usually a girdle or a wide band of elastic material. You may be instructed to wear this for 3 to 6 weeks. Many patients can return to work after 2 weeks after tummy tuck surgery, but this depends on how extensive your surgery is and what you do for a living. In some cases, you may need to be off work 4 or more weeks.
You will start to see a difference after the swelling subsides and the drains are taken out. A full abdominoplasty is considered a very invasive procedure. Give your body time to heal and you will reap the many benefits of the procedure.
An abdominoplasty is serious surgery and you must understand there are some serious risks. As with any surgery with anesthesia, there are risks that primarily due to the anesthetic. Please see our Anesthesia Section for more information.
Because skin, fat, and other tissue are being loosened and rearranged, they may be inadvertently detached from their blood supply. This can cause tissue death, which is also called necrosis. If a small amount of fat becomes necrotic, it tends to turn into orangey-clear liquid and may drain from the incision. To some extent, this is normal.
But if other tissue becomes necrotic, or you have a larger amount of fat die, that's a different story. Necrotic tissue must be removed before a major infection develops, possibly leading to gangrene. This amount of necrosis rarely happens, but you should take precautions against it anyway. Not smoking and proper wound care make a big difference.
Sometimes liposuction is done as part of the abdominoplasty. Liposuction carries its own set of risks, which you can learn about here. There may be asymmetry, hyperpigmentation (permanent dark spots) from the bruising. Major blood loss is a factor is some cases with liposuction, as is a hematoma (pocket of blood) and infection. Just remember, abdominoplasty or liposuction are not a way to lose weight.
Another rare risk of abdominoplasty is a pulmonary thromboembolus. A thromboembolus is a blood clot in the circulatory system that can cause a blockage anywhere in the body. If this blood clot lodges in the lungs it is a pulmonary thromboembolus. This can cause serious difficulty breathing and lead to cardiac arrest or coma, and possibly death. Pulmonary thromboemboli can happen within 3 weeks after surgery, but if they occur, they will most likely happen within 72 hours. The symptoms are shortness of breath and fatigue, but pulmonary thromboemboli can occur suddenly, without warning.
Pulmonary thromboemboli are very rare. But the reason you have to get up and walk around as often as possible after your surgery is to reduce the risk of pulmonary thromboemboli, so no matter how sore you feel, just do it.
The results can last for many, many years. If you have no large weight gain or pregnancies after your tummy tuck, then the changes will be relatively permanent. There will be some relaxation of the tissues with age, but not to the extent prior to surgery.
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