If you find yourself feeling self-conscious about drooping skin or fat around your abdomen area that cannot be eradicated regardless of how much you exercise or diet, then abdominoplasty — also known as tummy tuck surgery — may be a procedure worth considering.
What Is a Tummy Tuck?
- What Is a Tummy Tuck?
- Is a Tummy Tuck Right for Me?
- 7 Abdominoplasty Techniques
- Preparing for Tummy Tuck Surgery
- Abdominoplasty Recovery: The Days Following Surgery
- Weekly Recovery Timeline
- 10 Tips for a Speedy Recovery
- Maintaining Your Results
- Minimizing Tummy Tuck Scars
- Latest Abdominoplasty Techniques and Scientific Studies
- Frequently Asked Questions
A tummy tuck is a transformative procedure for women who have failed to regain their abdominal tone following pregnancy, or people who have lost a substantial amount of weight.
In a nutshell, the goal of a tummy tuck is to remove excess fat and skin, and restore weakened or separated abdominal muscles if necessary. This results in a flattened and taut abdomen.
This popular and proven cosmetic surgical treatment can easily be customized to meet your specific goals. There are a number of unique variations of the procedure, each designed to target particular areas of the mid-section.
Is a Tummy Tuck Right for Me?
While abdominoplasty is not considered a weight loss procedure, it can refine the contours of your belly where diet and exercise have failed. Patients who struggle with the following concerns have the most to gain from tummy tuck surgery.
Post-Pregnancy Muscle and Skin Laxity
Pregnancy often has the unfortunate side effect of stretched skin and separated abdominal muscles, especially in the case of Caesarean section births or multiple pregnancies. Diet and exercise are often not sufficient to re-tighten the abdominal area after childbirth. Due to a loss of muscle tone and skin elasticity, especially after multiple pregnancies, surgical treatment may be the most effective way to regain your pre-pregnancy figure.
Note that if you plan on having more children, it’s best you wait before undergoing a tummy tuck. Any future pregnancies can re-separate the repaired muscles, known as diastasis recti, and re-stretch the skin around your stomach. Your tummy tuck will essentially be undone, and you’ll need to undergo another surgery to restore the results.
That being said, if you become pregnant unexpectedly, your earlier tummy tuck will have no impact on the health of your baby. You will still be able to have a child even if you’ve had a tummy tuck.
Loose Skin After Significant Weight Loss
The loss of a significant amount of weight means improved overall health, but it can also be accompanied by some unfortunate aesthetic side effects. Excess loose skin and overstretched abdominal muscles can cause self-consciousness. Some people become so discouraged that they neglect their new, healthy lifestyle, instead falling back on old habits and regaining the weight.
A tummy tuck procedure can help sculpt a figure that better represents the achievement of dramatic weight loss.
Countless bariatric surgery patients, as well as those who have lost significant weight through diet or exercise, choose to undergo a tummy tuck to treat unwanted extra skin. As such, ideal tummy tuck candidates are generally within 15 to 20 pounds of their target weight.
Aging and Loss of Abdominal Definition
Two of the most common effects of aging include a loss of elasticity in the skin and a slow weakening of the muscles. These two factors can often have an especially profound impact on the abdominal area, causing the skin and muscles to visibly sag.
For many people, the loss of abdominal definition is one of the first signs of aging. A tummy tuck can help rejuvenate the abdominal area, helping restore the contours of youth.
Even though tummy tucks are fairly low-risk procedures, you should avoid the surgery if you have any underlying medical concerns that could cause complications.
Unfavorable Genetic Predispositions
The places your body stores fat and its overall shape are mostly decided by your genetics. For some people, no matter how much they work out or how strictly they stick to a diet, fat inevitably gathers in the midsection. Age is often not a factor, and a predisposition to abdominal fat accumulation can begin to appear as early as your twenties.
Fortunately, a tummy tuck can often help address this problem. The best way to make sure abdominoplasty is the most effective option for you is to discuss your goals with a board certified cosmetic surgeon.
Bear in mind that although a tummy tuck can have a profoundly positive impact on your overall appearance, it is not intended to be a weight loss solution. A healthy diet and plenty of exercise will still be needed to maintain your results.
Malpositioned Belly Button
Another somewhat less frequent reason many people seek an abdominoplasty is to adjust the positioning of the belly button. If your belly button is too high, it can be repositioned by pulling down skin tissue.
You may also wish to consider an umbilicoplasty, or belly button reshaping surgery. This procedure is commonly performed in conjunction with a tummy tuck to achieve a more natural result.
7 Abdominoplasty Techniques
No two patients visit a cosmetic plastic surgeon with the same concerns, nor do any two patients begin a cosmetic journey with the same goals in mind. For this reason, several variations on the tummy tuck procedure have evolved to address each patient’s needs and goals.
Your surgeon will recommend the specific technique best suited for your particular goals, with an eye for the most natural-looking results and minimal scarring.
The Full Tummy Tuck
This is the most commonly performed tummy tuck procedure, producing the most dramatic results. A long incision that extends from hipbone to hipbone is made, which allows the surgeon to contour the skin, tissue, and muscle as necessary.
An additional incision may be made vertically from the belly button to the horizontal incision. This method involves moving the position of the belly button, and might require the use of drainage tubes under the skin for several days.
A full tummy tuck is best suited for addressing the full length of the abdominal wall, including the area above and below the belly button. It can also improve the sides of your mid-section to a certain extent.
In general, a complete or full abdominoplasty is performed in 6 steps:
- A first incision is made just above the pubic area, extending from hip to hip.
- A second incision is made around the belly button to separate it from the surrounding skin.
- The skin is detached from the abdominal wall, giving the surgeon access to the muscles and fibrous tissue (called the fascia) below, which is tightened using sutures.
- Often, liposuction is used at this point to refine the transition zones of the areas treated. This fourth step is optional depending on your goals and what you have discussed with your surgeon.
- Excess skin is removed, a new hole for the belly button is created, and the skin is pulled taught and sutured.
- A dressing and compression garments are applied. Drains may be placed if necessary, although the drainless tummy tuck option is becoming more common these days. This is made possible through a unique technique which uses quilted sutures to minimize empty cavities and fluid build-up within the treated area.
The Extended Tummy Tuck
An extended tummy tuck is the same procedure as a full abdominoplasty, but also includes the flanks and hip regions. This method requires an incision that is even longer than the full tummy tuck, extending to the flanks on either side of the abdomen.
The procedure is performed as follows:
- After the incision has been made, the surgeon tightens the exposed muscles and creates a new belly button to match the new shape of the abdomen.
- Liposuction can be used to smooth out the transition areas.
- Excess skin is trimmed away from the abdomen, hips, flanks, and even a small part of the back.
- The remaining skin is then joined and closed using sutures.
The longer incision allows the surgeon to remove a much larger volume of fat and excess skin, making this procedure ideal for people with more apparent sagging. It is particularly effective at improving skin laxity and fat on the sides of the body, making it ideal for patients who have experienced massive weight loss, especially as a result of bariatric surgery.
The extended tummy tuck targets unwanted fat and skin around the hips, and upper lateral thighs. However, this technique leaves more scarring than some patients might be comfortable with.
The Mini Tummy Tuck
A mini tummy tuck utilizes a much shorter incision than the full tummy tuck. The incision is made just above the pelvic mound, giving the surgeon access to unwanted fat deposits while allowing the removal of excess skin. This produces a scar that can be more easily concealed. Recovery time is also significantly shorter.
The procedure is performed as follows:
- A smaller incision than a full abdominoplasty is made in the lower abdomen.
- The skin and fat of the lower abdomen below the navel are detached from the muscles and fascia layer below, but in a more limited way. The skin is stretched down, and all excess skin is removed.
- Sometimes the surgeon will choose to divide the belly button stalk from the muscle layer, allowing it to slide down to a lower position on the abdominal wall.
- Depending on your goals, a portion of the abdominal wall may be tightened.
- Again, as an optional step, liposuction can be applied to better contour the transition areas.
- The skin flap is sutured back into place.
A mini-abdominoplasty procedure is not suitable for all patients. It only treats the area directly below the bellybutton down to above the pubic mound, but does not address the area above the belly button. Results are likely to disappoint in cases where a full tummy tuck might have been more appropriate.
The floating abdominoplasty, also known as the FAB technique, represents another variation of tummy tuck. Instead of making an incision around the belly button, the surgeon disconnects the navel from the stalk that anchors it to the abdominal muscles below. This is done through a small incision made in the lower abdomen. It is through this same incision that the abdomen is shaped and tightened.
This method is referred as ‘floating’ due to the fact that the belly button remains attached to the surrounding skin. When the skin is pulled down and tightened, the belly button moves (“floats”) with it to a new position lower on the abdomen.
Rather than using an incision around the navel like other methods, the FAB technique uses a much smaller cut, located farther down on the lower abdomen. This allows the scar to be more easily concealed. Belly buttons that are positioned high before surgery can be moved to a lower position for a more natural appearance.
Unfortunately, this procedure is only suitable for a small group of patients who have a belly button that sits higher up on their stomach.
To summarize, the floating abdominoplasty technique involves the following steps:
- The surgeon makes a very small incision in the lower abdomen, and makes no incisions around the belly button at all.
- Excess skin is removed through this small incision.
- The belly button is detached from its stalk but remains attached to the skin of the belly.
- The muscles are then be reshaped and tightened from the sternum to the pubic area through the same small cut. This incision is so small that an endoscope may be used.
- The skin is then tightened, and the belly button is reattached from inside the body.
- Liposuction can be applied to further sculpt the abs and transition areas.
The Fleur-De-Lis Method
The name for this technique is taken from the shape drawn on the abdomen prior to surgery, which resembles the French symbol.
This method involves more surgical work than a full tummy tuck, incorporating the removal of extra fat and skin from the lower abdomen, tightening of the abdominal muscles, as well as the removal of extra, unwanted fat and skin from the center of the abdomen, around the ribs to the pubic region.
Designed for patients who have undergone significant weight loss, the fleur-de-lis abdominoplasty is the most extensive tummy tuck procedure:
- As with other procedures, an incision is made just above the pubic area. The longer this incision is, the more skin and tissue can be removed; this will be something you can discuss with your surgeon during your consultation.
- A vertical line is drawn down the center of the abdomen, and skin is removed from either side of it, forming a triangle shape.
- From the pubic region upwards, the skin is separated from the muscle layer. The extent of this will depend on your goals and what you have decided with your doctor.
- The abdominal wall is then tightened, and the belly button repositioned.
- Finally, the skin is repositioned and the incisions are closed.
Because this technique was specifically designed to remove large quantities of excess skin resulting from significant weight loss, it has the most extensive scarring of all the tummy tuck procedures. Once healed, the scars extend from hip to hip, and from pelvis to sternum.
The Reverse Tummy-Tuck Method
The reverse tummy tuck is performed by making an incision along the underside of the breasts, rather than near or below the belly button. As in the case of a traditional tummy tuck, excess skin and fat is removed and the remaining skin is redraped. However in this case it is pulled up to the breasts, rather than down to the pelvic area.
Reverse abdominoplasty focuses on removing excess skin and fat from the upper abdomen, and doesn’t tighten the underlying muscle layer at all:
- An incision is made along the crease on the underside of the breasts, also known as the inframammary fold.
- Through this incision the surgeon removes unwanted loose skin and small fatty deposits along the upper abdomen.
- The remaining skin is pulled tight, and the incision is closed.
- This procedure doesn’t require any modification of the belly button at all.
All scarring associated with this technique is hidden within the crease on the underside of the breasts. Additionally, this method is believed to slightly reduce the odds of complications because the blood supply isn’t interrupted as much.
Lipoabdominoplasty combines a tummy tuck with liposuction to attain a more sculpted and defined look:
- The first step in this procedure may be tissue excision or liposuction. The targeted, unwanted fat is saturated with tumescent fluid, a sterile saline solution, which helps its removal from the body.
- Using a small medical suction tube, the surgeon then sucks out the fat cells of the abdomen, flanks, and hips through a small incision.
- Fat in the lower abdomen is left to be taken care of by the tummy tuck. Once liposuction is complete, the operation generally follows the procedure for a standard abdominoplasty.
Combining liposuction with abdominoplasty was once considered risky, but recent medical research shows that it can actually improve the safety and efficacy of mid-section body contouring. Using liposuction helps render the tummy tuck procedure significantly less involved, resulting in smaller scars, reduced risk of complications, and a shorter recovery time.
There are a number of benefits to this approach:
- Complications are less likely than following traditional liposuction or abdominoplasty alone. This includes reduced rates of seromas, which are a collection of fluid that builds up beneath the skin, and less postoperative numbness.
- A more uniform, “hourglass” contour is given to the treated areas. This is particularly the case in harder to reach areas, such as in the upper range of the mid-section and along the sides.
- This technique leaves a significantly shorter scar.
- A greater number of blood vessels in the abdomen are left intact, allowing more blood flow to the area, which helps speed up the healing process.
- The recovery period is briefer (1-2 weeks until you can return to your regular activities) with reduced swelling, bruising, and pain.
As lipoabdominoplasty has become more commonplace, it has slowly started to become the go-to technique for many surgeons. However, some plastic surgeons may not yet be very experienced with this approach, as it is still a relatively new technique. Lipoabdominoplasty also takes longer than a traditional tummy tuck. This is because it’s essentially a combination of two procedures.
Preparing for Tummy Tuck Surgery
No matter which tummy tuck procedure represents the best option for you, it’s important to remember that this operation almost always includes the removal of extra skin, fat, and other tissues, as well as the tightening of the abdominal wall muscles below the skin if necessary.
The extent of this surgery means a significant recovery period, so it’s especially important for your surgeon to minimize the risk of any excessive bleeding or other complications during the procedure. This is achieved through a simple pre-op consultation.
During this meeting you’ll discuss your medical history, as well as any medications or supplements you’re currently taking. It’s important for your surgeon to carefully assess if you are at risk of developing complications such as thrombosis, which is the formation of a blood clot inside a blood vessel and can lead to serious complications.
Your surgeon may also ask you to follow these instructions in the days before your procedure:
Lab work — If you are approved for surgery, you will be asked to undergo some blood tests at a laboratory. For older patients, more extensive blood work may be necessary, along with an ECG (electrocardiogram).
General health — Be sure to report any sign of illness, like a cold, infection, or sores well before surgery. Your tummy tuck may be rescheduled if you have an active infection.
Medication — Cease taking blood thinning medication, hormones or certain herbal supplements and diet pills for at least two weeks prior to surgery. This also applies to medications that contain aspirin, ibuprofen, or naproxen/naproxen sodium.
Smoking — It is critical to give up nicotine for at least three months prior to surgery. You will also need to refrain from smoking during your recovery. This is because nicotine in the bloodstream hampers your body’s ability to heal and prolongs the recovery process.
Vitamins — About 2 weeks before your surgery it’s a good idea to start taking a high-quality multivitamin. This should help ensure that your body has all the nutrition it needs to handle the stress of the operation, and the recovery period that follows.
Items to purchase — You’ll also likely be given a list of things to buy or to make sure you have around the house during your recovery period. This simple list will probably include things like cold compresses and antibacterial soap, as well as gauze and other dressings for your incisions. The more you prepare for your recovery beforehand, the easier and more pleasant the experience will be for you.
Transportation arrangements — It’s important to arrange to have someone drive you home after the procedure, and to stay with you for at least the first 24 hours after surgery. This support person will need to watch for rare signs of complications, and help you move around the house and complete basic tasks. You may be surprised at how difficult the simplest of tasks can be right after your surgery.
Personal hygiene — Shower the night before and on the morning of your operation with a germ-inhibiting antibacterial soap. Shampoo your hair on the morning of your procedure, as showering properly in the days after surgery will be difficult. Refrain from applying any makeup, creams, lotions, hair gels, sprays, perfumes, powders, or deodorants before surgery, as these products can add bacteria to your skin and increase the risk of infection.
Clothing — On the day of your surgery be sure to wear comfortable, loose fitting clothing that you won’t have to pull over your head. Comfy, pull on pants and a button-up top are recommended. You might also want to consider slip-on shoes because you will not be able to bend over easily.
Abdominoplasty Recovery: The Days Following Surgery
Recovering from your tummy tuck procedure is a balance between allowing your body the time it needs to heal properly, and getting your body up and moving as soon as possible.
Resting — Try to mostly stay in bed or on the couch with your head comfortably elevated, and a few pillows under your knees. This will help to keep your torso slightly elevated and reduce the stress on the skin of your belly.
The skin in the abdominal area will have been stretched at the end of your surgery, so reducing the tension on the incision will help with blood flow and further reduce the chances of any complications.
Exercise — During these first few days you should be very careful when moving around. While walking is recommended, too much moving around this early in your recovery can cause the skin and underlying muscles to slide against each other, rather than knit together. This can lead to fluid or blood build-up beneath the skin, known as seromas and hematomas. The purpose of the drains is to help move the fluid out of the body, but if you move too much, fluid will build up despite the drains.
Diet — You’ll most likely be able to return to your normal diet, but be sure to drink a lot of fluids, including juices or sports drinks, especially during the first 72 hours.
Compression garments and drains — During these first few days of recovery you’ll probably be instructed to wear a compression garment. This helps to reduce swelling and prevents harmful fluid build ups. You should wear the garment 24 hours a day during this initial recovery period.
Don’t remove it for at least the first five days, except when showering. If you find that is itchy or uncomfortable, you can wear a thin fitted cotton shirt underneath it. Your compression garment should fit snugly but not impede your breathing or be painful. If it is, please tell your surgeon. They may provide you with a different one.
If one or two drains were placed during surgery, you will need to take care of them. The drain bulb will need to be emptied as it fills, and the amount of fluid should be measured and recorded. This information is important for your surgeon to assess how you’re healing and to catch any problems before they become serious. This process will have to be repeated several times until the drain can be removed, which may be a few days to a week or more.
Pain management — After abdominoplasty it’s normal to have pain and discomfort. Don’t be afraid to take your pain management medication as prescribed by your surgeon. Some patients might be given a pain pump designed to treat the area with a local anesthetic. Be sure to discuss your pain medication with your surgeon, but you should be able to combine approved pain pills with the pain pump without any problems. These two types of pain medication are very different, so they won’t react negatively with one another, and combining them can help speed up your recovery.
Follow-up appointments — Some time within the first 5 days or so you’ll most likely have your first post-op follow up appointment. Most people will have their drains and pain pumps removed during this meeting. Once all the tubes, drains, and pumps are fully removed you’ll feel a bit better, and a lot more mobile. Your surgeon will then discuss the plan for the rest of your recovery with you.
Weekly Recovery Timeline
After a week spent in bed, you’ll most probably be eager to start moving around. It’s around this time that you should try to become a little more active. Remember not to overdo it though, because the newly forming connection between the muscle layer and the skin layer is fragile, and can be damaged easily leading to fluid accumulations.
Week 2 — Try to get up and walk around the room a few times a day. This helps to get your muscles moving, helps your breathing, and greatly reduces the risk of blood clots forming in your legs.
Most surgeons will recommend that you continue to wear your compression garment for the next week to help prevent this. Your compression garment will continue to help reduce swelling and bruising, as well as improve the contraction of your skin so that it conforms to your new leaner contour.
Week 3 — You should be feeling a lot better. You’ll be able to start moving about the house more easily, but you should stay indoors as much as you can; as you won’t be ready for outdoor activities quite yet. This also means no driving but your surgeon may let you know if you’re ready to go back to work.
Around this time, you should start to get a feeling for what your body can handle, and what’s just too much. Allow your body to inform you. Be sure not to overdo your walking, and try not to lift anything that is more than a few pounds.
You may be able to stop wearing your compression garment 24 hours a day this week, but you should still have it on at least half the time. In fact, most patients choose to leave it on all the time for a full month, even at night; many say it makes them feel more secure. There is no harm in wearing it as much as you want if it makes you feel better.
Week 4 — At this point, most patients are sufficiently healed that they can start making short trips out of the house. You should feel ready for some more vigorous exercise, but avoid lifting anything over about 5 pounds. Continue wearing loose, comfortable clothing, except, of course, your compression garment, which you should still be wearing at least half the time.
You might feel like you’re in pretty good shape by this time, but it’s best if you continue to avoid driving for a little while. Sudden stops or sharp turns can damage your delicate, still healing muscles.
Week 5 — During the fifth week, you’ll probably be able to return to your normal activities. You might still have swelling, but your body’s new profile should be showing through. You’ll most likely have another follow-up appointment at this time, to assess your progress after a month of healing.
It’s important to remember that everybody is different, and there may be factors that lead to a somewhat longer recovery time. That’s okay. Your surgeon will be with you every step of the way, keeping note of your progress.
Weeks 6 to 8 — By this time, you should be okay to return to full physical exercise, including strength training.
10 Tips for a Speedy Recovery
1. Don’t measure yourself after surgery. Many patients get excited about showing off their new body right away, and might be discouraged by how they look and feel right after surgery. Remember, there will be swelling and it will last for weeks. Your body will also retain water more than usual, so your scales will be inaccurate too. You can reduce swelling after a tummy tuck by drinking plenty of fluids, going to the washroom regularly, cutting back on sodium and moving around leisurely to help with circulation.
2. After your first post-op appointment you’ll be allowed to begin showering again. When you start to bathe again it’s recommended you use lukewarm water. Avoid using hot water for a while because when you remove your compression garment your blood vessels will relax, and hot water will cause them to relax even further. If they get too relaxed too quickly, this can cause a fainting episode.
3. If you have a shower that is large enough, you may want to try a shower chair. This might be more comfortable than trying to shower in a half bent over position. You might also want to ask a friend or significant other to help you wash your hair in the sink, saving you some pain and discomfort.
4. Around your second week of recovery it will be important to keep your skin relaxed to allow it to heal fully. This will mean keeping the head of your bed elevated and your knees bent while resting, and staying a little bent over when you get up and walk around. Don’t try to stand up straight yet! That might pull on the wound too much and make scarring worse.
5. When choosing your recovery entertainment, consider skipping the comedies. Comedies are very therapeutic, and you may have fond memories of laughing your sick days away as a child, but this is different. Your abdominal muscles will be quite sore, and belly-laughs are something you’ll want to avoid for at least the first few days.
6. Consider using a cane or walker during your recovery period. You’ll be walking slightly bent over for the first few weeks thanks to tension on the incision, and your tightened abdominal muscles healing. This often results in some temporary back strain that the use of a cane or walker can help ease.
7. Think about getting some underwear that is a little too big for you for your recovery. After a procedure like a tummy tuck, a fair amount of swelling is to be expected and can travel down to the pubic area due to the effects of gravity. Your usual undergarments might feel tight. A tight elastic band around an already swollen and sore abdomen is something to avoid.
8. Talk to your surgeon about using an antibiotic ointment on your scars. They can help soothe the incision, while also helping the healing process. That being said, many surgeons prefer that you don’t touch your incision at all. Always follow your surgeon’s instructions.
9. Once your incision has closed and healed, consider a scar treatment. Your surgeon can give you advice about this.
10. Eat a healthy and nourishing diet during your recovery. This can also help foster good habits as you move beyond the recovery period, so you can maintain beautiful results.
Maintaining Your Results
With the right maintenance and proper care, abdominoplasty results can last for years. For most patients, the most important results of their tummy tuck procedure is a flatter, more toned, more appealing midsection, and a smoother overall body shape. Similar to other cosmetic procedures, abdominoplasty can also have a very real positive impact on a patient’s self-image and self-esteem.
That being said, it’s important to remember that this procedure can only do so much. It’s essential that you have a clear and frank discussion with your surgeon ahead of time so you can have realistic expectations of the results you can expect, and so your surgeon understands your goals.
Anyone considering abdominoplasty should also remember that the final results won’t be fully revealed for up to 6 months or even a year. You can expect the majority of swelling to go down after 4 weeks or so, but your incisions and scarring can take up to a year to settle. Your figure will continue to change as they do.
Despite the fact that a tummy tuck can have dramatic results, it’s not meant to be a weight loss procedure, and thus can’t prevent future weight gain. Of course, with proper diet and exercise, your results can last for decades to come. A pleasant side effect of surgery is that some patients love their results so much that they work hard to keep them with a healthy lifestyle.
Proper nutrition and diet are the best things you can do to maintain your tummy tuck results. To keep your tummy looking tight, as well as protect your overall health, stick to a diet that is high in lean proteins, whole grains, low fat dairy, and fresh fruits and veggies. After an abdominoplasty it is even more critical to avoid processed foods, treat yourself to high fat or high sugar goodies in moderation, and keep your healthy dishes properly proportioned.
The other important factor in maintaining your results is physical activity. Not only does exercise keep you looking and feeling great, it also helps the healing process (when your body is ready for it), and can help tighten your abdominal muscles further. Similar to your diet, there’s no need to go to extremes, but it’s strongly recommended that you engage in moderate activity for 30 to 45 minutes a day, at least 5 days a week.
Minimizing Tummy Tuck Scars
Unfortunately, due to the nature of the operation, post-surgery tummy tuck scars are simply unavoidable. The length and position of your incision will determine just how visible and extensive the scarring will be, and that will depend entirely on the specific type of procedure you undergo.
Abdominoplasty scars can range in size a great deal, from a single, small scar after a mini-abdominoplasty, to the much more extensive scarring that is unavoidably associated with the fleur-de-lys technique. Most tummy tucks involve a scar that runs from hip to hip, and a small scar around the navel.
In general, the more skin and tissue to be removed, the larger the scar. Of course, despite the fact that tummy tuck scars can be fairly prominent, experienced surgeons do an excellent job of placing the incision strategically, so that the resulting scar can easily be hidden by underwear and swimwear. The scar around the belly button is also well hidden, as it blends easily with the texture of the navel.
The very first thing you can do to minimize the appearance of scars after your procedure is to seek the services of an experienced and qualified cosmetic surgeon in the first place. Even once you’ve done this, however, how well your scars heal is much more dependent on you and your body’s recovery process.
Smoking, for example, has one of the most powerfully negative effects on the healing process. Keep in mind that smoking doesn’t only place you at a higher risk for complications, it can also lead to larger scars. If you are a smoker, it’s important that you quit at least 4 weeks before the procedure and continue to abstain for at least 4 weeks after the surgery. The longer you refrain from smoking, the better. Cigarette smoke and nicotine causes the blood vessels to shrink, constricting the flow of oxygen to the skin cells. This can slow down your healing process, hinder the immune system, and create more noticeable scars.
In general, the longer and more difficult your recovery is, the more apparent your scars will be. Most tummy tuck scars slowly become both lighter in color and flatter over time, but don’t feel too concerned if they grow more noticeable before they begin to fade. This is more common than you might expect, and while it’s always a good idea to contact your surgeon if you are concerned, this is usually just a normal step in the healing process.
The healing process can take about a year before scars are considered mature. Remember, tummy tuck scars will never completely disappear. However, once you’ve reached a certain point in your recovery process your surgeon might recommend a cream or ointment. This is normally after the incisions have fully closed. It’s also a good idea to keep your scars out of direct sunlight for at least a year to avoid hyperpigmentation. This shouldn’t be too difficult as most of them should be easily hidden under clothing and swimwear, even a bikini.
It is important to note that even under the best circumstances, some patients simply just heal with more noticeable scars. They may be thick, wide, irregular, or discolored, and while some of these issues can be treated and improved, it’s important to speak to your surgeon about the possibility of unsightly scarring before going forward with the procedure.
Latest Abdominoplasty Techniques and Scientific Studies
Over the years, the tummy tuck has shifted from being a procedure designed to remove abdominal fat to a more aesthetically-oriented one. Throughout this progression, surgery has become safer with more effective results. However, some patients who undergo abdominoplasty experience seroma (accumulation of fluid beneath the skin) as a result of surgery.
Current research has placed a focus on new techniques to reduce the risk of seroma occurring, and to prevent subsequent complications such as wound separation, skin infections, necrosis and re-operation which can detrimentally affect results.
Surgeons have experimented with multiple approaches to avoid seroma formation but with limited success. However, a 2017 study in the Aesthetic Surgery Journal outlines the development of a new technique to reduce the incidence of seroma: the use of barbed progressive tension sutures. This new technique allows the incision to be sealed using tension sutures, which hold the wound intact as it heals without the need for drains. The sutures are safe and straightforward to use, and improve the abdominal contour while minimizing the risk of complications such as seroma.
For patients who suffer from a deformity or weakness in the anterior abdominal wall due to pregnancy, age, obesity or genetics, restoring this key part of the abdominal core can be an impossible task for surgeons, however, the search for methods to address this issue is ongoing. A 2017 innovation published in the Aesthetic Surgery Journal outlines the use of a retro-rectus prosthesis to address this weakness. Use of this prosthesis would allow for the recreation of the myofascial core, restoring the original anatomy and its function to a reasonable degree, promising improved abdominoplasty results for these patients.
Frequently Asked Questions
How much does a tummy tuck cost?
The cost of an abdominoplasty can vary substantially from location to location, and depends on the type of procedure to be performed. There might be other costs after the operation, or additional costs if you combine your tummy tuck with another procedure. In general, abdominoplasty can range in price from about $4,000 to as much as $15,000.
What are the side effects/risks involved?
Abdominoplasty is considered a very safe and effective procedure. That being said, no surgery is without its risks and side effects. The side effects of a tummy tuck can vary in intensity and seriousness, and include:
- Pain and swelling.
- Slow healing.
- Fat necrosis.
Though extremely rare, there are a few more serious side effects to be cognizant of, including:
- Blood clots, especially in patients who smoke or have a preexisting medical condition.
- Dramatic fluid buildup in the extremities or abdomen.
- Persistent swelling in the legs.
- Nerve damage.
- Skin discoloration.
- Prolonged swelling around the incisions.
- Reappearance of loose skin.
- Unevenness of the skin in the abdominal area.
What are “dog ears” after tummy tuck surgery?
Dog ears are protrusions of excess skin located at the ends of the abdominal incision line. They occur more commonly when liposuction to the flanks is done at the same time as a tummy tuck. They can be removed as a simple office procedure under local anesthetic, usually at least 3-6 months after the tummy tuck when all the swelling has subsided.
How can I recognize the symptoms of infection?
As with all surgical procedures, the risk of infection is always present, and if not treated it can spread throughout the body. Symptoms of an infection include:
- Malodor and pus
- A general ill feeling
You can reduce the risk of infection by keeping the incisions clean and regularly changing the dressings as advised.
What is fat necrosis?
Fat necrosis is a complication caused by a localized lack of blood supply to the fat tissue under the skin. The fat gets firm and feels like a nodule. It is a benign condition and is usually left alone unless it is causing a problem such as pain or a cosmetic deformity. In those cases, it can be removed usually as a quick office procedure under local anesthetic.
How do I decide between a tummy tuck or liposuction?
Making a decision between a tummy tuck and liposuction usually comes down to one factor: the amount of loose, sagging skin you have in your midsection. If you have a lot of excess skin and stretched stomach muscles, a tummy tuck can remove the extra skin and tighten the muscles. On the other hand, if you have minimal skin laxity, small, well-defined pockets of unwanted fat, and good abdominal muscle tone, liposuction can target that extra fat.
Additionally, liposuction can often be performed in addition to the tummy tuck, to help contour those troublesome transition areas. A consultation with an experienced cosmetic surgeon can help you make the best decision for your body and your goals.
Mini vs full tummy tuck: which is right for me?
As mini-abdominoplasty boasts a smaller incision, many patients wonder if they are a good candidate.
Unfortunately, the mini tummy tuck isn’t always a viable option for all patients. When trying to decide which procedure is best for you, consider that the mini is not effective for overall skin tightening, as it can only tighten a small area directly above the pubic region and below your belly button. Any more tightening often results in extended scarring that isn’t as well hidden. Similarly, the mini can’t take care of stretch marks or any muscle wall separation above the belly button.
On the other hand, the full tummy tuck can treat muscle wall separation, as well as loose skin on the belly above and below your belly button. In essence they are two very different procedures, and a consultation with your surgeon is the best way to determine which is right for you.
What is a panniculectomy?
A panniculectomy is when the excess skin and fat hanging down over the front of the thighs (called a “pannus”) is removed. This is different from an abdominoplasty in that a panniculectomy only entails removing the pannus while an abdominoplasty also includes plicating or tightening the abdominal wall. Furthermore, a panniculectomy is a functional surgery, while abdominoplasty is a cosmetic one.
What that means is that a panniculectomy may be covered by insurance as it is designed to relieve problems associated with excessive overhanging skin that happens after massive weight loss. The most common issues are skin irritation, skin erosion under the pannus, and interference with normal everyday activities.
Can a tummy tuck get rid of stretch marks?
Yes, to a certain extent. To remove stretch marks, the skin affected by them must be removed. That means you need to have a certain amount of loose skin to make this possible. Generally speaking, stretchmarks located under the belly button can be removed, but those above cannot be. Because the skin is stretched taut, remaining stretch marks may be improved in appearance.
Updated, December 2017