Tummy tuck is a major surgical procedure that tightens abdominal muscles and gets rid of excess skin and fat.
If you already have good abs, but they are hiding behind persistent excess fat and skin, then you may want to sculpt the area to bring out your hidden six-pack with vaser liposuction.
Best Candidates for Tummy Tuck
Tummy tuck surgery is a highly individualized procedure and you should do it for yourself, not to fulfill someone else's desires or to try to fit any sort of ideal image.
Abdominoplasty is a good option for you if:
- You are physically healthy and at a stable weight
- You have realistic expectations
- You are a non-smoker
- You are bothered by the feeling that your tummy is too large
What Tummy Tuck Can Do
Also known as abdominoplasty, a tummy tuck removes excess fat and skin, and in most cases restores weakened or separated muscles creating an abdominal profile that is smoother and firmer.
A flat and well-toned abdomen is something many of us strive for through exercise and weight control. Sometimes these methods cannot achieve our goals. Even individuals of otherwise normal body weight can develop an abdomen that protrudes or sags.
What tummy tuck does not do:
A tummy tuck is not a substitute for weight loss or an appropriate exercise program. Although the results of a tummy tuck are technically permanent, the positive outcome can be greatly diminished by significant fluctuations in your weight. For this reason, individuals who are planning substantial weight loss or women who may be considering future pregnancies may be advised to postpone a tummy tuck. Also, a tummy tuck cannot correct stretch marks, although these may be removed or somewhat improved if they are located on the areas of excess skin that will be excised, generally those treated areas below the belly button.
Tummy Tuck Alternatives
The good news is that today's tummy tucks can be personalized based on your needs. If the problem is just loose skin, plastic surgeons can perform a "skin only" tummy tuck, which gets rid of excess skin, but leaves the muscles in-tact. If you have a small roll of loose skin and some muscle bulge from having children, you can have a smaller incision along your bikini line, have the muscle tightened, let your belly button "float down" slightly, and remove the extra skin. This operation is known as a mini tummy tuck. If the problem is excess fat alone, doctors can use liposuction it is weak ab muscles without loose skin, an endoscopic tummy tuck may be right for you. An endoscopic tummy tuck is performed using a small camera, called an endoscope, which is attached to small surgical instruments. It involves very small incisions that are easily concealed. The incisions are usually placed above the pubis or inside of the navel. The muscles are tightened and sutured through the incision. If you have loose ab muscles, loose skin, and excess fat, a complete tummy tuck will likely do the trick.
People who are obesity may be asked to consider weight loss first. This would include diet and exercise recommendations, and referral to a bariatric surgeon when appropriate. Popular weight loss surgery procedures include Lapband surgery and gastric bypass. In some rare cases, where patients have a significant amount of excess hanging skin, a patient may need a modification of the tummy tuck procedure called panniculectomy.
For less severe conditions, you may want to consider the less-invasive mini tummy tuck.
Preparing for Tummy Tuck
The surgeon will take a thorough medical history. He or she will review any medications that you are taking, whether you have any allergies or have had any prior surgeries or pregnancies. The surgeon will also perform a physical exam to measure the extent of excess fat and the degree of loose skin in your abdominal region.
He or she will also assess the condition of your abdominal muscles and skin tone while you are standing up and lying down. The surgeon will likely take some "before" photos during this consultation process.
Once you have decided to undergo a tummy tuck, chosen a surgeon and scheduled your procedure, your doctor will give you a list of pre-operative instructions. This will likely include some lab testing such as routine blood work and a cardiac work-up if there is any history of heart disease.
In the two weeks leading up to your tummy tuck, your plastic surgeon will likely ask you to stop taking certain medications including aspirin, non-steroidal anti-inflammatory drugs (NSAID) and blood thinners, all of which can increase bleeding risk.
Certain herbal remedies may also increase bleeding risk. Just because a product or preparation is "all-natural" does not mean it is safe. For example, vitamin E, omega-3 fatty acids, green tea and gingko biloba all may increase bleeding risk during and after tummy tuck surgery.
Make sure you tell your surgeon about EVERYTHING that you are taking. But never stop taking any medication abruptly without first speaking to your doctor.
Your surgeon may also suggest that you add certain medications to your daily regimen in the days and weeks leading up to your tummy tuck such as 500 mg of vitamin C each day.
The pre-op instructions will also include a list of do's and don'ts about eating and drinking before your tummy tuck.
Most surgeons recommend that prospective patients kick the cigarette habit for the month before and the month after the tummy tuck. Smoking can cause a delay in wound healing and skin necrosis (death).
The good news is that many tools are available today to help smokers become ex-smokers.
Nicotine replacement products such as nicotine patches, nicotine gum and nicotine lozenges are available over-the-counter. A nicotine nasal spray and inhaler are currently available by prescription. These products can help relieve nicotine withdrawal symptoms.
Nicotine patches and or other nicotine replacement systems can't be used as smoking cessation aids immediately before or during surgery. They cause some of the same problems with wound healing as cigarette smoking. Tell your surgeon if you are using any nicotine replacement products.
Drugs such as buproprion SR (Zyban) and varenicline tartrate (Chantix) are non-nicotine pills that may help you quit smoking before a tummy tuck. Talk to your doctor about a prescription. Hypnotherapy or acupuncture may help some people quit smoking, too. Acupuncture involves placing extremely thin needles into the skin along specific acupuncture points to help curb the desire to smoke.
Tummy Tuck Surgery Overview
A full tummy tuck requires a horizontally-oriented incision in the area between the pubic hairline and navel. The shape and length of the incision will be determined by the degree of correction necessary.
Through this incision, weakened abdominal muscles are repaired and sutured and excess fat, tissue and skin is removed.
A second incision around the navel may be necessary to remove excess skin in the upper abdomen.
Sutures, skin adhesives, tapes or clips close the skin incisions.
Abdominoplasty is often performed with general anesthesia. It can also be done using a local anesthetic with a sedative. There may be some discomfort with local anesthesia. The tummy tuck surgery takes about two to five hours.
A tummy tuck usually begins with a relatively long incision across the abdomen, from hip bone to hip bone. The shape of the incision is like a smile, with a flat bottom. The flat part of the smile occurs at the bottom point of the abdomen immediately above the pubic area. The sides of the smile form a gentle curve along the pelvis up to the top of the hip bone. A second incision is made around the belly button to free it from the abdominal tissue.
The skin is separated from the abdominal wall, up to the ribs, exposing the vertical abdominal muscles (rectus muscles). These muscles have usually been stretched apart by previous pregnancies. The rectus muscles are then stitched into a new position, tightening the muscles and reducing the waistline. After the muscles have been repositioned and tightened, the excess skin is stretched and removed.
The remaining skin is redraped over the abdominal area and sutured in place. The belly button is then brought out through the overlying skin in its new location.
Closing the Incisions
Incisions are closed with layered sutures in the breast tissue and with sutures, skin adhesive or surgical tape to close the skin. Over time the incision lines will fade.
Tummy Tuck Results
Your tummy tuck will result in a flatter, firmer abdominal contour that is more proportionate with your body type and weight.
The final results may be initially obscured by swelling and your inability to stand fully upright until internal healing is complete.
Within a week or two, you should be standing tall and confident about your new slimmer profile. However previous abdominal surgery may limit the potential results of a tummy tuck.
In women who have undergone cesarean section, the existing scars may often be incorporated into the new scar.
Recovery After Tummy Tuck
Tummy tuck is a major surgical procedure: you can expect a considerable recovery time compared with other plastic surgeries. Most people require one to three weeks before returning to work and a normal schedule. Some patients may not need an overnight hospital stay. Others may spend one or two days in the hospital, depending on the extent of the procedure.
Your abdomen will be swollen and sore for the first few days. Your surgeon can prescribe pain medication as needed. This typically entails narcotics for the first few days after surgery, and then non-narcotic pain relievers after that.
It is a good idea to exercise after surgery, but only after enough healing time has passed. Your surgeon will give you specific instructions on when you can exercise after your tummy tuck and what type of exercises are appropriate. As a general guideline, tummy tuck patients can start light to moderate activity after four weeks. After six to eight weeks, most people can resume all exercise and activity.
The abdominal scars will appear to worsen during the first three to six months. They may take nine months before they flatten and lighten in color. The scars never disappear completely, but clothing can hide them easily. Ask your surgeon if he or she recommends any creams or ointments to use after you've completely healed, to help with the scars.
People who have had tummy tucks should maintain their result, but they can have a second tummy tuck if they have children again. The good news is that even if you gain and lose a significant amount of weight, you will rarely need a secondary tummy tuck.
When You Return Home
If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur after breast augmentation, you may require hospitalization and additional treatment.
The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.
Following your physician’s instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.
Tummy Tuck Post Operative Care
Because breast tissue is stretched and separated, and because implants are inserted through incisions, the breasts will be bruised, sore, and swollen after surgery. You can expect to wear a surgical bra for several days. There may be some moderate pain, but that can be treated by a prescription from your plastic surgeon. Your doctor may suggest that you wear an athletic or support bra until the swelling has subsided.
Heavy lifting or straining should be avoided after surgery because this can cause the breasts to swell and increase pressure. You can typically return to work within a week and to full activity within a few weeks. Sensation in your nipples may be reduced temporarily, but should return to normal as your breasts heal. Breast feeding usually is not hindered; however, it is important to ask the doctor about breast feeding during your initial consultation.
After healing, some permanent scarring will remain. Scars are typically small and inconspicuous. Your surgeon’s goal will be to make them as unnoticeable as possible. Inframammary and periareolar incision scars are on the breast. Transaxillary or TUBA incisions can be placed in a natural fold in the skin under the armpit, virtually unnoticeable after surgery.
Possible Tummy Tuck Risks
These potential complications can be mitigated if you carefully follow your surgeon's pre- and post-surgery instructions, including quitting smoking. Note that these risks are higher in people with underlying medical conditions such as heart or lung disease, poor circulation or diabetes. In addition, people who have had another surgery recently in the abdominal region are at higher risk for complications.
Tummy Tuck Risks Include:
- Anesthesia risks
- Tissue loss
- Collection of blood beneath the skin (hematoma)
- Collection of fluid under the skin (seroma)
- Blood clot to the lungs
- Aspiration pneumonia
- Bleeding under the skin flap
- Insufficient healing that may result in the need for a second surgery