A tummy tuck or abdominoplasty is an elective cosmetic surgery to remove excess skin around the abdomen (belly). The goal is to tighten and slim the belly or tummy area. It may also involve tightening or sewing abdominal muscles back together.
Tummy tucks are not a weight loss surgery. If weight loss is your goal, you may also need liposuction or other types of surgery to achieve your desired outcome. Long-term results are not guaranteed, but avoiding weight gain after surgery can help maintain results.
This article reviews what you can expect from tummy tuck surgery, how to prepare, and tips for recovery and healing after surgery.
2021 Plastic Surgery Statistics
In 2020-2021, a tummy tuck was the third most common plastic surgery in the U.S. The Aesthetic Plastic Surgery National Databank ranked them as follows:
- Liposuction - 491,098 procedures
- Breast augmentation - 364,753 procedures
- Abdominoplasty (tummy tuck) - 242,939 procedures
Types of Tummy Tucks
A tummy tuck looks like a taut core by removing excess skin and fat. It might also include fastening the underlying abdominal muscles.
The following are the most common tummy tuck techniques:
- Full or standard: This involves a hip-to-hip incision and another around the belly button.
- Extended: The incision goes around to the sides of the lower back. This is because it removes more skin, and it is usually reserved for those who have lost an extreme amount of weight.
- Fleur-de-lis: This technique gets its name from the shape of the incision. It uses a horizontal (side-to-side) incision and a vertical (up and down) incision between the belly button and pubic area. It is reserved for patients who need skin tightened both vertically and horizontally.
- Mini: This requires a small horizontal incision between the hipbones. It only addresses the lower abdomen (below the belly button). Ideal candidates are usually close to their ideal weight and have small amounts of stubborn fat, excess skin, or stretch marks.
- Reverse: A reverse tummy tuck is a partial abdominoplasty in which loose skin is removed from the upper portion of the abdomen.
- Tummy tuck with liposuction: Since a tummy tuck alone does not remove fat, liposuction with a tummy tuck is ideal for those who need pockets of fat removed.
Diastasis recti occurs when abdominal muscles separate down the middle. Pregnancy is the most common cause of diastasis recti due to pressure from the baby on the muscles. These muscles can be sewn together as part of a tummy tuck.
You may be advised against having this procedure if you have a high risk of surgical complications due to:
- A major chronic illness such as diabetes (especially if uncontrolled)
- Morbid obesity
- Bleeding disorders
- Immune deficiency
- Current tobacco use (can delay healing)
- Current, significant infection
- Newly detected kidney disease
Significant weight fluctuations or pregnancy can alter the cosmetic effects of a tummy tuck. While the procedure is not prohibited in these situations, your provider may recommend waiting as it may not result in a lasting desired outcome. Most plastic surgeons recommend you are within 10 to 15 pounds of your goal weight for several months before having a tummy tuck.
Overall, the outcomes of this procedure are good and most people are satisfied with the results. A permanent post-surgical scar will be visible when you are completely undressed. It follow the natural crease that runs along the lower abdomen.
Complications of abdominoplasty can include:
- Wound infection
- Blood clots
- Asymmetry of the shape of the abdomen
- Severe scarring or discoloration of the skin
- Loose skin
- Numbness or pain in the surgical region
- Unsatisfying cosmetic results
Purpose of Tummy Tuck Surgery
Aging, pregnancy, previous surgeries, heredity, and weight fluctuations can cause the abdomen to look bloated or loose and saggy. A tummy tuck changes the look and feel of the abdomen, so it appears flat, taut, and toned.
This procedure can improve your quality of life if it makes you more satisfied with your physical appearance, but it does not improve your physical health.
Tummy tuck surgery is not weight loss surgery. If you have excess fat in your abdominal area, your provider may suggest liposuction along with the tummy tuck. It involves the removal of fat without surgically remodeling skin or muscle, and it isn't limited to the abdomen. Liposuction is a cosmetic procedure.
If you are severely overweight and weight loss is your goal, your provider may discuss bariatric surgery with you. This is a type of weight loss surgery that involves surgically restructuring the digestive system to prevent overeating and absorption of excess calories. It is typically done to prevent medical complications of obesity rather than for cosmetic reasons.
A panniculectomy is a surgical procedure in which excess, stretched out, overhanging skin (the pannus) is removed from the abdominal area. While it is similar to a tummy tuck, it would not involve surgical intervention to fat or muscle.
How to Prepare
Often, the decision to have a tummy tuck is a process that takes months or longer. You might try weight loss and exercise before deciding to go ahead with this procedure to see if you can achieve the look you want without having surgery.
You will want to ensure that you are at a relatively stable weight before you schedule your abdominoplasty so you can maximize the procedure's benefits.
Your surgeon will order pre-operative testing and medical clearance to ensure that you can safely have this procedure. This may include blood work such as a complete blood count (CBC) or electrolyte (chemistry) test.
If you have a pre-existing medical issue such as heart disease that puts you at high risk during surgery, they may also order an electrocardiogram or other tests to be safe.
Because a tummy tuck is cosmetic, most health plans don't pay for this procedure.
A tummy tuck is performed in a surgical suite or operating room at a hospital or a surgical center. Most people go home the day of the surgery. An overnight hospital stay may be required if you have a medical issue and need closer monitoring, a complication arises during surgery, or your pain is not controlled with oral medication.
What to Wear
You can wear whatever you would like to your surgery appointment as they ask you to change into a gown when you arrive to the hospital or surgery center.
Food and Drink
Generally, your healthcare provider will instruct you not to eat and drink after midnight the night before your tummy tuck surgery. However, follow your surgeons instructions as the science behind this concept evolves.
Your healthcare provider might ask you to stop taking blood thinners several days before your procedure. If you take oral steroids or medications for diabetes, you might need to follow an adjusted dosing regimen in the days before your tummy tuck surgery.
Most vitamins and herbal supplements are typically stopped a few weeks before surgery. Be sure you are clear about the instructions in your case and follow them exactly.
What to Bring
Bring a form of identification, your health insurance information, and a method of payment when you go to the appointment for your tummy tuck surgery.
Pack comfortable clothes that you can change into when you head home. It's a good idea to wear loose clothes that allow access to a post-operative drain, if one is placed.
Pre-Op Lifestyle Changes
You will need to be at a healthy weight and maintain good nutrition before your procedure so you can maximize the chances of a good recovery.
In the weeks before your surgery, your healthcare provider or a nutritionist may discuss dietary issues with you. If you tend to gain weight or diet excessively, you might start on a nutrition plan to ensure that you are getting the nutrients and calories you need to stay healthy for a better recovery.
Since smoking hinders recovery, your healthcare provider may also ask you to quit smoking if you are a smoker.
What to Expect on the Day of Surgery
When you arrive at your appointment, you will sign consent forms and check in. You will be guided to a pre-op area, where you will change into a gown and have your vital signs—temperature, blood pressure, pulse, oxygen level, and respiratory rate—checked.
You might have some blood tests, including a CBC and electrolyte tests, to make sure you don't have an acute health problem or infection.
Your vital signs will be continuously monitored before, during, and for at least a few hours after surgery.
Before the Surgery
When it's time for your surgery, you will go to the operating room or surgical suite. You will have an intravenous (IV) line placed. You may also have a urinary catheter placed so your bladder can release urine, especially if you have general anesthesia.
You will have either general anesthesia or IV sedation during your procedure. With general anesthesia, you will be intubated with a breathing tube so you can breathe with mechanical assistance during your surgery.
Your surgical team will place a drape around your abdomen, exposing the area where you will have your incisions. Your skin will be cleansed with an antiseptic solution. Your surgeon may measure or mark areas on your abdomen before making incisions.
During the Surgery
A tummy tuck can take from two to five hours, and this largely depends on the technique used. The steps are as follows:
- Incision: The surgeon will make one or two incisions, depending on the type of tummy tuck. With a full abdominoplasty, the incision is from the hip bone on one side to the hipbone on the other side of the body, close to the pubic area; the other incision is around the navel.
- Remove excess skin: After the incisions are made, the skin will be separated from the abdominal muscles. Excess skin (and fat if liposuction is required) will be removed from the abdominal area. If the tummy muscles are separated, they might be pulled together and stitched into place.
- Reconstruction: The remaining skin is then stretched over the abdominal area, creating a tighter appearance. If your surgeon included the navel (belly button) in the incisions, it will be reconstructed in a position where it looks natural.
- Closing the incisions: Once the surgeon is pleased with the results, they will close the incision using sutures, surgical adhesive (glue), and steri-strips (tape). A surgical drain may be inserted under your skin to collect excess fluid. This will stay in place for a couple of weeks before it's removed. A sterile dressing is applied over the area.
After the Surgery
After your surgery is complete, your anesthesia will be stopped (IV) or reversed (general). If you have a tube in place to help you breathe, this will be removed so you can breathe on your own before you leave the operating room.
You will be taken to a post-operative area where your vital signs will continue to be monitored. Once you are awake and considered stable, your nurse might collect urine from your catheter or ask if you can urinate in a bedpan.
It takes several hours before you can get up and walk with assistance. You will go home or to a hospital room according to your plan before surgery.
While you recover in the post-operative area or during your post-operative hospital stay:
- Your medical team will take care of your surgical wound and drain and show you how to do so at home.
- You will receive pain medication, and your healthcare provider will give you instructions for managing postoperative pain.
- You will resume (or be instructed on when to resume) taking any prescription medications.
- Your medical team will ensure you can comfortably and safely walk, eat, and use the toilet before you are discharged to go home.
If you develop signs of complications such as a fever or severe pain in the hours after your recovery, you might need to stay in the hospital for longer than planned as your medical issue is evaluated and treated.
Recovery from any type of abdominoplasty may take two weeks to two months. You should expect to avoid strenuous activity for at least six weeks. Generally, if you have a large wound and/or had a substantial amount of skin and fat removed, you should expect a longer recovery than if you have a small wound and had a small amount of tissue removed.
Carefully follow post-operative instructions. While your specific instructions may vary slightly, the following are tips to help prevent complications:
- Hydrate: Drink plenty of water. Some providers will suggest an occasional Gatorade or Pedialyte. Dehydration can make you feel generally ill, so consider drinking a glass of water if you feel bad.
- Proper nutrition: Follow a healthy diet with lean protein, fiber, and fruits and vegetables to prevent constipation and speed wound healing.
- Rest: Getting up and moving every couple of hours is important, but you should rest in between to increase healing.
- Movement: Try to get up to go to the bathroom or kitchen every two to three hours. It's also a good idea to move your ankles around in circles every 15 minutes while awake. Mild activity decreases your risk of blood clots or lung infections.
- Deep breathe and cough: Take deep breaths and cough (using a pillow to protect your tummy) every couple of hours to help decrease the risk of pneumonia.
- Manage your pain: Work with your provider regarding pain management. If you are in extreme pain, it's hard to rest and heal.
It's important to follow your provider's post-operative incision care plan so that your incisions heal well and your scarring is minimal.
You will need to wear a compression garment (abdominal binder) over your bandage and underneath your clothes during your recovery.
Keep the incision clean and dry. Care for your wound and drain according to the instructions you received from your providers. Be sure you are clear on how to replace your dressing and when you can resume showering. Keeping the incision free of infection helps decrease the risk of excess scarring.
Your provider may suggest a scar cream or patch after the incision is healed. They will also advise you to keep the healed incision out of direct sunlight and use sunscreen for several months. Keep in mind that the scar may not significantly fade until one-year post-surgery.
Infection: When to Call Your Healthcare Provider
In the weeks after your tummy tuck surgery, you should avoid strenuous activity and avoid lifting heavy objects. When you have your healthcare provider’s permission, you can return to work and start to exercise.
Your drain and wound will be examined when you go to your follow-up appointments with your healthcare provider. When the drain is no longer needed, it will be pulled. A suture or steri-strip may be placed to close off the opening in the skin.
Your surgical wound will be inspected, and any non-absorbable stitches will be removed once it has healed.
You shouldn't need any specific long-term care after recovering from a tummy tuck surgery.
Possible Future Surgeries
Generally, tummy tuck surgery doesn't need to be followed up with other procedures and doesn't typically cause medical issues.
If you are unhappy with your post-surgical scar, you can consider discussing a scar revision procedure with a plastic surgeon. Your scar might be different than expected if you had a problem with healing or a wound infection after your surgery.
Any future abdominal surgical procedures for any medical or cosmetic reason will need to be planned with consideration of your incisions.
Weight gain might reverse the effects of surgery by adding fat to your abdominal area and allowing the muscles to separate. Weight gain followed by weight loss can cause the skin to become saggy again.
Exercising and following a healthy diet are necessary for weight management and optimal long-term benefits after tummy tuck surgery.
If you are prone to extreme dieting, discuss this with your healthcare provider.
A tummy tuck surgery is an elective cosmetic surgery that you might consider if you want a flatter, firmer stomach. Techniques vary based on the individual and desired results. This is not a weight loss surgery, other procedures may be needed if this is your goal.
To heal appropriately and have the least amount of scarring possible, it's important to follow your surgeon's post-operative care plan. Keep your incision clean and dry, and wear your compression as advised. While you should avoid strenuous activity for six weeks (in general), walking around a little every few hours is important to decrease your risk of post-surgical complications.
A Word From Verywell
If you are not satisfied with the appearance of your tummy area, this procedure may help increase your self-esteem. There are many issues you need to keep in mind when deciding if this would be the right treatment for you.
Have an open conversation with your healthcare provider about the pros and cons of this surgery as well as the recovery period and expected to scar. They can help you make an informed decision about your situation.
Frequently Asked Questions
Can you have a tummy tuck at the same time as a hysterectomy?
Yes, a tummy tuck can be done during the same operation for those in overall good health.
Are there weight requirements for a tummy tuck?
Before having a tummy tuck, you should be within 10 to 15 pounds of your desired or goal weight.
Is a tummy tuck better than liposuction?
It depends on your goal. A tummy tuck tightens the skin and muscles (if needed) in the belly area to create a more taut or toned look. Liposuction is a procedure that removes unwanted fat and can be used in other areas of the body as well. A tummy tuck and liposuction are often used together.