Abdominoplasty

(Tummy Tuck)

by Michael Jubinville, MPH

Definition

Abdominoplasty is a cosmetic procedure. It’s performed to remove excess fat and skin from the lower belly. Muscles and supporting structures in the belly may be tightened. This will give you a slimmer look.

Reasons for Procedure

Abdominoplasty is meant to make your belly look better. It may fix sagging or overhanging skin. It can also help with weak or protruding muscles that persist after diet and exercise. This can happen with:

Losing large amounts of weight—can happen after bariatric surgery
Pregnancy
Extreme weight gains and losses
Normal aging
Genetics

It can be done at the same time as liposuction, hernia repair, or hysterectomy.

Possible Complications

Problems are rare, but all procedures have some risk. Your doctor will review possible problems such as:

More bleeding than normal
Infection
The wound comes apart—dehiscence
Death of skin or fat tissue—necrosis
Fluid buildup—seroma
Blood clots
Belly looks uneven
Nerve damage
Blood collects under the skin—hematoma
More surgery
Loss of the belly button

Talk to your doctor about how to lower your chances of problems related to:

Smoking
Drinking
Chronic disease such as diabetes or obesity

What to Expect

Prior to Procedure

You may have:

A physical exam
Blood tests

Your doctor will talk to you about what you expect from the surgery.

Leading up to the procedure:

Talk to your doctor about your medicines.
Certain medicines may need to be stopped up to 1 week in advance.
Let your doctor know of any allergies you have.
Arrange for a ride home.
Arrange for help at home.
Don’t eat or drink after midnight, unless told otherwise.

This surgery is not for everybody. Talk to your doctor if your future plans are for:

One or more pregnancies
Continued weight loss

Smoking interferes with wound healing, making the chances of scars higher. If you smoke, you will need to stop smoking before and after the procedure. Most surgeons advise stopping smoking for at least 4 weeks before and after surgery.

Talk to your doctor about how you can quit for successfully.

Anesthesia

General anesthesia is often used. Some doctors use sedation. Sedation will help you relax. It may also put you to sleep.

Description of the Procedure

The exact steps of the procedure will depend on your goals. Common steps:

A cut made in the lower belly. The length depends on the how much surgery is needed. The largest cut can go from hipbone to hipbone.
Sometimes the belly button is separated out. Once the skin is adjusted, a new hole for the belly button is made. The belly button is pulled through the new hole and stitched into place. In a mini abdominoplasty, the belly button’s not moved.
Stitches may be placed down the middle of the abdominal muscles. They will go from the breastbone to the pubic area. This helps bring the muscles back together. In some cases, they may be placed inside the body.
When underlying tissue work is completed, your body will be flexed, or bent, at the hips and the skin is pulled down and any excess skin is removed.
Liposuction may be done during this surgery to remove excess fat under the skin.

Once the work is complete, drainage tubes will be placed in the belly. These tubes will work to drain fluid from the site.

The incisions are closed with stitches, adhesive, tape, or clips and covered with a bandage.

Liposuction of the Abdomen

Immediately After Procedure

You will be taken to the recovery room and monitored.

How Long Will It Take?

2-5 hours

How Much Will It Hurt?

Anesthesia will prevent pain during surgery. Medicines will help with pain after.

Average Hospital Stay

In some cases, abdominoplasty is an outpatient procedure. You will be able to go home after you wake up from anesthesia. In other cases, an overnight stay is needed. You will need to stay longer if there are problems.

Post-procedure Care

At the Hospital

You will be in a recovery room where your vital signs are watched. Recovery may also include:

Pain medicine
Blood thinners to prevent clots

The healthcare staff may have you walk around as you are able. This will help keep blood moving in your body.

During your stay, the healthcare staff will take steps to lower your chances of infection such as:

Washing their hands
Wearing gloves or masks
Keeping your incision covered

There are also steps you can take to lower your chances of infection such as:

Washing your hands often and reminding visitors and healthcare staff to do the same
Reminding your healthcare staff to wear gloves or masks
Not allowing others to touch your incision

At Home

Recovery depends on the extent of your surgery. Arrange for help at home for the first few days. You may need to avoid activities that cause strain. Walking will help with healing.

What to expect:

Remain flexed at the hip for several days. Don’t straighten out. This prevents extra tension on the belly.
Don't lay flat at night to sleep for several days.
Drains may remain in the belly for up to 1 week.
You may have bruising, swelling, and pain for up to 6 weeks.
A binder may be needed. It’s a compression garment to support the belly during healing.

Call Your Doctor

Call your doctor if any of these occur:

Fever or chills
Fluid leaking from the wound
Pain that doesn't go away with the medicines you were given
Your stitches come apart
Bleeding that does not stop after 10 minutes

If you think you have an emergency, call for emergency medical services right away.

RESOURCES:

American Association of Plastic Surgeons
https://www.plasticsurgery.org

American Society of Anesthesiologists
http://asahq.org

CANADIAN RESOURCES:

Canadian Society of Plastic Surgeons
http://plasticsurgery.ca

Health Canada
https://www.canada.ca

References:

Abdominoplasty. Encyclopedia of Surgery website. Available at:
...(Click grey area to select URL)
Accessed June 27, 2018.

Abdominoplasty (tummy tuck). University of Pittsburgh Medical Center website. Available at:
...(Click grey area to select URL)
Accessed June 27, 2018.

Tummy tuck. American Society of Plastic Surgeons website. Available at:
...(Click grey area to select URL)
Accessed June 27, 2018.

Last reviewed May 2018 by EBSCO Medical Review Board Donald W. Buck II, MD
Last Updated: 6/27/2018

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