A tummy tuck (technically termed abdominoplasty) is a major surgical procedure to remove excess skin and fat from the middle and lower abdomen and to tighten the muscles of the abdominal wall. The procedure can dramatically reduce the appearance of a protruding abdomen, but it produces a permanent scar that, depending on the extent of the original problem and the surgery required to correct it, can extend from hip to hip.

Are you a candidate?

The best candidates for abdominoplasty are men or women who are in relatively good shape but are bothered by a large fat deposit or loose abdominal skin that will not respond to diet or exercise. The surgery is particularly helpful to women who, through multiple pregnancies, have stretched their abdominal muscles and skin to the point where they can not return to normal. Loss of skin elasticity in older patients, which frequently occurs with slight obesity, can also be improved. Bariatric surgery-a relatively new surgery for the treatment of obesity-leaves many individuals with a great deal of excess and lax skin necessitating specialized forms of abdominoplasty and other body contouring procedures.

If you intend to lose a lot of weight you should delay the surgery until you reach your goal weight. Women who plan future pregnancies should wait, as vertical muscles in the abdomen that are tightened during surgery can separate again during pregnancy. If you have scarring from previous abdominal surgery, you may not be a candidate for an abdominoplasty or may be cautioned that your scars could be unusually prominent.

What are the different types of abdominoplasty?

During your initial consultation, your surgeon will evaluate your health, determine the extent of fat deposits in your abdominal region, and carefully assess your skin tone. Be sure to tell me if you smoke and if you are taking any medications, vitamins, or other drugs.

If your fat deposits are limited to the area below the navel, you may require a less complex procedure called a mini abdominoplasty, also know as a mini-tummy tuck. You may, on the other hand, benefit more from modified, standard, or extended abdominoplasty.

Can you have abdominoplasty and other procedures simultaneously?

The recommendations may depend on the type of abdominoplasty that is best for you. Generally it is not recommended to undergo any other procedure in conjunction with a standard or extended abdominoplasty. With a mini or a modified abdominoplasty, Liposuction can be safely performed to remove fat deposits from the hips, for a better body contour.

What will the recovery period be like after surgery?

For the first few days, your abdomen will probably be swollen. You are likely to feel some discomfort that can be controlled by medication. Depending on the extent of the surgery, you may be released within a few hours.

You will be given instructions for showering and changing your dressings. Although you may not be able to stand straight at first, you should start walking as soon as possible. Surface stitches will be removed in four to seven days, and deeper sutures, with ends that protrude through the skin, will be removed in two weeks. The dressing on your incision will be covered by a support garment.

Will incisions be visible?

Your scars may appear to worsen during the first three to six months as they heal. This is normal. Expect it to take nine months to a year before your scars flatten out and lighten in color. While they will never disappear completely, abdominal scars will not show under most clothing, even under bathing suits.

What is the surgery like?

Standard and extended abdominoplasty usually takes two to five hours, depending on the extent of work required. Mini and modified abdominoplasty may take an hour or two. Most commonly, as with standard and extended abdominoplasty, the surgeon will make a long incision from hipbone to hipbone, just above the pubic area. A second incision is made to free the navel from surrounding tissue. With mini abdominoplasty, the incision is much shorter and the navel may not be moved, although it may be pulled into an unnatural shape as the skin is tightened and stitched.

Next, the skin is separated from the muscles. These muscles are tightened by pulling them close together and stitching them into their new position. This provides a firmer abdominal wall and narrows the waistline. The skin is then stretched down and the extra skin is removed. A new hole is cut for your navel, which is then stitched in place. Finally, the incisions will be stitched, dressings will be applied, and a temporary tube may be inserted to drain excess fluid from the surgical site.

In mini abdominoplasty, the skin is separated only between the incision line and the navel. This skin flap is stretched down, the excess is removed, and the flap is stitched back into place.

Are the effects permanent?

The effects of all types of abdominoplasty are permanent. Following complete healing, you will be able to return to full and normal living.

Abdominoplasty, whether mini or standard, produces excellent results for patients with weakened abdominal muscles or excess skin. In most cases, the results are long lasting if you follow a balanced diet and exercise regularly.

What are the risks of abdominoplasty?

Thousands of abdominoplasty procedures are performed successfully each year. Risks are always associated with surgery and specific complications may occur. Postoperative complications such as infection and blood clots are rare. Infection can be treated with drainage and antibiotics. You can minimize the risk of blood clots by moving around as soon after the surgery as possible.

Poor healing, which results in conspicuous scars, may necessitate a second operation. You can reduce your risk of complications by closely following your surgeon’s instructions before and after the surgery, especially with regard to when and how you should resume physical activity.

How do you prepare for surgery?

You will receive specific instructions on how to prepare for surgery, including guidelines on eating and drinking, taking or avoiding certain vitamins and medications, and not smoking. If you smoke, you must quit at least two weeks before your surgery and do not smoke during the postoperative recovery period because smoking can inhibit your ability to heal. Avoid overexposure to the sun before surgery, especially to your abdomen, and do not go on a stringent diet. If you develop a cold or any type of infection, your surgery will probably be postponed.

Whether your surgery is performed on an outpatient or inpatient basis, you should arrange for someone to drive you home after your surgery and to help you out for a day or two after you leave the surgical facility.

Where is the procedure performed?

Most patients choose to perform their surgery in an outpatient surgical center or an office-based facility; some patients prefer a hospital.

What will the recovery period be like?

It may take weeks or months before you feel like your old self again. If you start out in top physical condition with strong abdominal muscles, recovery from abdominoplasty will be much faster. Some people return to work after one week, while others require two or three weeks to rest and recuperate. Exercise will help you heal better. Even people who have never exercised before should begin an exercise program to reduce swelling, lower the chance of blood clots, and tone muscles. Vigorous exercise, however, should be avoided until you can do it comfortably.