Sometimes skin and abdominal muscles become overstretched due to weight gain, weight loss, pregnancy, prior surgery or some other reason, and exercise and weight loss alone are not enough to give someone the appearance they desire. The purpose of the “tummy tuck”, also known as an abdominoplasty, is to tighten the musculature of the abdomen, remove excess skin (and sometimes fat) to give an appearance of a smaller, firmer, waist and abdomen. A tummy tuck is not alternative to weight loss, rather it is a way to tighten and firm the abdominal tissue which has been overstretched, though sometimes removal of some excess fat is part of the procedure. Overall, most patients are very satisfied with the results of a tummy tuck and see a significant improvement in their appearance.

What do I need to consider before seeing a Cosmetic or Plastic surgeon?

When you visit a surgeon to discuss a tummy tuck, you will need to discuss

• your past medical and surgical history
• what medications, if any, you are currently taking
• any allergies or bad reactions to medicines you have had in the past
• your goal for the surgery and what you are expecting from the tummy tuck
• the cost of the procedure

You will need to discuss what your expectations are with the surgeon, and he or she will tell you whether or not they are realistic.  The surgeon will take pictures of your body and will probably order some pre-operative tests such as an electrocardiogram (EKG) and blood tests.  Based on your health and your goals, the surgeon will tell you if you are a good candidate for the surgery.  The cost of a tummy tuck varies, but it is generally between $6000 – $12000. The tummy tuck cost will depend on the extent of the tummy tuck procedure and the renown of the surgeon performing the operation.

What does a Tummy Tuck involve?

Tummy tucks vary in how extensive they are; some may involve removing excess fat and skin from the hips using liposuction, and others are more minimal depending upon what the patient and surgeon agree will give the best result.

Tummy Tuck Surgery

The procedure will generally involve a horizontal incision in the skin across the lower pelvis and an incision around the umbilicus (belly button).  The length of the incision will depend upon how extensive the surgery will be. Underneath the skin, a vertical incision in the abdominal muscles is made in order to bring them together and tighten them.  The incisions are sutured, a compressive bandage is applied, and usually a tube is placed going from the wound to outside the body to enable the drainage of blood and fluid which accumulate in the post operative period.

What are the possible risks with having tummy tuck surgery?

It is important to understand that the tummy tuck is not considered a minor surgical procedure.  It almost always requires full general anesthesia, and will generally require bed rest and pain relief medication during the tummy tuck recovery period.   In terms of avoiding a complication following surgery, the overall health of the patient is important and whether or not they are a smoker.  As with all surgical procedures, there are inherent risks.

Some, but not all, of the possible risks are:

• infection
• wound healing problems
• numbness around the incision area
• excessive scarring or keloiding (hypertrophic scarring)
• blood or fluid accumulation under the wound
• difficulty controlling the post operative pain
• possible need for a revision surgery
• complications from the anesthesia
• blood clots, which can lead to a clot in the lungs called a pulmonary embolus

The best way to minimize the chances of these complications is:

• to be in generally good health prior to the surgery
• to give an accurate medical history to your surgeon
• if you smoke, to abstain from smoking prior to and after the surgery
• to choose a reputable surgeon
• If you have diabetes it will be important to keep strict control of your blood sugars after surgery since this can affect wound healing.

What are important factors in choosing a surgeon, and what should I ask the surgeon?

The cosmetic outcome of the tummy tuck depends upon a number of factors, including:

• The skin tone of the patient
• How the patient’s body heals, or makes a scar (some people are prone to keloids)
• The extensiveness of the correction
• The skill and experience of the cosmetic surgeon

The patient should choose a cosmetic surgeon who can show credentials that they have had the proper formal training in this procedure and that they are experienced.

Some questions to ask the surgeon are:

• Approximately how many cases he or she has performed?
• What complications they have seen and how often do they occur?
• Is the surgeon board certified and have they had fellowship training in plastic surgery?

Tummy Tuck Recovery – what can I expect after surgery?

It would be unfair not to warn the patient that there can be a good deal of pain following the procedure, fortunately it can be well controlled with medications in most cases.

• You will need to take some pain relief medications in the first several days after surgery and sometimes longer.
• You will have bandages around the incisions and very likely a small tube coming out of the wound which is used to drain excess fluid and blood that accumulates in the healing period.
• The sutures and drain will be taken out at a follow up appointment with your surgeon.
• The anesthesia and the pain medications may cause some nausea and constipation.   If these are severe enough, there are other medications which can be used to control these symptoms.
• You will need to have someone drive you home from surgery or have some other mode of transportation available when you are discharged from the clinic or hospital.