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The Lowdown on Tummy Tucks


  • What is a Tummy Tuck?

Dieting and the exercise are great, however most of the time it cannot get rid of the tummy pouch; that results from a lifetime of weight fluctuations or pregnancy. Factors such as multiple pregnancies and genetics can contribute to the development of loose skin, fat deposits, and stretch marks in the abdominal region. The changes that occur to the body – in the mid-section with one pregnancy, let alone multiple pregnancies can contribute to a lot of damage. Sagging skin, stretch marks and even muscle separation in the abdominal area is very common after a pregnancy.

A tummy tuck procedure applies to both men and women alike and is one of the most common plastic surgery procedures, as any substantial weight loss can contribute to the development of loose skin in the abdomen. Even with proper diet and exercise, sometimes the abdomen will appear disproportionate with the rest of the body. The procedure can improve the appearance of excess abdominal fat, skin and tissue in any healthy adult.



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A Full Tummy Tuck or Abdominoplasty works by removing loose skin, fat deposits, and stretch marks from the abdominal region. A tummy tuck cannot correct stretch marks per se, 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 procedures can be performed alone, but are often performed with liposuction to further improve body contours. Vertical abdominal muscles that have been stretched and weakened over time are tightened restoring a much firmer, flatter abdomen. A full tummy tuck incision is normally made in the shape of a “smile” that goes from hip to hip. If there is sagging skin that extends up to or above the belly button, it can only be corrected by an additional incision around the navel. When the skin around the navel is released, the upper abdominal skin is pulled downward, and a new opening for the belly button is created. The surgeons do this so that the tightened skin of the abdominal area appears more natural.



                  Copyright 2010 -British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS)


The most important thing to remember with a tummy tuck is that it should not be considered as a treatment for obesity, or a substitute for proper diet and exercise. Ideally, the patient needs to be in good physical health and at a stable weight, have realistic expectations, and preferably be a non-smoker to undergo this surgical procedure.

Future pregnancies and substantial changes in weight following a tummy tuck, as well as some of the scars from prior surgeries can and do affect the longevity of the treatment. There are many plastic surgeons that will not do this procedure on patients who have not remained stable at their weight for more than six months.




A tummy tuck is used to correct diastatsis, a condition where the abdominal wall muscles (rectus abdominus) have separated. The most common reason these muscles become weakened or separated is multiple pregnancies. Many women have some degree of this condition and don’t even know it. In some women who have never been pregnant, there can be a ‘bulge’ in the lower abdomen (from the belly button down) due to muscle separation that will not be closed with exercise. Exercise tends to only strengthens the muscle. Surgery closes the separation and flattens the abdomen.

The procedure of abdominoplasty is done with the skin and fat layers that lie above the abdominal wall, and they are separated from the wall by using a cautery device. The tissue is then lifted upward toward the rib cage to expose the abdominal muscles. To tighten the abdominal muscles, the surgeon then will suture the abdominal muscles, pulling them closer together, which creates a flatter, firmer abdominal wall and a slimmer waistline.

The replacement of skin and also the new navel position is completed by stretching the layer of skin and fat so that this is lifted away back tightly over the abdominal wall. The navel will remain intact and attached to the abdominal wall. It is then covered by the new layer of skin when it is pulled back into place. The surgeon will make an incision through the layers of skin and fat to create a new hole for your navel. The excess skin and fat that hangs beyond the original incision line will be removed and discarded.

The incision closure for a tummy tuck will more than likely include drainage tubes. These drains will remain in place for approximately two to three weeks. The incisions will be sutures and dressings and bandages will be applied.

Full Tummy Tuck results will take several weeks into months until you see the final end outcome. Most patients are able to return to work in one to three weeks time, however it may take several weeks until you feel you are able to return to full normal activity level – including heavy lifting and strenuous exercise. You will have a permanent scar, which will fad over time. It is important to realize that if you become pregnant or experience substantial weight gain or loss, the results from your procedure may be compromised. Proper diet and exercise and with maintaining your weight, this procedure (tummy tuck) can last several years.







                                                Copyright 2010 ADAM, Inc. - Used with permission



                                       Copyright 2010 ADAM, Inc. - Used with permission






  • Candidates for Abdominoplasty

A good candidate for Abdominoplasty or Tummy Tuck Surgery:

  • Has realistic expectations with the surgical outcome
  • The patient is emotionally stable for surgery
  • The patient fully understands the risks of abdominoplasty surgery
  • Ideally, the patient should be close to their ideal body weight (within 30%)
  • The patient’s weight has been stable for at least 6 months or more
  • Has specific areas of loose skin or fat that is completely incapable of responding to diet  and  exercise
  • Skin tone and elasticity are in good shape



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Types of Abdominoplasty Procedures

Various types of Abdominoplasty / Tummy Tuck Procedures



Also know as “The Scar-less Tummy Tuck” involves the tightening of the abdominal muscles and the removal of small amounts of fat. No skin is removed. This is the only tummy tuck procedure that involves no skin being removed. This procedure is minimally invasive and has a fewer side effects, including less scarring, swelling and bruising. Also, it has the less recovery time. The endoscopic tummy tuck is a version of the mini tummy tuck which requires the use of an endoscope (a lighted tube with a camera on the end of it) and scars are minimized in this procedure. Because there is less bleeding and trauma done with this procedure, the recovery is shorter compared to regular abdominoplasty.




The Traditional Tummy Tuck or Full Tummy Tuck is mainly concerned with the flaws in the entire abdominal area both above and below the navel. This procedure is performed under general or twilight anesthesia, and can last anywhere from two to five hours. The traditional Tummy Tuck is the most commonly performed surgery. Traditional tummy tucks are most commonly combined with abdominal liposuction.

Full tummy tuck procedures typically require two incisions. The surgeon will make an incision just above the pubic area that spans from one hip bone to the other. The length of the incision and its shape will depend on the extent of treatment as well as the contours of your body. While the surgeon will attempt to place the incision so that it is hidden by a bathing suit or undergarments, it is important to realize that you will have a permanent scar. A second incision is usually made around the navel. Hospital stays can depend on the extent of the surgery, anywhere from a few hours to several days.




                                        Copyright 2010 ASAPS - Used with permission

                                    Full Abdominoplasty / Tummy Tuck Incision Line                





The plastic surgeon concentrates on the area below the navel. Patients who are within 10 percent of their ideal body weight are the perfect candidate for this procedure. A smaller amount of skin is removed with a mini tummy tuck, and the navel is left intact. A mini tummy tuck is definitely less invasive than a full abdominoplasty.  The surgeon will determine the length of the incision needed based on the individual's own body.

The length of the incision involved in a mini tummy tuck will depend on the amount of skin to be removed, but will subsequently be smaller than the incision required by a traditional tummy tuck. Liposuction is commonly added with this procedure to sculpt the area more definitively. This procedure can be performed under both general anesthesia and or a local with sedation. However because this procedure is less invasive, normally most patients will receive twilight or a local with sedation.




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                                Mini Tummy Tuck Procedure with No Muscle Repair

                                                                 10 Days Post Operative




The Extended Tummy Tuck is an expanded abdominoplasty procedure. The plastic surgeon removes excess skin from the patient’s sides and improves muscle laxity at the flank (or love handles) and hip region. This procedure is offered to those patients who have substantial weight loss and are trying to restore the tone back into these areas. Extended tummy tucks can remove excess skin sometimes weighing several pounds. Patients who have a significant amount of fat and skin in the flank, upper hip, and lower back regions are ideal candidates for this procedure. The incision goes from the entire length of the abdominal area to the hips.

The plastic surgeon tightens the exposed muscles and creates a new navel to match the patient’s new body shape. Because of the extent of the surgery and the amount of tissue that was cut away, surgeons usually require that patients remain in the hospital to recover for at least one day. Drainage tubes are placed under the patient’s skin to prevent the accumulation of fluid and to allow the incisions to heal properly.








A Circumferential Abdominoplasty is performed when there has been a massive weight-loss

(mostly commonly from gastric bypass surgery), leaving an apron of loose skin around the entire patient’s torso. This procedure is commonly called a Lower Body Lift. In this procedure, the surgeon will make an incision that will extend all around the entire waist line, in which they will remove excess skin and fat – and tighten the muscles. The outer thighs and buttocks are lifted. Liposuction is commonly used to re-contour the figure from the ribs to the knees.

circumferential tummy tuck can take as long as three to five hours to complete, and requires a much longer recovery period than a traditional tummy tuck procedure. This procedure can require a hospital stay of two to four nights following the procedure, and there will be drainage tubes to keep fluid from accumulating.




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After Massive Weight-Loss

  • Options for patients with massive weight-loss

Increasing numbers of people are losing massive amounts of weight – 100 pounds or more – with surgical assistance. But what many don’t realize is that gastric bypass is a minor surgical procedure compared to the reconstruction some need after losing all that weight. Excess weight stresses and stretches the skin dramatically. Rapid weight loss does not allow skin to conform to the new body size and shape. The result is excess hanging skin that can only be corrected through surgical body lifts. It is not just an appearance issue for some. Sagging loose skin may become macerated (wet and infected) if not removed, possibly turning into a serious health problem.

After massive weight loss, even young patients with good skin quality may need a lift. Procedures sometimes are staged over many months for comfort, health and safety. Plastic surgeons want their patients to have a safe operation and get through the procedure with minimal risk. The most important thing to remember is not to expect perfection, as with any uplifting procedure there will be visible scarring, and not all contours will be perfectly smooth, symmetrical and proportionately balanced. But to most patients who have undergone massive weight loss, this does not deter them. Massive weight loss patients have the ability to accept scars where they might not have ever considered them before – simply because they want a better shape.



A Panniculectomy is often confused with a tummy tuck – reduces excess skin and fat which hang below the abdomen like an apron. The degree of overhang can be moderate, with the folds hanging down to just above the public region, or much more severe; such as low as the knees, over the hips, and around the back. A tummy tuck is performed on people of relatively normal weight, but a panniculectomy can be performed on patients with weight ranges from normal to severely obese, and who have lost significant weight.

An incision is made from the lower area below the navel to the pubic bone. Another horizontal incision is made at the pubic area where the excess fat and skin can be removed. The skin remains is then pulled together and closed. The reduction of excess fat and skin through panniculectomy can greatly improve quality of life for many patients with these conditions interfering with everyday life, such as walking, standing, or even sitting. The health issues that are caused by this excess skin include back problems, rashes, ulcers and many different skin disorders.

The procedure is often performed under general anesthesia and requires a hospital stay, typically ranging from one day to one week. Insurance coverage for the cost of the panniculectomy varies. If the procedure is strictly for cosmetic reasons, insurance will not cover the procedure. However, the insurance carrier may cover all or a portion of the costs if medical conditions are correlated with excessive weight loss.







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