Tummy Tuck

Why have a tummy tuck? 

It is important to be aware that a tummy tuck is not a type of weight loss surgery. It is therefore not an appropriate procedure for you if you are seeking to lose more weight. The ideal tummy tuck candidates include patients who have a stable weight and are looking to remove stubborn fat and skin that they cannot remove through exercise and diet alone.
Ideal tummy tuck candidates include those who: 

• Are not happy with the look of their abdomen
• Want to remove excess skin or fat from their abdomen
• Have loose or weak abdominal muscles that need tightening
• Are not currently pregnant or planning a future pregnancy.

Before you consider having a tummy tuck, you must make sure that you are:

• Physically and emotionally fit for surgery
• Not smoking or using nicotine products for at least 6 weeks before the operation
• Willing to adopt a healthy diet and do regular exercise to maintain results after surgery
• Expecting realistic goals from your operation.

Who is not suitable for a tummy tuck?

Weight loss

As tummy tuck surgery is not a procedure that aids weight loss, surgeons only recommend this operation for patients who have stubborn fat or excess skin that cannot be removed through exercise or diet alone. You should be aware that major weight loss or weight gain after the operation may affect the results of the procedure. We, therefore, recommend that you reach an optimal and stable weight before you have your tummy tuck.

Pregnancy

If you are a woman who is planning on becoming pregnant, tummy tuck surgery may not be suitable for you until after you complete your family. This is because the surgery will involve tightening of the abdominal muscles, which will stretch during pregnancy. Therefore having a pregnancy after a tummy tuck will stretch the muscles back to their pre-surgery state. This will also put you at a greater risk of developing a hernia if you were to become pregnant.

How is a tummy tuck procedure performed?

A tummy tuck procedure often lasts between 2 to 4 hours. Before you have your procedure, you must follow the advice given for eating, drinking and taking medications the night before. The procedure involves the following steps:

1. Consent form

Before or on the day of your surgery, you will be given a consent form to sign by your surgeon and anaesthetist. After you have given consent, your surgeon will draw lines on your abdomen and discuss the goals of your tummy tuck.

2. Anaesthesia

Before your surgeon starts, your anaesthetist will give you your anaesthetic. This is usually a general anaesthetic but may also be a local anaesthetic with IV (intravenous) sedation.

3. Incisions

There are several tummy tuck techniques that your surgeon may use. Your surgeon will choose which technique is most appropriate for you. The incisions made depend on the type of tummy tuck you have. There are four different procedures that are currently used for tummy tuck surgery:

• Full abdominoplasty
• Mini (modified) abdominoplasty
• Endoscopic abdominoplasty
• Fleur-de-Lis abdominoplasty

A full tummy tuck procedure involves making two different incisions:
1. The first one is made around the belly button.
2. The second one is made along the bikini line, from one hip to the other.
This is the ‘classic’ tummy tuck technique that targets both the upper and lower abdomen. The surgeon will tighten the abdominal muscles and remove excess skin and fat. It is most suitable for patients who have recently lost a great deal of weight or women who have excess, stubborn fat and weak muscles after pregnancy.
A full tummy tuck is not suitable for patients who are planning a future pregnancy as the pregnancy will re-stretch the muscles and reverse the results of surgery.
Although a full abdominoplasty causes a large amount of scarring, it allows for a greater improvement in shape than a mini or endoscopic tummy tuck.

A mini tummy tuck mainly targets the lower abdomen. Your surgeon will make a single incision line made across the bikini line (smaller than in a full tummy tuck). There is no scar around the belly button but your surgeon may stretch it to a different shape. Surgeons use this technique when only a small amount of excess skin and fat needs removal. The surgeon may or may not tighten the muscles, depending on necessity. While not ideal, it is a more suitable option for women planning a future pregnancy but as pregnancy will stretch abdominal muscles, you may need revision surgery if you give birth after the procedure. A mini tummy tuck causes a smaller amount of scarring than a full tummy tuck, however the final results are not as effective.

For an endoscopic tummy tuck, you surgeon will make several small incisions in the following areas:

1. Around the pubic line and
2. Around the base of the belly button.

The surgeon then uses a small camera called an ‘endoscope’ with small surgical instruments attached to perform the procedure.
This technique is the least invasive and is most suitable for patients with a protruding abdomen and a small amount of excess skin.  It is the best option in patients for whom muscle tightening is the main goal.
This technique causes very minimal scarring that you can easily conceal.

The three incisions made in a Fleur-de-Lis tummy tuck include:

1. Around the belly button
2. Across the bikini line, from one hip to the other
3. Vertically down the middle of the stomach.

This technique is the most extreme type of tummy tuck and is not often used. It is most suitable for patients who have lost a very large amount of weight, resulting in large amounts of excess skin. This can be a result of having weight loss surgery such as a gastric bypass. This type of tummy tuck causes a large amount of scarring but allows for the greatest amount of improvement.

3. Closure of incisions

After your surgeon removes the excess skin and fat and tightens the muscles, they then close the incisions. They will apply some tape and strapping to the stomach. They may also insert some drains to help reduce swelling and bruising.

4. Return to the ward

Finally, you are taken back to the ward to recover from the anaesthetic. You should be able to go home after spending 1 to 3 nights in hospital. It may take 6 to 8 weeks for the swelling and bruising to go down before you can appreciate the full cosmetic results of your procedure. Your surgeon will discuss the different techniques with you and will suggest which procedure will achieve the best results for your body. Their choice will depend on a number of factors including:

• The amount of excess skin and fat on your abdomen.
• The elasticity of your skin.
• The tone of your underlying muscles.
• Your own desired outcome.

It can be difficult for you to determine which kind of tummy tuck procedure is right for you. Your surgeon will discuss which procedure will achieve the best results possible.

What should I expect during my consultation?

You will meet your surgeon for a tummy tuck consultation which will usually last 15 minutes to an hour. During this consultation, your surgeon will discuss all aspects of the surgery and answer any questions you may have. 
When assessing which tummy tuck technique is most suitable for your body, your surgeon will consider the following:

• The amount of excess skin and fat you have
• Your skin’s elasticity
• The tone and strength of your stomach muscles
• All past and current medical conditions you have
• If you are planning to become pregnant in the future.

After your surgeon has taken your medical history, they will also take some photographs of your abdomen for your medical record. They will then discuss the following:

• Your goals for the procedure
• The risks and complications of a tummy tuck
• The likely outcome of your surgery
• Your current use of medications (including prescribed, over-the-counter and herbal drugs)
• Your smoking, alcohol and recreational drug use
• Any previous surgeries you have had.

Questions to ask during your tummy tuck consultation

Your consultation time is the best opportunity for you to be as honest as you can be with your surgeon. You should be candid about what you would like to achieve from surgery. This will allow your surgeon to explore if this is possible or not.
Some important questions you may want to ask your surgeon include:

• Am I a good candidate for a tummy tuck?
• Do you think what I want to achieve is realistic?
• What can I do to get the best results?
• How will my results change over time?
• Do you have before and after pictures from previous tummy tuck procedures you have done?

Our surgeons want to help you achieve the best possible results from your tummy tuck. Being honest during your consultation will help them to do this.

What are the main tummy tuck risks?

It is important to educate yourself on the potential tummy tuck risks and complications. This will make sure that you make a fully informed decision before having your surgery. The following tummy tuck risks and complications include:

General surgical & anaesthetic complications

All surgeries carry some common risks. These include (but are not limited to): blood clot formation, vomiting and nausea, blood loss, infection and problems with anaesthesia. You will be made aware of all the possible risks before you have surgery, and every effort will be made to prevent any complications occurring.

Seroma

A seroma is a pocket of fluid that builds up under the skin. This usually develops under or around the incision site. To reduce the risk of a seroma developing, your surgeon may place drains in the abdomen to drain excess fluid build-up. If your surgeon keeps these in place after the surgery, they will give you specific instructs on how best to take care of them.

Bleeding, bruising & haematomas

You should expect to experience some minor bruising and bleeding after the surgery. In some cases, you may experience more excessive bleeding. Any major bleeding usually happens during the procedure, and your surgeon to resolve it right away. However, it can occasionally occur a few weeks later. If this does happen, you may need to have further surgery. With time, things should settle down and it is unlikely to  affect the results of your surgery.

Tissue, skin or fat necrosis

During a tummy tuck procedure there may be some disruption to the blood supply in certain areas. This can result in a loss of blood supply to the skin, fat and tissues in and around your stomach. If the disruption is large enough, it may result in ‘necrosis’, which is the death and loss of tissue, skin or fat.
Depending on the amount of tissue that is affected, the damage may resolve itself within a few weeks or you may need to have further minor surgery to remove the dead tissue. 
Smoking increases the risk of necrosis occurring. It is for this reason that we strongly recommend that you stop smoking at least 6 weeks before and after surgery.

Infection

You must take infections seriously if they occur. They are often mild wound infections that your surgeon can treat with a short course of antibiotics. Rarely, the infection can spread and become more severe. If this occurs, you may need to go back into hospital for treatment.

Aesthetic

There is always a risk that you may be unhappy with the aesthetic results of your surgery. We therefore advise patients to choose their surgeon carefully and make sure he or she fully understands your expectations.

Changes in skin sensation (nerve damage)

There may be some damage to the nerve supply in the abdominal area during a tummy tuck. This may cause you to feel an increase or decrease in sensation in certain parts of your stomach, or (rarely) upper thighs. You may also feel strange sensations such as tingling or burning. These changes are often temporary and should resolve a few months after the procedure. They can, however, become permanent. 

Scarring

Scarring is an inevitable outcome of all types of tummy tuck procedures. Where possible, your surgeon will place incision lines in areas that are less visible. Some patients may experience more severe scarring such as keloid or hypertrophic scars. These patients however, are often aware of this prior to surgery.
Your surgeon can give you specific advice regarding how you can reduce the appearance of your scars.
Choosing a highly experienced and skilled surgeon will reduce the risk of developing any of the above complications. This is one of the reasons why it is important to choose your surgeon carefully. It is essential that you follow your surgeon’s pre and postoperative advice to further reduce the risk of complications.

How can I prepare for a tummy tuck?

A tummy tuck procedure is a major surgery and it will, therefore, take some time before you fully recover. It is therefore sensible to think about your tummy tuck preparation before you go in for your procedure. You should allow yourself enough time to rest and heal after your surgery. 
Below you can find some tips for your tummy tuck preparation:

Household chores

It may be useful to get household chores such as laundry and taking the bins out of the way before you have your operation. You may want to place hard to reach cupboard items such as mugs and plates on the kitchen counter so that you do not strain your incisions by trying to reach for them.
As you will not be able to do any heavy lifting straight after the operation, you may want to do a big grocery shop beforehand and prepare some meals for the freezer.

Children & pets

As you will need to rest well after surgery, you should ask friends and family to help look after children and pets during your recovery period.

Diet

Maintaining a healthy diet will help you during your recovery. Try to eat high-protein, low-sodium foods including lots of vegetables and fruits. Hydrate your body well by drinking lots of water and avoiding drinks with caffeine.

Clothing

Wear comfortable, easy to wear clothing during your recovery. Choose shirts that fasten easily from the front or the back, easy to pull on trousers and slip on shoes. You will have to wear a compression garment after your tummy tuck procedure. The instructions for this including how long to wear it for will be given to you by your surgeon.

Sleep

You will need to get plenty of rest after your operation. It may be comfortable for you to sleep propped up for the first few days after surgery, so make sure to have plenty of extra pillows on your bed! Try to rest and sleep on your back in an inclined position for 1 to 2 weeks after your operation. It is also important that you do not sleep on your stomach for the first 6 weeks after your tummy tuck.

Travel arrangments

As you will not be able to drive straight after your surgery, you should arrange for a family member or friend to take you home after the operation. Your Avrupamed patient care adviser can also help you with travel arrangements!

Your surgeon will give you specific advice regarding how best to prepare for a tummy tuck.

What can I expect after a tummy tuck?

Your surgeon will give you details regarding what to expect after you have your tummy tuck procedure. It is very important that you follow their specific tummy tuck aftercare advice.

What happens after a tummy tuck?

You will need to spend 1 to 2 nights in the hospital for close monitoring. Before you go home, your surgeon will arrange an appointment so you can return within a few weeks to have your stitches removed (if they are not dissolvable). You may not be able to drive for 5 days to 2 weeks after your surgery, depending on your surgeon’s advice. You must, therefore, arrange for someone to take you home after your surgery.

General care

It is very important that you follow the tummy tuck aftercare instructions given by your surgeon, including specific advice on how to take care of any drains you are sent home with. To reduce the risk of blood clots developing, you should start light walking as soon as possible. Surgeons also recommend that for the first few days after surgery you remain flexed at the hips and avoid straightening your torso. This will prevent you from placing extra strain on your surgical incision sites.

Showering & bathing

Your surgeon will give you specific advice on when you will be able to shower and bathe after your surgery. Some surgeons may allow you to shower right away, whilst others may ask you to wait up to 48 hours after surgery. 
After washing, please dry your stitch lines carefully with a towel or hair dryer. You should also avoid hot tubs and saunas for at least 4 weeks.

Scar care

When it comes to scar care, there are a number of techniques that your surgeon may recommend that can aid the healing of your scars following surgery. These include:

1. Massaging your scars – if your surgeon recommends this, you should start only after your incision fully heals and your scab disappears on its own.
2. Silicone sheets, gels or creams – use this on your scar for 6 months to 1 year once it has fully healed. 
3. Keep the scars out of the sun and use a high factor sunscreen. This helps to avoid skin colour differences and protect the damaged skin.

Going back to work

If you have a desk job, surgeons often advise that you take at least 2 weeks off work. If your job includes physical activity, e.g. waitressing, the usual advice is to take at least 3 to 4 weeks off work.
In any case, you should try to avoid even light duties for at least 2 to 4 weeks.

Sports & exercise

Your surgeon will tell you when you are able to resume your regular sports and exercise again. However, in general, we recommend the following:

Weeks 1 to 2

We recommend that no exercise is done during this period as even minor aerobic activities may cause swelling. You should, however, take light walks to prevent blood clots forming. We also advise that you avoid sexual activity for at least 2 weeks as this can also increase swelling and bruising.
Make sure that you do not raise your arms above your shoulders, push anything or lay on your stomach.

Weeks 2 to 4

After 2 weeks, you should be able to resume very light cardio activity such as walking on a treadmill.

Weeks 4 to 8

After 4 weeks, you may resume more vigorous activities such as cycling, but nothing that involves heavy lifting or contact sports.

After 8 weeks

8 weeks after you have your tummy tuck procedure you should be able to resume all sports and activities.

Post-operative garment

An important part of your tummy tuck aftercare involves wearing a post-operative compression garment. This is a tight corset that must be worn around your abdomen to help reduce swelling after surgery. Your surgeon will give you very specific advice regarding how long to wear your garment for, but most surgeons require you to wear it day and night for 4 to 6 weeks, only removing it to bathe.

Final results

It will take some time before you are able to see the final results of your surgery. You will have bruising and swelling around your abdomen for the first 6 to 8 weeks. Once all the swelling and bruising settles, you can begin to see the full, permanent results of your tummy tuck. However, you should be aware that it can take 6 to 9 months before everything completely settles.
In order to preserve the results of your surgery for as long as possible, it is important to try your best to maintain a stable weight through regular exercise and a healthy diet.

Tummy tuck FAQs

It is important that you get answers to all the questions you have about treatment so that you can make a fully informed decision. This tummy tuck FAQs page answers some common questions patients have.

What effect can taking recreational drug use have on my tummy tuck?

Smoking, having a large BMI, drinking large amounts of alcohol and taking drugs or medications are all factors that can increase the risk of complications occurring during and after surgery.
Smoking in particular can delay the time it takes for your wounds to heal, and therefore increase the risk of developing wound infections. You must therefore stop smoking for a minimum of 6 weeks before and after your operation.

Do I need a GP referral for a tummy tuck?

You do not need a referral from your GP to have a tummy tuck. Your surgeon may however, contact your GP so that they can get your full medical history from them.

How long after pregnancy must I wait before having a tummy tuck?

Surgeons usually recommend that you wait 6 months after pregnancy before having an abdominoplasty. This is because it can take around 6 months for the stretched abdominal muscles to recover after childbirth.

Can I get pregnant after having a tummy tuck?

You should complete your family before you consider having a tummy tuck. This is because a pregnancy will re-stretch the muscles that your surgeon tightens during the procedure, therefore reversing the results.

What effect will weight gain or weight loss have on the results of a tummy tuck?

The aim of a tummy tuck is to remove excess fat and skin that you cannot remove through exercise and diet alone. It is not a treatment to aid weight loss and you must therefore reach your optimal weight before having surgery. Excessive weight loss after the operation will produce excess loose skin which can negatively affect the results of surgery.
Similarly, excessive weight gain after a tummy tuck will stretch the abdominal skin and muscles. This will result in loss of the muscle tone and firmness that was achieved with surgery, thereby affecting the long-term aesthetic results of the procedure.
The effect this has depends on the amount of weight that you lose or gain, but minor changes should not affect the results.

Are the results of a tummy tuck permanent?

As we grow older our bodies continue to change and our skin continues to lose its elasticity. Despite this, the results of a tummy tuck should last many years. The results will last longer if you avoid pregnancy and major weight changes.
Your Avrupamed surgeon will do their best to achieve the best, most long-lasting results possible.

Will a tummy tuck get rid of stretch marks?

Depending on which procedure you have, the tightening of the abdominal muscles and excision of excess skin may reduce the appearance of stretch marks in some patients, however this is not the aim of surgery. You must therefore not expect this to happen.

What will happen to my belly button after a tummy tuck?

In every case, you will keep your original belly button. However, particularly when having a full abdominoplasty, it will be necessary to create a new hole at a higher part of the torso skin. This may result in your belly button going in a higher position than before.

Will liposuction be included in my tummy tuck?

The use of liposuction during a tummy tuck can help contour the shape of the abdomen. Some surgeons choose to include liposuction in their procedures and some choose not to. This choice will depend on your personal needs and on the surgeon’s regular practice. It is worth asking your surgeon if they will include liposuction.

If you have any further questions that do not appear in this tummy tuck FAQs page, give one of our patient care advisers a call so they can help answer them for you.