Tummy Tuck or Abdominoplasty
A tummy tuck is a plastic surgical procedure to remove extra skin and fat around the waist or abdomen. It can be done as a stand-alone procedure, or combined with other cosmetic procedures, such as liposuction or body lift. When a mini tummy tuck or full tummy tuck is performed with a breast augmentation, it is sometimes called a Mommy Makeover. A tummy tuck can also include muscle tightening. The result is a smoother stomach with less excess fat and skin. A tummy tuck is also known as an abdominoplasty in the plastic surgery community.
Why Have a Tummy Tuck? What Can It Do?
What can a tummy tuck do? It can:
- Flatten the stomach.
- Firm the waist area.
- Change the way you look.
- Get rid of extra skin and fat.
- Tighten the abdominal muscles.
- Give a smoother stomach.
- Lessen the number of stretch marks you have.
- Make your waist be in proportion again.
- Create a dramatic change in your look.
Tummy tuck results are generally long-lasting. This is especially true for someone who follows a good diet and exercise routine.
There are other options that some people may consider as well. For example, liposuction alone may be an option for some people. This may be the case for someone who already has good skin tone and who is already a normal weight. In that case, just removing some fat can be a good option and a tummy tuck may not be needed. Small amounts of loose skin can also be treated with a laser. And of course, diet and exercise will reduce some body fat as well.
Each of these options has pros and cons and can create specific outcomes. Schedule a consult to discuss what option might be best for you.
Who Can Get a Tummy Tuck?
Anyone who has lost the shape or tone of the stomach may be a candidate. Both men and women are eligible to get the tummy tuck procedure. Having extra skin around the abs or extra fat near the belly button are two prime items that can be targeted. This is most often caused by aging, pregnancy, or weight loss, but it can also be from other surgeries, or even heredity.
The best result will be for someone who is already in good shape but can’t get rid of the last bit of fat and skin in the ab area with diet and exercise alone.
Most often, weight changes or pregnancies cause the stomach to change shape. These changes can lead to tears in the deeper layers of the skin—stretch marks. (Of course diet and exercise can help to improve the stomach tone, but these methods do not change the skin tone). People with stretch marks may benefit from a tummy tuck if the stretch marks are in the area of skin to be removed.
A tummy tuck is not well suited for some people. For example, for someone who plans to become pregnant soon, a tummy tuck would not be a good idea until after the pregnancy. Likewise, for someone who plans to lose a lot of weight, it is best to wait to have the procedure.
What to expect at the Tummy Tuck consult
When you call Dr. Brown to set up a consult, there will be several things to discuss and to review. Here are some tips:
- You will need to come prepared to talk about your medical history.
- You will asked about your goals for the tummy tuck.
- The exam will evaluate:
- How much loose skin is there?
- How much extra fat is there?
- What shape the muscles are in?
- If you are a good candidate, then the options will be discussed.
- You will have a chance to get your questions answered.
- You will get all of the relevant details like where to go, when to schedule it, how to prepare, and how much it costs.
Full Tummy Tuck vs Mini Tummy Tuck
Not everyone knows that there are more than one type of tummy tuck. You can get a mini tummy tuck, which is also called a partial tummy tuck. Or you can get a full tummy tuck, also called a complete tummy tuck. The right choice depends on each person’s situation: how much extra skin needs to be removed and how much muscle tone exists.
Full Tummy Tuck
When there is a lot of skin and fat to remove, the full tummy tuck may be the best option. Even within this option, there are variations. The exact procedure depends on whether the muscles get tightened at the same time as the skin and fat removal. This is a question because tightening the muscles is more extensive and takes longer to recover from. For someone who already has good muscle tone, it may be skipped.
In either case, an incision is made to access the stomach. This incision is used to change how the skin and muscles lay. The length varies and depends on how much is being changed. Scars from other surgeries (such as a c-section) can be used again. The belly button is moved as the extra skin is taken away. Another incision is used to separate the navel and the abdominal tissue.
Mini Tummy Tuck
A mini tummy tuck may be an option for someone who doesn’t have as much skin and fat to remove. Usually their excess skin and/or fat is just on the lower ab area. This option is ideal for someone who has needs a better result than liposuction alone can provide, but does not have enough excess skin and fat to require a full tummy tuck.
In a mini tummy tuck:
- the incision is shorter
- the belly button is not moved
- the naval tissue is not separated from the abs
- less (or no) muscle tightening is done
- only a small amount of extra skin can be removed
- the procedure is shorter
- the recovery is faster
- the mini tummy tuck risks are less
As a result, the change will not be quite as dramatic. The stomach will be tighter, but not as much as with a full tummy tuck.
Both Tummy Tucks Options
In both options, scars from other surgeries can be used again. The length of the scar depends partially on which surgery is being performed. It also depends on your body shape and how much skin and fat will be removed. The incision is usually across the body above the pubic area. It can be placed in such a way so that the scar is hidden by bathing suits or underwear. In fact, the incision location can vary quite a lot and can take into account personal preference. That said, once the incision is made, the scar will be permanent, of course. In either option, liposuction might be done at the same time.
How to prepare for Tummy Tuck
You will get detailed information on how to prepare in advance of your tummy tuck. For example, the information you receive will include guidance on:
- what can and cannot be eaten or drank before the surgery
- the need to quit smoking in advance of the procedure
- how medicines can affect the procedure, including vitamins
Besides the required steps to prepare, there are also actions you can do in advance to help improve the outcome and the recovery. For example, you should create good diet and exercise habits in advance. The healthy diet will help maintain an ideal weight. Exercise is a good habit in any case because:
- The heart will be stronger with regular exercise
- In the time right after the surgery, you will have limited activity. Weight gain can easily result during this time. However, if your metabolism is already humming along from a long-standing exercise routine, you will be less likely to gain weight during this period. This is also because increased muscle tone helps keep the metabolism up.
- Having an established routine makes it easier to start exercising again once you’re able.
- Strong abdominal muscles will help make the recovery easier.
- Active, healthy people tend to recover faster in general. They also have fewer complications and the best outcome.
In addition to exercise and having a good diet, there are other healthful steps you can take in advance of the tummy tuck that will improve the result:
- Quit smoking at least three weeks (and ideally four or more weeks) before the tummy tuck. Smoking increases your chances of having complications.
- If you don’t quit permanently, at least do not start smoking again for at least two weeks after the surgery.
- Don’t use nicotine patches or gum to quit. Unfortunately, these can lead to more complications with the procedure.
- Manage other medical problems before having a tummy tuck. It is advised to have a general health screening in advance to be sure you are ready.
Finally, there are a lot of things you can do that will make the recovery easier on yourself. Naturally many of these are all optional, but they may help make your recovery as simple as it can be.
- Plan to have someone with you who can drive you home after the procedure.
- If possible, plan to have someone stay at your home to assist you for the first couple days after.
- If you have children, arrange for child care for the first few days.
- If you have pets, make plans for someone to help take care of them as well.
- Have a welcoming environment that does not require much work on your part. This might include:
- Having the house cleaned in advance
- Having all of the laundry done in advance
- Placing often-used items in easy reach so that you won’t have to stretch or bend
- Pre-purchasing food that is easy to prepare—or food that does not require preparation
- Having your books, magazines, TV remote, movies, laptop, etc., all readily available
- Designating a place where you can relax and elevate the upper body. This might be a recliner or your bed with lots of extra pillows. You can also have extra pillows to put under your knees.
- Before your procedure, be sure to fill the prescriptions you were given
- Also buy all of the bandages and such that you will need during recovery. Have them at home before you go.
- You may not be able to wash your hair on your own right away after the surgery, so it would be best to do this before as well.
- On the day of the tummy tuck, wear something that is comfortable. It should be roomy and you should be able to open it from the front. The pants should also be comfy; something with elastic waist is ideal.
Another part of preparation is having realistic expectations. Every procedure has trade-offs. This one requires a long recovery time. It also will result in permanent scars. Be sure you know what you’re getting into and are comfortable with what to expect. Be sure to understand the risks of full tummy tuck.
Tummy tucks are not usually covered by insurance, nor are any complications that may result. The main exception is in the case of a hernia or if the muscles have spread. If you think your insurance may provide any coverage, you should check with them in advance. If your insurance does have any coverage, Dr. Brown can write a letter to them explaining the need for the procedure (if you are an exception as outlined above). Be sure to talk to Dr. Brown about any insurance-related issues.
Tummy Tuck Recovery
Much like preparation, you will get information on what to expect during recovery. There will be instructions to follow. These are crucial to ensure that you heal as fast as possible.
The actual recovery time will depend on the person and on the procedure. Some factors play a part:
- What shape you’re in
- What type of work you do
- How physically active you are
- Whether or not the muscles were tightened during the tummy tuck
- The skill of the plastic surgeon (this can affect how the tissues heal, as well as how likely you are to face complications)
Here are some things to expect:
- Your tummy will appear swollen for the first few days. In fact, the swelling could take a few weeks or even months to go away completely. Even after it starts to decrease, some swelling can return as you start to move more. (Use this as a guide to tell you when you are becoming too active too soon).
- There will be some pain as you recover from surgery. This can be helped with medicine. You will also receive information about the best ways to sit and to lie down—ways that will reduce the pain.
- During the tummy tuck, drainage tubes are often placed to aid in healing. If you do have these, they will be removed after a few days or once the volume of fluid draining has reduced enough. The fluid that drains should be tracked. First it will be bloody—this is normal. Over time the fluid will be lighter and it will thin out. Then it will become yellowish or clear (and it will thin out even more).
- The incision will be stitched up and bandaged so that it can heal. You will need to change the dressings. You will get wound care information on this from Dr. Brown’s office. The incision line itself will be red for up to a few months. Over the course of 9-12 months, the scar will get flatter and the color will get lighter.
- For the first 10-12 days (less for a mini tummy tuck or if no muscle tightening was done), you will not be able to stand up straight. However, it is still important to walk around during that time. Start as soon as you’re able. Walks promote blood flow. The skin will slowly relax so that you can stand.
- For the first few weeks, you’ll need to wear a support garment.
- Avoid doing anything that involves lifting or bending or straining. There is a risk of causing problems with the stitches – especially those within the muscles. If no muscle tightening was done, this rule still applies, but you may be able to do light lifting again after about 10 days.
- Try to sleep with extra pillows. For example, have one under your knees and some behind your back.
- You may be able to get back to work anywhere from 1-3 weeks after the tummy tuck. The timing depends on several things:
- How extensive the tummy tuck was
- What type of work you do
- Your physical condition
- It may take up to 8 weeks before you are able to do any heavy exercises. That said, exercise is an important part of recovery. It will:
- Reduce swelling
- Help the healing process
- Reduce the chances of blood clots forming in the legs as you heal
- Tone the muscles further
Overall, it may take up to a few weeks or months to feel back to normal.
Realistic Expectations from Tummy Tuck
Some women come into the office and want all of the excess skin removed from below their belly button (after pregnancy) but do not want a scar. You must understand that every plastic surgery has trade-offs and limitations. Having realistic expectations is key. Prepare to have a permanent scar and a lengthy recovery. With any surgical procedure, it is best that you have read and understand the tummy tuck risks and consent form.
Insurances generally will not cover elective plastic surgery. They also don’t usually cover any complications that may occur. A tummy tuck is usually considered an elective surgery. This is true unless there is extreme spreading of the muscles or a hernia. It is best to check with your own insurance carrier about the amount of coverage (if any). Talking with your company at the beginning is important. You should talk to Dr. Brown about your insurance concerns too. In some cases, if exceptions may apply to your case, Dr. Brown may be able to write a letter to your insurance carrier.
When considering any surgery such as a tummy tuck, it is important to know of other options as well. Liposuction may be an alternative to a tummy tuck if there is good skin tone and only local abdominal fatty deposits in a person of normal weight. Dr. Brown has lasers that are used to tighten modest amounts of loose skin on the lower abdomen and around the belly button. Diet and exercise programs may be of benefit in the overall reduction of excess body fat.
Tummy Tuck Surgery Testimonials*
History: Giving birth to a child is one of the most rewarding experiences a woman can have in her life. I am very proud of the two handsome boys that I carried and delivered into this world. They both add so much to my life. However, during this beautiful and natural process, my body was not spared some of the most common side effects of pregnancy. I gained over 70 pounds, developed many ugly stretch marks, and had a C section delivery with both boys. My boys both weighted 10 pounds at birth! So, where did this leave the shape of my once 115 pound body not to mention my self-esteem? Surgery: After establishing a good healthy diet and following a consistent exercise plan, I lost the 70 pounds I gained during the pregnancy process. However, I did not loose the lower abdominal bulge from the C-section, weight gain, and the stretch marks. I decided to research plastic surgery as an option, because I realized the bulge was not all fat. The bulge was loose skin! I exercise every day, and I do a lot of sit-ups. The abdominal problem remained despite my effort. I consulted with several plastic surgeons all over the Northern Virginia Area about my lower abdominal problem. What bothered me is most of the plastic surgeons I consulted with, gave me unrealistic ideas of what to expect after the tummy tuck. For instance, one plastic surgeon told me that my body would look just like it did when I was eighteen. Yeah right! No one in the right frame of mind would believe such a story. I quickly realized that some of these plastic surgeons would tell me anything just to win my business for my money. At this point, I was certain that I wanted the tummy tuck but I did not want to choose a physician that tried to sell me on unrealistic results. I have more faith and confidence in someone who tells the truth. I consulted with Dr. Brown and was very impressed with his realistic approach to my tummy tuck. Dr. Brown told me up front that he could make my tummy look better than it did, but did not promise me that eighteen year old body I once had. Out of all the physicians I consulted in the plastic surgery field, Dr. Brown was the first physician that was up front about a realistic after surgery appearance. He delivered the results that I expected.Recovery: Because of my experience with two prior C sections, I recovered rapidly. My scar is a little bigger than the C section scar, but my tummy is as flat as a board now. The scar is fading with time, just as it did with the C sections. The appearance of my stretch marks is not as noticeable. I can wear my bikini again thanks to Dr. Brown. Thank you, Dr. Brown – you really have changed my life.T.N.
Confidence: I would have had the Tummy Tuck a long time ago if I had known how much better I would feel about myself. I have spent a good 12 years disguising my tummy and unsuccessfully exercising and dieting. It wasn’t until I met Dr. Michael J. Brown and he clearly explained the tummy tuck procedure, that I felt I may have a new lease on life. I can now wear clothes that actually fit. I used to have to buy clothes that were big enough to disguise my midsection and would in turn be too big everywhere else, causing me to look and feel ‘dumpy’. I can actually breath in my jeans!!!! By having a tummy tuck procedure, a whole new world has opened up for me. I feel better about the way I look which has given me more confidence to shed my clothes and actually be proud of my body once again. I truly feel that I gave my heart, soul, and body over the years to having children. I wouldn’t trade them for the world, but it is my time now! I have done my tour of duty and my body took some serious ‘hits’. I believe I deserve to have my body back and I could not have done it without Dr. Brown! Thank you for giving me the courage to have the tummy tuck procedure and the new confidence that I wake up with each day!E.S.
Plastic Surgery Referral
If you have come across this page and live in Providence, RI and are searching for a plastic surgeon, we highly recommend Dr Richard Zienowicz. Dr Zienowicz is a board certified plastic surgeon who is well respected and well trained. To learn more about his practice, visit his website at http://www.bodybyz.com.
George Washington University Professional Center
The Loudoun Center for Plastic Surgery
45155 Research Place, Suite 125
Ashburn, VA 20165