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Tummy tuck (abdominoplasty)

Published by Bupa's health information team, December 2009.

This factsheet is for people who are having tummy tuck surgery, or who would like information about it.

To meet your individual needs, your care may differ from what is described here. It's important that you discuss your tummy tuck surgery with your surgeon.

About tummy tuck
Getting advice
What are the alternatives?
Preparing for a tummy tuck
What happens during a tummy tuck
What to expect afterwards
Recovering from a tummy tuck
What are the risks?
Questions and answers
Related topics
Further information
Sources

About tummy tuck

Tummy tuck surgery, also called abdominoplasty, is an operation to remove excess fat and skin from your tummy and tighten your abdominal muscles. It can give you a tighter, flatter stomach and remove or reduce the appearance of stretch marks on your lower abdomen.

The operation can remove folds of skin left behind after losing a lot of weight, and tighten stretched skin and muscles after pregnancy.

Tummy tuck surgery is not a treatment for weight control or a substitute for regular physical activity and a healthy, balanced diet.

The results of a tummy tuck can be permanent as long as you maintain a healthy weight after your operation.

Getting advice

It's important not to rush into the decision to have cosmetic surgery. Discuss your options with your GP, who may be able to recommend a reputable surgeon or give advice about how to choose which hospital to be treated in.

Before opting for a tummy tuck, discuss with your surgeon what you're hoping to gain from the operation and the result you can realistically expect.

What are the alternatives?

Alternative options include:

liposuction - fat is sucked out through small cuts in the skin
skin creams, beauty treatments and diet supplements - some of these may help to reduce areas of fat and cellulite, but there is little scientific proof that they work

Preparing for a tummy tuck

Your surgeon will explain how to prepare for your operation. For example, if you smoke you will be asked to stop, because smoking increases your risk of getting a chest or wound infection, which can slow your recovery.

Your surgeon may also ask you to:

lose weight - a tummy tuck gives the best results in people who are the right weight for their height
stop taking the contraceptive pill six weeks before surgery, to reduce the risk of blood clotting (thrombosis) - make sure you use a different method of contraception

A tummy tuck is done under general anaesthesia. This means you will be asleep during the procedure. For a general anaesthetic, you will be asked to follow fasting instructions. Typically, you must not eat or drink for about six hours before a general anaesthetic. However some anaesthetists allow occasional sips of water until two hours beforehand.

At the hospital your nurse may do some tests such as checking your heart rate and blood pressure, and testing your urine.

Your surgeon will usually ask you to sign a consent form. This confirms that you understand the risks, benefits and possible alternatives to the procedure and have given your permission for it to go ahead.

Your surgeon may draw on your tummy to mark the operation site and may take photographs so that the results of surgery can be compared with your original appearance.

You will be asked to wear compression stockings to help prevent blood clots forming in the veins in your legs. You may need to have an injection of an anti-clotting medicine called heparin as well as, or instead of, wearing compression stockings. You may be measured for a support garment to wear after the operation.

What happens during a tummy tuck

You will need to stay in hospital at least one night, and for up to four nights.

The operation takes up to three hours. There are several types of tummy tuck - the one you have depends on how much skin and fat you want removed. Your surgeon will explain which type is most suitable for you.

Standard tummy tuck

Surgical cuts will be made in your abdomen and above your bikini line. Your belly button will be cut from the surrounding skin. Your surgeon will pull stretched or torn muscles together and stitch them in place. He or she will remove excess fat, pull down the skin and trim off the excess. Your belly button will be repositioned.

Cuts are closed with stitches and your lower abdomen will be firmly strapped with bandages.

You will have a scar around your belly button and a long curved scar along your bikini line, which you can usually hide with your underwear.

Mini tummy tuck

The skin and fat below your belly button is removed, leaving a long curved scar along your bikini line.

Extended tummy tuck

Excess skin and fat from your abdomen and back is removed. You will have a scar around your belly button and a long curved scar along your bikini line and around your back.

Illustration showing the position of the scars after abdominoplasty surgery
The position of the scars after abdominoplasty surgery

What to expect afterwards

You will need to rest until the effects of the general anaesthetic have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off.

You may have a catheter to drain urine from your bladder into a bag. You may also have fine plastic tubes running out from under the wound. These drain fluids into another bag and are usually removed after a day or two.

You may have a drip in your arm to keep you hydrated. It's usually removed when you can drink enough fluid.

You may wear an elasticated garment to support your abdomen. Keep your knees bent when you are in bed to stop putting strain on your stitches. You may find it difficult to stand up straight at first.

It's important to do deep breathing exercises to help to reduce the risk of getting a chest infection. Your surgeon or nurse can show you how to do these.

Stitches will be removed after one or two weeks, or you may have dissolvable stitches. The amount of time your dissolvable stitches will take to disappear depends on the type of stitches you have. They usually disappear in around two to three weeks, but it can sometimes take longer.

Recovering from a tummy tuck

Your surgeon will have given you painkillers. You can also take over-the-counter painkillers such as paracetamol or ibuprofen. Follow the instructions in the patient information leaflet that comes with the medicine and ask your pharmacist for advice.

Sometimes dressings are needed for a few weeks. It's not unusual to have some tightness around the healing wound, You will need to wear a support garment for one to six weeks.

You will be able to do light activities comfortably after around 10 days. Most people can return to work after two to four weeks, but don't do any vigorous activity for at least six weeks. Your surgeon will give you specific instructions depending on the type of operation done.

What are the risks?

A tummy tuck is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications.

Side-effects

Side-effects are the unwanted but mostly temporary effects you may get after having the procedure, for example feeling sick as a result of the general anaesthetic.

Side-effects of a tummy tuck include:

pain and bruising for at least the first few days
swelling - this may not completely settle for a few months
scarring - this usually fades over the course of a year, but won't completely disappear
numbness of your tummy skin - the skin below your "new" tummy button will be numb for several months, but this numbness will gradually reduce as new nerves grow

Complications

Complications are when problems occur during or after the operation. Most people aren't affected. The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding or developing a blood clot, usually in a vein in the leg (deep vein thrombosis, DVT). This can move to the lungs (pulmonary embolism) and be life-threatening. Specific complications of tummy tuck are uncommon, but can include:

infection - this may need antibiotic treatment and sometimes surgery
bleeding under your skin (haematoma) - this may need surgery to stop the bleeding and drain the area
numbness - this is usually temporary, but can be permanent; in the early stages (three months) after a 'standard' abdominoplasty you will have numbness in the lower half of the tummy and you will need to take special care of the skin until sensation has returned
unusually red or raised scars - these may take a long time to settle but your surgeon will recommend treatments to help

The final position of your belly button may be off-centre, and there's a small risk of losing your belly button completely.

It's possible that you may not be completely satisfied with your appearance after the operation.

The exact risks are specific to you and will differ for every person, so we have not included statistics here. Ask your surgeon to explain how these risks apply to you.