What is tummy tuck (abdominoplasty) surgery?

Abdominoplasty surgery is a procedure whereby we remove excess skin and tissue from the lower abdomen. Generally, during this procedure, we tighten up the rectus muscles which tend to have a form of rectus dilation, which is where the muscles separate slightly. This is most commonly caused by pregnancy or extreme weight gain.

So the muscles separate and they don't actually go back together. So all we do is we gently stitch those back together. We don't change the muscles or anything. We just bring them back together and this helps to flatten the stomach. If you have any bulging from this, we remove the skin fat and tissue from the belly button and below. This is for a standard full abdominoplasty.

Depending on the length of your scar, it can help to take away any fullness from the flanks or you can have liposuction to help with this also.

Why have a tummy tuck?

A tummy tuck is great for people who have any fullness or excess skin fat or an overhang of their lower abdomen. So, we remove that excess skin and tissue and we pull down the skin and it gives you a tighter appearance of your stomach.

What will happen during my tummy tuck consultation?

During your initial abdominoplasty consultation with your consultant, you will come to be in hospital and you'll be greeted by a friendly reception staff who will ask you to take a seat in one of our outpatient areas.

You'll be called through to your clinic room where you will meet the consultant and myself. We will go through your past medical history, your social history. We need to make sure that you're fit and well enough for surgery and that you've got good social support at home for after surgery and before. And we will go through what it is that you want from the surgery. What are your expectations?

We'll discuss how the surgery is done and we will make a plan for you. We'll decide what type of abdominoplasty is best for you. So whether this is a standard abdominoplasty, a mini, a larger extended abdominoplasty, a Fleur de Lis, which is where we have a vertical scar as well. That's more commonly used for massive weight loss where you have a lot of laxity for the stomach and the abdomen.

Or you can have a circumferential or a lower body lift, which is a scar that goes all the way around. And this is definitely for a larger weight loss procedure.

Will tummy tuck surgery be painful?

Abdominoplasty surgery generally is not referred to as painful. It can be uncomfortable, especially if we tighten the muscles, which we most commonly recommend doing alongside the skin excision.

So, the abdominoplasty itself just to tighten and strengthen your core. So, paracetamol and Ibuprofen is recommended to have at home after surgery. And if you need something stronger, we will give it to you.

How long does a tummy tuck take?

Abdominoplasty surgery on average takes around three hours. Sometimes if we add in liposuction or we combine it with another procedure, it can take a bit longer. But the average time for abdominoplasty surgery is three hours.

What is the recovery period from a tummy tuck?

Recovery time following abdominoplasty or tummy tuck. It's generally around six weeks. So, for the first two weeks, it's a bit of rest and relaxation at home. You can generally return to work after about two weeks as long as your job isn't too strenuous. But we advise you to avoid heavy exercise and any strength activities for the first six weeks.

Scars can take up to 18 months to heal and you might not see the overall result for the first three months, but generally after two weeks, you'll be feeling back to yourself doing more normal things, but it's six weeks before you return to full normal activity.

Does a tummy tuck get rid of stretch marks?

A tummy tuck gets rid of any stretch marks that are in the area of skin that we're removing - so, from the belly button downward. If you have stretch marks in that area and you have a full or an extended abdominoplasty, it will remove all of that fat, skin and tissue. So, it will take away those stretch marks. If you have a mini abdominoplasty, it tends to just take away a little bit of excess skin that you have at the bottom. So, it won't touch any of those stretch marks that are above that lower area just above the pubis.

If you have a Fleur-de-Lys abdominoplasty, then we bring some of the skin in as well as down. So, it would remove stretch marks from within that area. Any that are above the belly button do get left behind. Sometimes stretching them can make them a bit more visible. It can also actually make them fade a little bit better.

What happens to my belly button after a tummy tuck?

During an abdominoplasty procedure, the belly button remains on the stalk. However, we remove the skin where the belly button comes through. So, we pull down the skin from higher up, which replaces the skin we've removed and we make a new hull and we just pop the belly button stalk back through and then we stitch it to the new skin.

Will there be any swelling after my tummy tuck?

Following an abdominoplasty or a tummy tuck, there will be a degree of swelling as with any procedure. You will have some fullness to the abdomen, and this is completely normal.

Is it safe to fly after tummy tuck surgery?

Flying after surgery is generally not advised until you've seen your nurse and your consultant. So, we generally don't advise that you fly for about six weeks following surgery. This is just so that we can make sure that you're fully recovered and that everything's going well in case of any slight delays, maybe a little bit of wound healing delay or something like that.

The general guidelines are around about four weeks for anything long haul, so more than four hours, but just make sure that your consultant’s happy that you're ready to fly.

The aim of a tummy tuck operation (commonly known as a abdominoplasty) is to remove extra skin, scars, stretch marks and fat from the tummy to improve the appearance and shape of the abdomen.

In some cases, it can also tighten the tummy muscles by re-joining the muscles of the abdominal wall if they’ve been pulled apart in the middle (known as the ‘divarification of the recti’). Stretch marks can sometimes be cut away or tightened to make them less obvious.

A tummy tuck may be further enhanced with additional procedures, such as liposuction targeted to specific areas.

A tummy tuck physically removes skin, fat and tissue, reducing an overhanging belly and making the stomach skin tighter.

Liposuction removes fat under the skin through small incisions. The skin remains and any folds, overhang or loose skin remain. This means that the belly can become looser after liposuction as we have removed the ‘stuffing’.

You might have this type of surgery to remove the extra skin and fat, or to get a flatter tummy, after pregnancy or gaining and losing weight. 

People who have had an abdominoplasty feel more confident about their shape and often comment on how they are able to wear clothes that they would not have even considered previously. Their previous self-consciousness about their abdomen disappears and this is usually reflected by a renewed vigour and energy.

A tummy tuck isn’t suitable if you’re overweight, nor is it carried out in order to lose weight. Your weight should be normal before the surgery. 

The outcome of your operation will be partly determined by the shape of your abdomen and the quality of your skin and tissues before surgery:

• If you’re very slim and have thin tissues, but an abdominal bulge (typically after multiple pregnancies), there is a chance you may be able to feel some of the internal stitches underneath your skin
• The scar of a tummy tuck is designed to lie low, so it will be hidden behind underwear and bikinis in the future. However, the scar may be slightly asymmetrical and may not be perfectly even - if this is a problem for you, you may not wish to proceed with surgery
• If you have a petite frame with very little space between your ribcage and hip bones, the results of a tummy tuck will not be as good as if you have a larger gap, as there will be less of a possibility of creating a distinct wait
• We’re all asymmetric to a degree - the left and right halves of our bodies are not identical. Following abdominoplasty, certain asymmetries you may not have been aware of prior to surgery may become apparent
• If you’re having surgery having lost a great deal of weight, it may be more appropriate to have an alternative operation such as a belt lipectomy or a lower body lift (surgery, and consequently the scar, go all the way around the body) as a tummy tuck alone may not be sufficient to address all the areas of redundant tissue. Another option that may be considered is a flankectomy in addition to a tummy tuck

Before seeing one of our Consultant Plastic Surgeons, you should think about what you’re hoping to achieve from a tummy tuck. You might consider:

Is my weight steady or am I continuing to lose weight as part of a diet or weight loss programme?

If so, it’s better to postpone surgery until your weight has plateaued for around six months. This is especially important if you’ve had bariatric surgery (a gastric band or a bypass operation), in which case a longer period of being at a steady weight is recommended (12 months) and you should also consult a dietician.

Why am I thinking of having an abdominoplasty at this time in my life?

You shouldn’t consider having cosmetic surgery if you’re experiencing any instability in your personal circumstances, as you’ll need time and space to recover afterwards.

How would I like to look after my abdominoplasty?

If you’ve not finished your family and are considering trying to become pregnant in the near future, an abdominoplasty is best postponed until your family is complete.

As with any surgery, abdominoplasty involves risks. Your Consultant will discuss these with you in detail at your consultation.

The operation itself takes around two to three hours, however, you will be away from your hospital room for longer than this as additional time is spent on the general anaesthetic, preparation in theatres for your operation and for you to wake up comfortably.

Most patients describe a feeling of being “very tight” and uncomfortable in the initial post-operative period, but this rapidly improves. A feeling of tightness may remain to some degree for one to two weeks after surgery.

We’ll give you painkillers to take after the operation. Most people find them helpful to take for around two weeks following surgery. If you’ve had liposuction, there may be a dull ache and bruising in the areas of treatment.

You should expect to have a scar after your abdominoplasty. The typical abdominoplasty scar is horizontal and ranges in size depending on how much excess skin needs removing. Occasionally if there is not quite enough skin, you can have a very short vertical scar. A fleur-de-lys abdominoplasty has both a horizontal and a long vertical scar.

Normally you’ll stay in bed until the morning after your surgery, and the bed will be bent in the middle, so your hips are flexed to take the tension off the wound.

The next day you’ll be helped out of bed and can take short walks to the bathroom and back. You’ll probably walk ‘bent over’ as your abdomen will feel tight; it’s important not to try to straighten up as this may put undue tension on the wound. Your posture will improve over the first week or two after surgery as your body adapts to its new shape.

You may also have pneumatic calf compression pumps fitted after surgery that will stay on until you get out of bed the next day. We’ll give you injections of blood-thinning medication once a day during your hospital stay to reduce the risk of blood clots in your legs while you’re less mobile immediately after surgery.

During your recovery in hospital, our caring nurses will ensure that your post-operative garment fits properly and you’re comfortable taking it off and putting it back on by yourself, in preparation for discharge from hospital. If you are having difficulty in getting to the bathroom after your operation, it may be necessary to insert a temporary catheter, so you do not have to get out of bed to pass urine (for 24 hours for example).

Another point to be aware of is that your abdomen has been tightened significantly, so your tummy will not be able to expand outwards after meals. You may feel more bloated than usual after eating, as your stomach will only be able to expand inwards. This may result in you needing to have smaller meals than usual, whilst your body adjusts to its new shape. It’s often a good idea to take some mild laxatives for a few days after surgery to soften your stools - this will prevent the need to strain and put further pressure on your abdominal wall.

You should be able to return to sedentary activity (i.e. an office job or light duties) at two to three weeks, depending upon how you feel. Heavier duties, or physical exercise should be postponed for at least six weeks after surgery, to allow the abdominal wall to heal properly.

It’s not uncommon to have small areas of delayed wound healing, often where a dissolvable stitch hasn’t dissolved quite as quickly as it should. These stitches may “spit” out of the wound (much in the same way as a splinter may start to work its way out of your finger after it has been there for a few days). This can be dealt with easily.

Once you get home, you’ll need to achieve a balance between resting, but not lying down and doing nothing, as this may increase the risk of certain complications, such as blood clots in the legs (deep venous thrombosis or DVT). You should take short gentle walks and make sure you drink plenty of fluids to further reduce the risks of developing DVTs.

Your wounds will have been dressed with surgical tapes, which are shower proof. You can shower every day but ensure the shower hose isn’t directed towards the main wound (as this may encourage the tapes to come off too early). The easiest thing is to face away from the shower for most of your showering.

The belly button is a common site of mild inflammation and therefore it is advisable to remove any dressing prior to showering and gently shower into the belly button itself every day. This will help reduce the risk of infection developing in this area. All wounds/tapes may be dried by gently patting with a clean towel or kitchen towel, or alternatively a hair dryer may be used on a cold setting.

A tummy tuck removes the skin from the belly button down, so any stretch marks in this area would also be removed.

Any stretch marks outside of this section of the belly will remain and may be more noticeable as the skin is stretched.

Not necessarily. An extended abdominoplasty removes skin, tissue, and fat from the area beyond the hips, so this will usually help with love handles. However, liposuction might be needed to reduce them further.

The belly button is left on the “stalk” and is re-sited, along with its blood flow, through the new skin to its new position.

We’d recommend that you don’t fly for four to six weeks after your tummy tuck.

Yes. As with any surgery, there will be post-operative swelling which will subside over time.