What is a Tummy Tuck?

A Tummy Tuck is a surgical procedure that removes excess skin and fat from the abdomen, and tightens the abdominal muscles. It helps you get rid of any “bulge”, giving you a smoother, flatter tummy. In this blog I answer the most frequent questions that people ask about this procedure.

HOW IS A TUMMY TUCK DONE?

Basically, a Tummy Tuck is done under general anesthesia in a Surgicenter. I place an incision about the same level as a C-section scar (occasionally it may be higher or lower but it usually extends across most of the lower abdomen). 

Then I elevate skin and fat off of the muscle, as far as the top of the abdomen. I tighten muscle/fascia with permanent sutures (the muscle is NOT cut). Following this, I excise or remove the redundant skin and fat. I always weigh this since my patients are always curious how much the removed tissue weighed.

I close the incision with dissolving sutures. I usually do not place any drains. Most of the time, I will liposuction the flanks/love handles. Patients are usually discharged from the Surgicenter 30-60 minutes after the procedure. I want you up walking the same day. You need to shower the following evening. 

There can be exceptions and variations to all of the above, but this is a good generalization. 

WHEN TO CONSIDER A TUMMY TUCK?

A Tummy Tuck is really your only solution if you are bothered by loose skin on your abdomen. This can be due to pregnancy or weight loss and weight gain. It is also the only way to tighten up abdominal muscles/fascia that have been stretched. 

Clearly, if you are planning to have more children in the near future, it may make sense to delay your Tummy Tuck until after you have finished having children. However, in select cases, I have done very successful Tummy Tucks, in women before they have had any children. In these cases (assuming they want children and of course, not all women desire children), I will avoid tightening the abdominal muscles. 

Some patients will have a roll in their lower abdomen and prefer to remove it completely and tighten the skin with a Tummy Tuck, rather than just somewhat reduce it by liposuction.

HOW MUCH WEIGHT WILL BE LOST WITH A TUMMY TUCK?

A Tummy Tuck is NOT a weight loss procedure. Of course, the weight of the skin/fat that is excised will weigh something and occasionally quite a bit. However, it is important to view a Tummy Tuck as a way to make you look much better, with a much better shape. 

It does not replace the need for a healthy diet (see my blogs for the diet that I recommend). This is also true with regard to liposuction. 

HOW DO YOU PREPARE FOR A TUMMY TUCK SURGERY?

You, of course, need to come in for a consultation, where I will examine you and take photographs (they will not show your face, unless you are also inquiring about facial procedures). 

After the examination, we will discuss different options with the pros and cons of each approach. If I see that you are a good surgical candidate, I will give you a written quote of all costs involved, including anesthesia and the Surgicenter. 

If you are over 50 years of age, you will need to get a pre-op clearance, including a letter from your family doctor, as well as blood work and an EKG. This needs to be within several months of your surgery. 

If you are less than 50 years old and in good health, you may not need anything other than a Covid test 3 days before your surgery (this could change in the future but this is required at this time).

Depending on your individual circumstances, I may ask you to get clearances from other specialists. If you are overweight, the more weight you lose before surgery, the better your final result will be. 

The day or night before surgery, you have to wash your body with Hibiclens, which is an antibiotic soap. You can do it again, the morning of surgery, if you have time. As with every general anesthesia case, you cannot have anything to eat or drink after midnight (you can brush your teeth). 

You can get Uber or taxi to the Surgicenter but you MUST have an adult drive you home and help get you in your house. You can definitely walk up stairs.

Please bring along the surgical garment and all the prescriptions that I will have given you ahead of time. If you use an inhaler for asthma, definitely bring it along. 

You definitely want to try on your surgical garment, well ahead of surgery. It should be comfortable and NOT be tight. You will swell and retain fluid after surgery, so you do not want it to be miserably tight after surgery. Bring sweats to wear over your garment, or at least something loose and comfortable and easy to put on. 

PLEASE arrive ahead of time and please make sure that your ride home arrives ahead of time. 

HOW LONG DOES A TUMMY TAKE IN THE OPERATING ROOM?

Generally a Tummy Tuck will take about 3 hours, including liposuction to the flanks. If someone is very small, it may take 2.5 hours and if they are larger, it may take 3.5 hours. 

Of course, if other procedures are added, such as a Breast Reduction, then it will take considerably longer. 

Be aware that all operating rooms count the time you are actually in the room, and not just the time that I am technically operating on you. They have to put you in the operating, start the IV, put you to sleep, prep and drape you etc. 

I inject a lot of local anesthetic into the incision before I start the actual surgery. At the end, the nurses have to dress your wound and you and then we have to move you off the operating bed to the recovery room.  

HOW DO YOU SLEEP AFTER YOUR TUMMY TUCK?

You should sleep with 3-5 pillows behind your head and 1-2 pillows behind your knees. It is perfectly fine to sleep more on one side or the other if you are not comfortable sleeping completely on your back. You should wear the surgical garment, which should feel comfortably snug, not miserably tight. 

HOW SHOULD I WALK AFTER MY TUMMY TUCK?

You absolutely should walk straight upright. DO NOT BE HUNCHED OVER! You will not come apart but if you stay bent over, you will have lots of back discomfort. It may feel tight but the sooner you stand completely straight up the better you will feel.

WHEN CAN I SHOWER AFTER MY TUMMY TUCK?

I want all of my patients to shower the following evening, i.e. about 30 hours later, after their surgery. It is perfectly fine for soap and water to run over the incision and the steristrips. You will feel much better after you shower and you should shower daily. No baths for at least 10 days. 

WHEN CAN I HAVE SEX AFTER A TUMMY TUCK?

There is no right answer for this. I had patients, who have had sex within a few days and others, who have had to wait for 3-4 weeks. Use commonsense. If it feels fine, it is almost certainly fine. However, it is clearly not the time to set some new personal record 🙂

WHEN CAN I EXERCISE AFTER A TUMMY TUCK?

Usually after about 2 weeks, I will let most patients return to some exercising. It should be low impact such as elliptical or spin class or weights for the lower body. Start easy and work up gradually. You can probably resume light jogging in 2.5 to 3 weeks. I would hold off doing a tough workout like Cross Fit or a tough HIIT for 4-6 weeks and then go easy for the first few times. 

WHEN CAN I RETURN TO WORK?

If you work from home, you should be able to put in several hours per day after about 5 days. If you have to drive to the office, most people should be fine in 10 days. I did a Tummy Tuck on my office manager, Cheryl, several years ago, and she returned to work in 6 days and worked 12 hours per day! I have had several patients, who returned to work in a week. If you are older or a bit more delicate, then plan on returning to work in 14 days. 

DOES A TUMMY TUCK LEAVE A SCAR?

Yes, it does. Every time you have a cut that goes all the way through the skin, you will get a scar. The scar from a TT will fade with time and get harder to see with each passing year. However, it will never completely disappear. It is usually easy to hide with clothing. Some patients will get tattoos over the scar which can hide them really well.

WHAT HAPPENS IF YOU GET PREGNANT AFTER A TUMMY TUCK?

I have had several patients get surprised when they found themselves pregnant after getting a Tummy Tuck (they were not planned). A few years ago, I actually had 2 patients, unexpectedly found themselves pregnant within 2 years of their Tummy Tuck.

Nothing to worry about. The baby always wins and it will not harm the baby. Of course, if you expect to get pregnant within a few years, it makes sense to delay the Tummy Tuck, until you are finished having children. 

WHAT IS THE DIFFERENCE BETWEEN LIPOSUCTION AND A TUMMY TUCK?

Liposuction uses a small incision and sucks out/withdraws fat, after infiltrating a special fluid. A Tummy Tuck excises/cuts out redundant skin and fat and leaves a long scar. Very frequently, liposuction is done on the flanks/love handles, when a Tummy Tuck is done. 

DOES A TUMMY TUCK HURT?

I think most patients are pleasantly surprised by the experience. It is surgery and it will be somewhat uncomfortable. However, the abdomen actually feels numb after a Tummy Tuck. The discomfort mostly relates to the tight feeling from the muscle being tightened. 

The best thing you can do is to get up and do some walking and moving etc. and then rest. The worst thing you can do is spend all your time in bed and barely get up. Most people I find worry way too much that they will do some damage by moving at all and hence tend to move super slowly and cautiously etc. You should do some gentle slow stretching a few times daily to loosen things up etc. 

CAN A TUMMY TUCK BE COMBINED WITH OTHER PROCEDURES?

It is frequently combined with liposuction to the flanks but can really be combined with any other procedure such as a breast augmentation or reduction or an arm lift or liposuction to additional areas etc. 

Be aware that when you combine a Tummy Tuck with other procedures, you will usually be somewhat more tired and slower to recover than if you did them separately. 

Also, the procedure will require a longer anesthesia which can increase your risk of DVT and pulmonary embolus. I will also almost always put you on Lovenox postoperatively with a combined procedure.