Abdominoplasty

Abdominoplasty (Tummy Tuck)

Abdominoplasty, or cosmetic tummy surgery, is an invasive procedure used to flatten and tighten the abdomen by removing excess skin and fat and tightening the abdominal wall muscles. Unlike minor surgeries such as eyelid or nose surgery, this is considered a major procedure.

If you're considering this surgery, it’s important to be well-informed before proceeding. Abdominoplasty is suitable for individuals who have tried non-invasive methods like diet and exercise without success and are not currently gaining weight.

Who is the Ideal Candidate for Abdominoplasty?

Ideal candidates are in good general health, have a stable weight, do not smoke, and have excess skin along with muscle separation in the abdominal midline. The procedure can significantly improve body contour in such individuals.

Who Should Avoid the Surgery?

1. Women who may still plan to become pregnant are advised to postpone the surgery or opt for a version without muscle repair (skin and fat removal only).
2. Individuals planning to lose weight should first reach their ideal weight before considering surgery.
3. The surgery involves a lower abdominal incision that leaves a permanent scar. Although in most patients this scar fades to a thin line within 6–12 months, there is a small risk of hypertrophic or widened scars. If you are unwilling to accept this risk, even if small, you should reconsider undergoing surgery.

How is Abdominoplasty Performed?

Depending on the extent of excess skin, fat, and muscle condition, the procedure can range from a small outpatient surgery (under 2 hours) to a major surgery lasting over 5 hours. General anesthesia is required in all cases. A “mini abdominoplasty” (limited to below the navel) may allow same-day discharge, but patients should have a reliable companion for the first couple of nights.

The exact extent of surgery will be determined during at least two preoperative consultations. The simplest and least invasive version is the mini abdominoplasty, which uses a smaller incision and typically avoids incisions around the navel. This option suits patients with excess fat and skin only in the lower abdomen. In patients with certain health risks (e.g., cardiac issues or smoking), this method may offer moderate results with reduced risk.

A full abdominoplasty involves an incision extending from one hip to the other. It's ideal for patients requiring maximum correction. The surgeon repositions the skin and muscles, sometimes accompanied by limited liposuction. An incision around the navel is needed to reposition the tissues. A drain may be placed postoperatively to collect fluid, usually removed after a few days.

The most extensive form is a circumferential (belt lipectomy) abdominoplasty, which involves incisions extending around the back. Performed in one or two stages, it is suitable for patients who’ve experienced massive weight loss. This surgery is more complex and carries a higher risk of complications.

No matter which type you undergo, proper postoperative care is essential. You will be instructed on wound care, drain management, sleeping and walking posture, and sitting techniques. You may also need to wear a compression garment (abdominal binder) for several weeks.

Preoperative Preparation

Smoking cessation is critical. For mini procedures, stop all nicotine use at least 2 weeks before and after surgery. For full abdominoplasty, you must quit smoking at least 1 month before and 3 weeks after the procedure. Even secondhand smoke, nicotine patches, and gums are prohibited. Simply reducing smoking is not enough — it must be eliminated entirely to ensure proper healing. Genetics, however, remains a non-modifiable factor.

Avoid extreme diets from 2 weeks before to 2 weeks after the surgery. Continue essential medications (e.g., for blood pressure or thyroid) under medical supervision. Discontinue unnecessary supplements and vitamins several days before and after surgery.

Potential Complications and Risks

Depending on the extent of surgery, patients may experience pain and swelling. Mini abdominoplasty usually causes mild pain, whereas full abdominoplasty with muscle repair may involve moderate to severe pain. Pain and tenderness can persist for weeks or even 2–3 months post-op. Fatigue and general weakness are also common after full procedures.

As with any surgery, risks exist — especially in patients with diabetes, heart/liver/lung disease, or those who smoke. Possible complications include: poor scarring, bleeding or hematoma, infection, fluid accumulation, skin discoloration, localized swelling, and asymmetry.

Is Abdominoplasty a Substitute for Diet and Exercise?

Absolutely not. To maintain results, you must keep a stable weight and strictly avoid gaining more than 5% of your current weight.

Does Insurance Cover the Cost?

Most insurance companies do not cover abdominoplasty. If you’re considering surgery, check all financial and insurance details with your provider and surgeon beforehand. The outcome of a full abdominoplasty heavily depends on your adherence to postoperative care. If you anticipate being unable to follow through, ask your doctor about simpler options or postpone surgery.

Another critical point to clarify before surgery is your recovery plan and activity restrictions. A light mini abdominoplasty may require only 7–10 days of downtime, while a full abdominoplasty with muscle repair and side liposuction can necessitate 4–6 weeks of limited activity and exercise.