7 Things You Should Know About Tummy Tucks

Aging, pregnancy, and weight loss make the abdominal muscles less elastic. Even with exercise, it may be impossible to get rid of sagging, loose skin or a protruding belly. An abdominoplasty (tummy tuck) is a surgery to contour the shape of the belly. It helps to remove excess skin and fat, and to repair any weakened muscles. 

A tummy tuck is a common cosmetic surgery. About 100,000 tummy tucks are performed each year. 

If you’re considering having the procedure, here are seven things you should know.

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1. Although a tummy tuck is a same-day procedure, it is a major surgery

A tummy tuck sounds simple, but it is a major surgical procedure with dramatic results. The procedure is generally done under general anesthesia. This means you will be asleep and need a breathing tube during the surgery. 

A tummy tuck corrects many issues from excess skin and fat to weakness in the belly muscles. So the surgery itself involves several steps. 

A tummy tuck usually includes these steps:

• Bikini cut: You'll get a horizontal incision below the belly button, in what's known as the bikini line. This means the scar will be low enough for a bikini bottom or underwear to cover it.

• Diastasis recti repair: If you have diastasis recti, your belly muscles are weak and have formed a gap. A tummy tuck tightens the muscles and pulls them back together.

• Excess skin removed: The skin is then pulled down tight like a window shade, and excess skin is removed. Your surgeon will bring your belly button up through a small incision, to put it back in the right position.

• Liposuction: If necessary, liposuction is then used to remove any small pockets of fat.

• Skin closure: The incisions are closed with sutures or surgical glue. And your surgeon will place a bandage over them.

Immediately after surgery, you will likely be fatigued, swollen, and sore. Although this will improve over the next several weeks, recovery takes time and patience. 

2. You might be able to have a mini tummy tuck, instead of the full surgery

There are different options for reshaping the midsection. You can have the full procedure or a mini tummy tuck. During your tummy tuck consultation, the surgeon will look at the condition of your skin, muscles, and tissue. This will help them determine which option fits your unique needs. 

About 10% of tummy tucks are mini. Most people are better suited for the full abdominoplasty. That’s because the mini tummy tuck only corrects the area below the belly button. 

What is a mini tummy tuck? 

A mini tummy tuck is a less invasive version of the standard abdominoplasty. The mini only requires a small incision, 4 to 8 inches long. The belly button does not get moved, and there is no excess skin removed from the upper abdomen. 

This procedure is best for people who are already close to their ideal shape, and who have minimal excess skin and lower belly fat. 

If you qualify for a mini, the advantages over a full tummy tuck include:

• A smaller scar

• Less downtime

• Quicker recovery

3. A tummy tuck involves some risk

If you have a tummy tuck, there is a 4% risk of a major complication. These complications include:

• Hematoma (blood collection)

• Infection

• Blood clot (pulmonary embolism or deep vein thrombosis)

You may also have an unexpected outcome after tummy tuck surgery. These risks include: 

• Numbness or changes in sensation along the scar

• A scar that becomes raised or doesn’t fade as expected

• An uneven appearance or persistent lumps under the skin

• Dissatisfaction with the result

4. Complete recovery from a tummy tuck can be up to 8 weeks 

Depending on the physical demands of your daily routine, you may be ready to return to your regular activities in 2 weeks. But a full recovery can take many more weeks, while you’re waiting for the pain, swelling, and redness to resolve. 

Your surgeon may make several recommendations to help minimize side effects and to help you heal faster. These can include:

• Compression: Along with the bandages placed on your sutures, you will wear an elastic bandage or compression wrap. You will likely need to wear a compression bandage for several weeks. This will help keep the swelling down. 

• Drains: A drain may be placed under your skin during the surgery and left in temporarily. This is a thin tube to drain any excess fluid that could accumulate. You may have a few drains after surgery. These are important for healing and to lower the risk of infection. 

• Light activity: You’ll be able to do light activity, such as walking, right away, but you’ll have to avoid strenuous activity for a little while. Lifting heavy objects, running, and doing abdominal exercises will likely be off-limits for at least 6 weeks. This includes lifting small children.

5. A tummy tuck isn’t for everybody

Although you may be unhappy with your current belly shape, a tummy tuck may not be the right choice for you. Some people have health conditions that make having the procedure too risky. And a tummy tuck isn’t useful for weight loss, so it’s not a good idea if you’re just beginning a weight loss journey.

A few signs that you could be a good candidate for a tummy tuck are:

• You have loose skin, fat, or stretched muscles of your belly that don’t respond to diet or exercise. 

• You are in good health.

• You don’t smoke.

• You’re close to your goal weight.

• You don’t plan on any major weight changes in the future, including from a pregnancy or with excessive weight loss.

• You have realistic expectations about what the surgery can and cannot do. 

6. While effective, a tummy tuck may not be a permanent fix

If you are a good candidate, a tummy tuck is a very effective way to give your abdomen a flatter, firmer appearance. The result is immediate, meaning you will wake up with tight skin and a flat contour. The result will improve over the next few weeks as the swelling decreases and the scar fades. 

The improvement is permanent as long as you don’t lose or gain more than 10 to 15 lbs after the procedure. This could cause the excess skin to return, and you might need another procedure to fix it.

7. A tummy tuck is not weight loss surgery

While a tummy tuck gives you a slimmer appearance, it is not a weight loss surgery. It has no effect on your appetite, digestion, or metabolism. Weight loss surgery, on the other hand, does change your digestive system, in order to reduce your calorie intake. But it does not remove excess skin or result in a firmer belly, like a tummy tuck.

There are several types of weight loss surgery. The three most common are:

• Gastric sleeve: This procedure is the permanent removal of 75% of your stomach.

• Gastric bypass: In this procedure, a surgeon reduces the size of your stomach to a small pouch that is then attached to a lower part of the small intestine. This allows food to bypass the remainder of the stomach and the first part of the small intestine. This cuts down on the calories and fat you can absorb from food. 

• Adjustable gastric band: This involves a surgeon placing a ring with an inflatable, adjustable band around the top of your stomach to create a small pouch. It can make you feel full with a smaller amount of food, is not very invasive, and is easily reversible.

What are the best alternatives to a tummy tuck?

A tummy tuck is not a replacement for weight loss. The best candidates are people who have achieved their goal weights. 

Once you’re at your goal weight, there are some other, nonsurgical alternatives to a tummy tuck. These in-office procedures help tighten the skin and reduce fat deposits with thermal energy, radio frequency, or a cooling process. They work best if you are looking for small improvements, or if you don’t have a large amount of excess skin or muscle weakness. 

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Written by:

Jennifer L. Claves, MD

Jennifer L. Claves, MD, is a practicing board-certified internal medicine physician with over two decades of experience. She earned her medical degree from Penn State University and completed her residency and chief residency at Thomas Jefferson University Hospital in Philadelphia.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

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