Why it's done

There are a number of reasons you might have excess fat, poor elasticity of the skin or weakened connective tissue in your abdomen. These include:

• Significant changes in weight
• Pregnancy
• Abdominal surgery, such as a C-section
• Aging
• Your natural body type

A tummy tuck can remove loose, excess skin and fat, and tighten weak fascia. A tummy tuck may also remove stretch marks and excess skin in the lower abdomen below the bellybutton. However, a tummy tuck won't correct stretch marks outside of this area.

If you've previously had a C-section, your plastic surgeon might be able to incorporate your existing C-section scar into your tummy tuck scar.

A tummy tuck can also be done in combination with other body contouring cosmetic procedures, such as breast surgery. If you've had fat removed from your abdomen (liposuction), you may decide to have a tummy tuck because liposuction removes tissue just under the skin and fat but not any excess skin.

Risks

A tummy tuck poses various risks, including:

• Fluid accumulation beneath the skin (seroma). Drainage tubes left in place after surgery can help reduce the risk of excess fluid. Your doctor might also remove fluid after surgery using a needle and syringe.
• Poor wound healing. Sometimes areas along the incision line heal poorly or begin to separate. You might be given antibiotics during and after surgery to prevent an infection.
• Unexpected scarring. The incision scar from a tummy tuck is permanent, but it's typically placed along the easily hidden bikini line. The length and visibility of the scar varies from person to person.
• Tissue damage. During a tummy tuck, fatty tissue deep within your skin in the abdominal area might get damaged or die. Smoking increases the risk of tissue damage. Depending on the size of the area, tissue might heal on its own or require a surgical touch-up procedure.
• Changes in skin sensation. During a tummy tuck, the repositioning of your abdominal tissues can affect the nerves in the abdominal area, and infrequently, in the upper thighs. You'll likely feel some reduced sensation or numbness. This usually diminishes in the months after the procedure.

What you can expect

A tummy tuck is done in a hospital or an outpatient surgical facility. During a tummy tuck, you'll be under general anesthesia — which makes you completely unconscious and unable to feel pain. In some cases, you might be given a pain-relieving medication and be moderately sedated (partially asleep).

Before the procedure

There are a number of different procedures for a tummy tuck, depending on your goals and the extent of change you would like to see. During the typical tummy tuck, your plastic surgeon makes incisions to remove most of the skin and fat between your bellybutton and pubic hair in a horizontal oval or elliptical shape. Connective tissue (fascia) that lies over the abdominal muscles is then tightened with permanent sutures.

The amount of excess skin removed and the type of procedure you have will determine the shape and length of the incision. The incision above the pubic hair will be stitched together and will leave a scar that falls along the natural crease within the bikini line.

Your plastic surgeon will also reposition the skin around your bellybutton. Your bellybutton will be brought out through a small incision and sutured in its normal position.

During the procedure you might be given an antibiotic to prevent infection.

The procedure typically takes about two to three hours.

After the procedure

After a tummy tuck, your abdominal incision and bellybutton will likely be covered with surgical dressing. Small tubes might be placed along the incision site to drain any excess blood or fluid.

Members of your health care team will help you walk as early as the first day after a tummy tuck to help prevent the formation of blood clots.

You'll likely be given pain medication. It's normal to have swelling in the surgical area.

Drains might be left in place for several days after surgery. Your doctor or another member of your health care team will show you how to empty and care for your drains. You might need to continue taking an antibiotic as long as the drains are in place.

Your surgeon might also prescribe a blood-thinning medication for a short time after your tummy tuck.

You'll wear a supportive abdominal garment (abdominal binder) for about six weeks after your tummy tuck. This helps prevent fluid buildup and provides abdominal support while you heal. Your doctor will explain how to care for your scar.

For the first six weeks after a tummy tuck, you'll need to be careful when moving around. You'll also need to avoid positions that strain your incision line — such as quickly bending at the waist — to prevent the reopening of the wound.

You'll need to schedule regular follow-up visits. Ask your doctor how often you need to be seen.

Results

By removing excess skin and fat and strengthening your abdominal wall, a tummy tuck can give your abdomen a more toned and slimmer appearance.

Tummy tuck results are usually long lasting if you maintain a stable weight.