Are sit-ups just not giving you the taut tummy you desire? If you've got a little too much flab or extra skin in your abdomen that won't go away with diet or exercise, you may want to consider an abdominoplasty, popularly known as a “tummy tuck.” This procedure flattens your abdomen by removing extra fat and skin and tightening muscles in your abdominal wall.
However, this is a major surgery, so if you're considering it, please take the time to educate yourself, thoroughly analyze your own situation, and do not rush to make the final decision. A tummy tuck should be the last resort for people who have exhausted all other measures, and the procedure should not be used as an alternative to weight loss.
Who are the best candidates for a tummy tuck?
A tummy tuck is suitable for both men and women who are in good general health overall and are at a stable weight. It is best to be a non-smoker.
A tummy tuck should not be confused with a liposuction (the cosmetic surgery used to remove fat deposits), although your surgeon may choose to perform liposuction as part of a tummy tuck. Women who have muscles and skin stretched after several pregnancies may find the procedure useful to tighten those muscles and reduce that skin. A tummy tuck is also an alternative for men or women who were obese at one point in their lives, and still have excessive fat deposits or loose skin in the abdominal area.
When should you avoid a tummy tuck?
If you're a woman who is still planning to have children, you may want to postpone a tummy tuck until you're through bearing children. During surgery, your vertical muscles are tightened. Future pregnancies can separate these muscles and cause a hernia.
Are you still planning to lose a lot of weight? Then you do not want to consider a tummy tuck until your weight has stabilized.
It's important to note that a tummy tuck causes scarring on the abdomen. This scar is usually long and might be noticeable . If this is something you don't want, you may want to reconsider.
Your doctor will discuss all these options with you when you go for the consultation. You and your surgeon will discuss the results you want, and the surgeon will determine the appropriate procedure during your consultation.
How is a tummy tuck done?
Depending on the results you want, this surgery can take anywhere from one to five hours. Your situation also will decide whether you have the surgery as an in-patient or outpatient procedure. You will receive general anesthesia, which will put you to sleep during the operation. It's important to have someone with you who can drive you home. If you live alone and you're sent home after the procedure, you also will need someone to stay with you at least the first night after the surgery.
This option is for patients who need the most correction. The incision (cut) is made low on the abdomen, at about the same level as your pubic hair, and usually extends from hip bone to hip bone. Your surgeon will then manipulate and shape the skin and muscle as needed. You will also have an incision around your navel (belly button) with this procedure, because it's necessary to free your navel from surrounding tissue. Drainage tubes may be placed under your skin; these will be removed in a few days as your surgeon sees fit.
Partial or mini-abdominoplasty
Mini-abdominoplasties are done with shorter incisions and are often performed on patients whose fat deposits are located below the navel. During this procedure, your belly button most likely will not be moved. Your skin will be separated between the line of incision and your belly button. This type of surgery may also be performed with an endoscope (a long tube with a small camera on the end). This procedure may take up to two hours, again, depending on your situation and needs. As with the complete abdominoplasty, you may have drainage tubes after surgery.
This surgery includes the back area. When there is a lot of excess fat in the back as well as the abdomen, you may have either liposuction of the back or circumferential abdominoplasty. The latter procedure allows for the removal of both skin and fat from the hip and back areas, which improves the shape of your body three-dimensionally.
After your partial or complete tummy tuck, your incision site will be stitched and bandaged. Your surgeon may have you wear an elastic bandage or compression garment after surgery. If so, it's very important that you follow all of your surgeon's instructions on wearing this garment and caring for the bandage. Your surgeon will also instruct you on how to best position yourself while sitting or lying down to help ease pain.
If you are exceptionally physically active, you will have to severely limit strenuous exercise for four to six weeks. Your doctor will advise you on this as you go through the healing process. You may need to take up to one month off work after the surgery to make sure that you recover properly. Again, your doctor will help you determine this.
How should I prepare for a tummy tuck?
Smoking can increase the risk of complications and delay healing. If you smoke, you will have to stop for a certain period as determined by your doctor. It is not enough to just cut down on smoking. You must completely stop using all forms of nicotine—gum, patches, and e-cigarettes—for at least two weeks before surgery and for two weeks after.
Make sure you eat well-balanced, complete meals. Do not try to diet excessively before the surgery. Proper nutrition plays a key role in healing properly.
As part of your pre-operative consultation, your surgeon may instruct you to stop taking some of your medications and dietary supplements for a certain period before and after the surgery. You must let your surgeon know if you are taking any blood thinners.
Make sure you set up the safest, most comfortable recovery area to meet your needs before you undergo the surgery. Your home recovery area should include:
- A supply of loose, comfortable clothing that can be put on and taken off very easily
- A telephone within easy reach
- A hand-held shower head and bathroom chair
What are the complications and side effects of a tummy tuck?
As expected, you will have pain and swelling after surgery. Your doctor can prescribe a painkiller if needed, and will instruct you on how best to treat the pain.
Soreness may last for several weeks or months. You may also have numbness, bruising, and overall tiredness for that same time period.
As with any surgery, there are risks. You may have an increased risk of complications if you have poor circulation, diabetes, heart, lung, or liver disease, or if you smoke. Complications can include:
- Hematoma (bleeding)
- Seroma (accumulation of fluid)
- Poor wound healing
- Loss of skin
- Blood clots
- Numbness or other changes in sensation
- Risks related to anesthesia
- Changes in skin color
- Long-lasting swelling
- Fat necrosis (death of fatty tissue located deep in the skin)
- Wound separation
- Asymmetry (unevenness or lopsidedness)
Return to living after a tummy tuck
Generally, most people love the new look after they've undergone this procedure; however, you may not feel like your normal self for months after the surgery. You've gone through a tremendous amount to make this happen. It is a big commitment, emotionally, physically, and financially. It is very important that you follow proper diet and exercise to maintain your new look.
Does insurance cover a tummy tuck?
Insurance carriers usually do not cover elective, cosmetic surgery. But your carrier may cover a certain percentage if you have a hernia that will be corrected through the procedure, or if you have had surgery for weight loss. It's extremely important that you begin communicating with your insurance company early on, and that you discuss your insurance concerns with your surgeon.
In most cases, your surgeon will write a letter to your insurance carrier, making the case that the surgery is medically necessary, if it applies to you. Insurance may only cover certain portions of the surgery, so make sure you get details. With any cosmetic surgery, this may affect future insurance coverage for you, and your premiums may increase.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 9/2/2016...#11017