Tummy Tuck (Abdominoplasty)

Definition

Abdominoplasty, commonly referred to as a tummy tuck, is a reconstructive and aesthetic surgical procedure that removes redundant skin and subcutaneous fat from the abdominal region while correcting weakened or separated abdominal wall muscles (diastasis recti). The procedure restores abdominal firmness, improves contour, and enhances both functional integrity and cosmetic appearance.

Abdominal laxity and skin redundancy often occur after pregnancy, significant weight loss, aging, or genetic predisposition. In many cases, these changes cannot be adequately addressed by diet or exercise alone. Abdominoplasty therefore offers both aesthetic rejuvenation and functional repair, contributing to improved posture, core stability, and quality of life.

Indications

Abdominoplasty is indicated for patients with:

Excess abdominal skin and soft tissue laxity after pregnancy or massive weight loss.
Diastasis recti: Separation of the rectus abdominis muscles, often seen postpartum, leading to abdominal protrusion and core weakness.
Loss of skin elasticity due to aging.
Genetic predisposition to abdominal wall laxity or localized fat deposits.
Umbilical or incisional hernia, which may be corrected concurrently.

The ideal candidate is in good general health, non-smoking, close to their target weight, and has realistic expectations. Importantly, abdominoplasty is not a weight-loss surgery, but rather a body contouring and muscle-repair procedure.

Preoperative Considerations

A detailed preoperative assessment is essential for safe outcomes:

Comprehensive medical evaluation including past surgeries, comorbidities (diabetes, hypertension), and medications.
Lifestyle modifications: Smoking cessation at least 2–4 weeks prior; discontinuation of anticoagulants under medical supervision
Surgical planning: The surgeon assesses abdominal wall integrity, distribution of adipose tissue, and degree of skin excess to determine whether a full abdominoplasty, mini abdominoplasty, or extended abdominoplasty is indicated.
Expectation alignment: Patients are counseled regarding realistic results, scar location, and recovery timeline.

Surgical Technique

Abdominoplasty is performed under general anesthesia and usually takes 2 – 5 hours, depending on complexity.

Steps of the Procedure:

Abdominoplasty is performed under general anesthesia and usually takes 2–5 hours, depending on complexity.

Incision: A low horizontal incision is made across the suprapubic area, typically concealed within the bikini line. The length corresponds to the degree of skin redundancy.
Muscle Plication: The rectus abdominis muscles are tightened with sutures to correct diastasis recti and restore abdominal wall tone.
Excision of redundant tissue: Excess skin and subcutaneous fat are excised. In cases of significant weight loss, extended excision may be necessary.
Umbilical transposition: In full abdominoplasty, the belly button is repositioned to a natural anatomic level.
Closure: Incisions are closed with layered sutures, and drains may be placed to prevent seroma formation.
Compression garment: Applied immediately postoperatively to reduce swelling and support healing.

Postoperative Course (Recovery)

Recovery is progressive and requires adherence to medical guidance:

Early phase (first 1–2 weeks): Swelling, bruising, and mild-to-moderate discomfort are expected. Analgesics and prophylactic antibiotics may be prescribed.
Mobility: Patients are encouraged to walk early to prevent thromboembolic complications, but must avoid strenuous activity.
Drain management: Drains, if placed, are usually removed within 5–10 days.
Activity resumption: Most daily activities resume within 2 weeks; heavy lifting and exercise should be avoided for 6–8 weeks.
Scar maturation: Incision lines fade gradually over several months, typically remaining hidden within clothing lines.

Risks of Tummy Tuck Surgery

When performed by an experienced surgeon, abdominoplasty is safe; however, potential risks include:

Infection or wound dehiscence
Bleeding or hematoma
Seroma (fluid accumulation)
Unsatisfactory scar or hypertrophic scarring
Skin necrosis (rare, associated with smoking)
Sensory changes in the lower abdomen
Thromboembolic events (rare but serious)

To minimize these risks, it is important that you carefully follow your surgeon’s recommendations and pay attention to the postoperative care process.