6 Things to Know Before Getting a Tummy Tuck

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More than 1.5 million tummy tuck procedures were performed last year alone. The surgery, which involves removing fat and sagging excess skin and repairing the muscles that have become stretched out, continues to be one of the most sought-after aesthetic procedures. But like any other type of plastic surgery, doing your homework is crucial to managing realistic expectations and a best-in-class outcome. 

Here, tummy-tuck expert and Voorhees Township, NJ plastic surgeon William Franckle, MD outlines six things to know before scheduling your surgery.

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There are different types of tummy tucks.
The two main types are a traditional tummy tuck (or abdominoplasty) and a reverse tummy tuck (or reverse abdominoplasty). A traditional tummy tuck addresses both the upper and lower abdomen. "The procedure involves removing fat and loose skin, as well as repairing the abdominal muscles that have separated during pregnancy, weight fluctuation or natural aging," explains Dr. Franckle. "A traditional tummy tuck is ideal for people who have lost weight and have left over loose skin—this procedure works from the chest down to the waistline."

Dr. Franckle explains that a reverse tummy tuck was designed to tighten the abdomen of patients who may have had previous surgeries, such as an open-incision gall bladder removal, "which makes the lower incision of the traditional tummy tuck dangerous because of alteration of the blood supply." Although a reverse abdominoplasty removes fat and skin from the upper abdomen well, Dr. Franckle contends "it does not do as good a job on the lower abdomen, especially if there is overhanging skin at the waist line. It is not performed very often."

However, there are also many variations of a traditional abdominoplasty, which Dr. Franckle says are chosen based on the unique needs of every patient. "If you are looking to reduce excess fat on your abdomen, a full tummy tuck, mini tummy tuck or liposuction alone may be your best option. Generally, if loose skin and/or stretch marks are a concern, experts prefer a tummy tuck over liposuction. "A consultation with a board-certified plastic surgeon can determine which tummy tuck technique is best for you.

You might not be the best candidate.
Generally, Dr. Franckle describes a good candidate for a tummy tuck as someone who is physically healthy, at a stable weight, a nonsmoker and someone with realistic expectations for what can be achieved with surgery. "Patients who are morbidly obese or have other serious health problems may need to have these problems addressed before considering plastic surgery," says Dr. Franckle. "Bariatric surgery can also assist the morbidly obese patient with achieving significant weight loss and overall improvement of their health status prior to plastic surgery."

If you're a smoker, Dr. Franckle advises quitting at least one month prior to surgery. "Smoking increases the risk of a poor outcome—from the quality of healing to more serious problems such as blood clots, wound breakdown and more."

You'll need to plan for a long recovery.
A typical recovery for a tummy tuck is between two and six weeks, but most of the bruising and swelling will dissipate within this period. "In my practice, most people return to work in an office environment after 10 days," says Dr. Franckle. "Full recovery for vacations or activities that may involve swimming or hiking can be as soon as two months. Full healing and maturation of scars may take from 9 months to a year or more, depending on the patient."

Insurance probably won't cover your surgery. 
The average cost for a tummy tuck can range anywhere from $6,000 to 12,000 or sometimes even more. "Because a tummy tuck is a cosmetic procedure, health insurance plans do not usually cover the surgery," says Dr. Franckle. "Sometimes an associated hernia or chronic skin irritation may give some insurance coverage depending on the health plan."

There's a high level of risk.
Due to the advanced nature of the procedure, tummy tucks have a very high rate of complication—many experts agree it has the highest rate of all plastic-surgery procedures. "Most patients are familiar with the look of a tummy tuck scar across the lower waistline, but what they don’t see is the underlying process that mobilizes and advances the tissue in order to remove the excess and create a pleasing body contour," says Dr. Franckle.

The most common complications include delayed wound healing, minor skin infections and fluid collections (aka seromas). "Less common complications are poor scar healing requiring revision, persistent seromas and blood clots leading to pulmonary embolism. Generally, the sooner the patient is up and moving around, the better to prevent these problems."

Seeing an expert is critical to a proper outcome.
Prior to booking your procedure, Dr. Franckle offers up this helpful list of questions to ask your surgeon: Are you certified by the American Board of Plastic Surgery? Were you trained specifically in the field of plastic surgery? How many procedures of this type have you performed? Do you have hospital privileges to perform this procedure? If so, at which hospitals? Am I a good candidate for this procedure? What can I expect for my recovery and post procedure visits to your office?

As with any surgery, the risks of a tummy tuck must be recognized prior to having the procedure, as should the vetting of a proper board-certified plastic surgeon. "Your plastic surgeon should be able to give you a realistic assessment of your expected results with a particular procedure and discuss any specific risks that may make one type of surgery a better or safer choice over another option," says Dr. Franckle.