Tummy Tuck 101: A Comprehensive Guide to the Procedure

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We’ve come a long way with tummy tucks since the procedure’s inception to treat wounds in the 1800s. Back then, patients wouldn’t even get a belly button with their result. Today, abdominoplasty, or tummy tucks, are designed to give a flatter and more toned midsection, restore abdominal muscles and remove excess skin. Here, we explore what to expect before, during and after the popular body-contouring surgery.

What are the benefits of a tummy tuck?

A tummy tuck will help achieve a natural-looking flat stomach and correct excess skin and “muffin top” tummies many women experience as they get older. “Apart from getting a flatter stomach, it addresses diastasis recti repair, which involves correcting the bulging of the stomach caused by abdominal wall injuries during pregnancy or weight gain,” says New York plastic surgeon Brad Gandolfi, MD. “The fat removed via liposuction can also be utilized to enhance contours in other areas of the body such as the breasts or hips through a transfer procedure.”

Dr. Capararo’s patient had a tummy tuck and liposuction to recontour her abdomen and flatten her stomach.

Before the procedure 

Prior to undergoing a tummy tuck, it is crucial to consult with a board-certified plastic surgeon to discuss goals and expectations. “During the initial consultation, your surgeon will evaluate your medical history, assess your abdominal area, and address any concerns or questions you may have,” says Denver, CO plastic surgeon Philippe A. Capraro, MD

How is a tummy tuck performed?

A tummy tuck is typically performed under general anesthesia and may take several hours to complete. Dr. Capraro says pregnancy and weight gain can lead to laxity of the inter-abdominal fascia, resulting in weakened and separated muscles. “Outside of surgery, there’s really nothing you can do to get those ab muscles back to how they were. It’s not possible no matter how many crunches you do,” he says. 

The surgery involves tightening the inter-abdominal fascia, which is the connective tissue that supports the abdominal muscles. The fascia is sutured tightly to bring the muscles together, effectively restoring their strength and structure. “I use a three-layer closure technique to ensure a secure and tight closure of the fascia,” he says, comparing the result to a trampoline. “Once those ab muscles are tightened, you’ll be able to bounce a quarter off of them.” He further highlights the role of liposuction during the procedure, which aids in removing excess fat deposits that are resistant to diet and exercise.

The type of liposuction done can help enhance results, too, says Pittsburgh plastic surgeon Brian Vassar Heil, MD. “I prefer ultrasonic liposuction, a technique that liquefies and emulsifies fat using high-energy sound waves,” he explains. “This method not only removes excess fat but also induces some skin tightening, providing patients with more sculpted and contoured results.”

“Without diet and exercise, a tummy tuck can be limited by excess fat inside the body, the intra-abdominal fat,” says Dr. Gandolfi. “At the same time, diet and exercise alone could never remove the amount of excess skin this patient had.” 

What is a mini tummy tuck?

For those who have a small amount of skin to remove and do not need muscle tightening, a partial abdominoplasty, more commonly known as the mini tummy tuck, is can help address excess skin below the belly button only. Mini tummy tucks are often performed as an outpatient surgery and require less downtime for recovery.

What is a drain-free tummy tuck?

Drains help rid the body of natural fluid buildup between the abdominal wall and the newly lifted tissue but can be cumbersome during recovery and sometimes lead to infection. Dr. Gandolfi reveals says that his drainless tummy tuck technique aims to minimize discomfort and enhance healing by reducing disruption to lymphatic channels and preserving underlying structures. “With this technique I use fewer sutures and there’s minimal burning of tissues, resulting in a reduced need for drains and improved patient comfort.”

What is the recovery process like after a tummy tuck?

A tummy tuck recovery period will last several weeks. During recovery, patients may experience swelling, bruising, and discomfort, which can be managed with pain medication prescribed by the surgeon. It is crucial to follow postoperative instructions carefully, including wearing compression garments and avoiding strenuous activities. “By week two, all major hurdles are usually over and most people begin to feel significantly better,” adds Dr. Gandolfi. “Some activities may still be restricted, but all hunching over precautions area lifted.”

By four weeks, patients can return to exercise and garments that are designed to control swelling can be worn. During the first few months the swelling will gradually subside, starting high and ending above the incision.

How long does it take for full tummy tuck results to be visible?

Dr. Capraro mentions that postoperative appointments are essential for monitoring progress and removing any stitches. These appointments allow the surgeon to ensure proper healing and address any concerns the patient may have. “At the one-year mark, your abdomen should be fully healed and the results visible. The inflammation should be gone and the scar should have faded,” adds the surgeon.

While the results may be life-changing, it’s important to note that they must be maintained. “A tummy tuck is designed to be permanent,” says Dr. Gandolfi. “Although some factors like aging, pregnancy and weight fluctuation could alter the results, it’s important to maintain a healthy lifestyle to help ensure the longevity of your investment.”

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