Abdominoplasty (tummy tuck)

About tummy tuck

Tummy tuck surgery removes excess fat and skin, and can tighten your abdominal muscles to improve the shape of your abdomen. It can also remove or reduce the appearance of stretch marks and unwanted scars on your abdomen.

The operation removes folds of skin left behind after losing a lot of weight, and tighten stretched skin and muscles after pregnancy.

Tummy tuck surgery is not a treatment for weight control or a substitute for regular physical activity and a healthy, balanced diet. A tummy tuck will not stop you from gaining weight in the future.

The results of a tummy tuck can be permanent as long as you maintain a healthy weight after your operation.

Getting advice

It’s important not to rush into the decision to have cosmetic surgery. Discuss your options with your GP, who may be able to recommend a reputable surgeon or give advice about how to choose which hospital to be treated in. See our common questions for more information.

Before opting to have tummy tuck surgery, discuss with your surgeon what you’re hoping to gain from the operation and the result you can realistically expect.

What are the alternatives?

Lipsosuction, which sucks excess fat out from under your skin, may be an alternative operation. Liposuction is also not a treatment for weight control or obesity. Your surgeon will discuss any alternative options with you.

Preparing for a tummy tuck

Your surgeon will explain how to prepare for your operation. For example, if you smoke you will be asked to stop, as smoking increases your risk of getting a chest and wound infection, which can slow your recovery. Your surgeon may not carry out the procedure if you smoke.

Your surgeon may also advise you to:

  • lose excess weight – a tummy tuck will give the best results if you are the correct weight for your height
  • stop taking the contraceptive pill six weeks before surgery, to reduce the risk of blood clotting (thrombosis) – make sure you use an alternative method of contraception

A tummy tuck is usually done under general anaesthesia. This means you will be asleep during the operation. If you're having a general anaesthetic, you will be asked to follow fasting instructions. This means not eating or drinking, typically for about six hours beforehand. However, it’s important to follow your surgeon’s advice. Very occasionally, certain types of tummy tuck can be done under local anaesthesia and sedation. Your surgeon will discuss your options with you.

Your surgeon will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed, so you can give your consent for the procedure to go ahead, which you may be asked to do by signing a consent form.

Photographs may be taken, so that the results of your tummy tuck can be compared with your original appearance.

You may be asked to wear compression stockings to help prevent blood clots forming in the veins in your legs. You may need to have an injection of an anticlotting medicine called heparin as well as, or instead of, wearing compression stockings.

What happens during a tummy tuck

Depending on how much fat and skin you’re having removed and the technique your surgeon is using, the operation may take up to three hours.

There are several types of tummy tuck. The one you have will depend on how much skin and fat you have removed. Your surgeon will explain which type is most suitable for you.

Standard tummy tuck

Your surgeon will make a long cut in your abdomen above your pubic area (in women this is known as the bikini line). He or she may also make a second cut to remove your belly button from the surrounding skin. Your surgeon will pull stretched or torn muscles together and stitch them in place. He or she will remove excess fat, pull down the skin and reposition your belly button in the correct position. Your excess skin is then removed.

Cuts are closed with stitches and your lower abdomen is firmly strapped with bandages. It’s likely you will have a scar around your belly button and a long curved scar on your abdomen above your pubic area. You can usually hide these scars with your underwear, but this may not always be possible.

Mini tummy tuck

The excess skin and fat from below your belly button is removed, leaving a long curved scar on your abdomen above your pubic area. Your belly button remains in place.

Extended tummy tuck

Excess skin and fat from your abdomen and lower back is removed. You will have a scar around your belly button and a long curved scar on your abdomen above your pubic area, and around your lower back.

The picture below shows an example of the position of the scars that you may have after a tummy tuck. This may differ from person to person and depending on the type of tummy tuck you have. Your surgeon will explain the scars you’re likely to have.

What to expect afterwards

You may need to stay in hospital for up to three days after your surgery.

You will need to rest until the effects of the anaesthetic have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off.

You may have a catheter to drain urine from your bladder into a bag. You may also have fine tubes running out from the wound. These drain fluid into another bag and are usually removed after a day or two. You may have a drip in your arm to keep you hydrated. It’s usually removed when you can drink enough fluid.

You will need to arrange for someone to drive you home. Try to have a friend or relative stay with you for the first 24 hours after your tummy tuck.

General anaesthesia temporarily affects your co-ordination and reasoning skills, so you must not drive, drink alcohol, operate machinery or sign legal documents for 24 hours afterwards. If you're in any doubt about driving, contact your motor insurer so that you're aware of their recommendations, and always follow your surgeon’s advice.

You may need to wear an elasticated garment to help reduce swelling and improve comfort for the first several weeks. You may also be advised to keep your knees bent when you’re in bed to prevent putting strain on your stitches. You may find it difficult to stand up straight at first.

Stitches will be removed after one or two weeks, or you may have dissolvable stitches. The length of time your dissolvable stitches will take to disappear depends on what type you have. Your surgeon will tell you how long this may be and whether you have any stitches that may need to be removed.

Recovering from a tummy tuck

It usually takes about six weeks to make a full recovery from a tummy tuck, but this varies between individuals and the technique used, so it's important to follow your surgeon's advice. Usually you can return to work about three to four weeks after your operation.

If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.

You may be advised to wear a support garment for up to six weeks after your surgery. It’s likely you will have some tightness around your healing wounds.

You will usually be able to do light activities comfortably about 10 days after your surgery. Most people can return to work after two to four weeks, but don’t do any vigorous activity for at least six weeks. Your surgeon will give you specific instructions depending on the type of operation you have.

What are the risks?

As with every procedure, there are some risks associated with tummy tuck surgery. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your surgeon to explain how these risks apply to you.

Side-effects

Side-effects are the unwanted but mostly temporary effects you may get after having the procedure.

Side-effects of a tummy tuck may include:

  • pain and bruising for at least a few days
  • swelling – this may not completely subside for several months
  • scarring – these usually fade over time, but won't completely disappear
  • numbness of your skin over your abdomen – the skin below your new belly button may be numb for several months, but this numbness will gradually disappear as the nerves regrow

Complications

Complications are when problems occur during or after the operation.

The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding or developing a blood clot, usually in a vein in the leg (deep vein thrombosis, DVT).

Complications of a tummy tuck may include:

  • infection – this may need antibiotic treatment
  • bleeding under your skin (haematoma) – this may need surgery to stop the bleeding and drain the area
  • seroma – a collection of fluid around your wound that may need to be removed using a needle
  • numbness – this is usually temporary, but can be permanent.
  • unusually red or raised scars – these may take several months to settle and fade

If you do get numbness in the lower half of your abdomen, take special care of your skin. Be careful if you apply heat to the area, for example if you use a hot water bottle, as you may damage or burn your skin.

The final position of your belly button may be off-centre, and there’s a small risk of losing your belly button completely.

It’s possible you may not be completely satisfied with your appearance after the operation.

After having twins, my stomach isn't toning up even though I exercise regularly. Will a tummy tuck help flatten my stomach?

Answer

Yes, a tummy tuck can help tighten stretched skin and muscles in your lower abdomen that may have been caused by pregnancy. 

Explanation

A baggy lower abdomen is a common problem after having a baby. Your tummy muscles are often weakened by pregnancy. Tummy tuck surgery involves removing excess skin from your tummy and tightening your abdominal muscles. However, it’s best not to have a tummy tuck if you plan to have another baby because this will stretch your skin again.

How do I know whether a tummy tuck is right for me?

Answer

It’s important to make an informed decision about any type of surgery – gather information about the operation, including the risks and benefits, as well as information about different hospitals, clinics and surgeons. Only you can decide whether the operation is right for you. 

Explanation

Don’t rush into a decision to have cosmetic surgery. Discuss your options with your GP who may know of any specialists in your area and can pass on any important health information from your medical records.

Before opting for a tummy tuck, discuss with your surgeon what you’re hoping to gain from the operation and the results you can realistically expect. Excess fat is a common reason to want a tummy tuck, however other types of surgery, for example liposuction, may be more appropriate. There are risks associated with any cosmetic surgery, such as bleeding and infection. You need to consider your options and the risks of surgery carefully when making your decision.

When choosing a surgeon, check they are recognised by the Royal College of Surgeons and that your surgeon is on the General Medical Council’s specialist register – you can do this by looking at the General Medical Council’s website.

Most surgeons who do cosmetic surgery have been trained in plastic surgery. Doctors with only basic medical qualifications should not do cosmetic surgery (basic qualifications are shown by the letters MBBS or MBChB). A doctor who has passed specialist exams in surgery may have the letters FRCS after their name. The British Association of Aesthetic Plastic Surgeons provides details of fully registered surgeons in the UK.

Before deciding to go ahead with cosmetic surgery, you should have an initial consultation with your surgeon. Take a list of questions to ask them.

How long will it be before I see the final results of my tummy tuck?

Answer

It may be several weeks before you see the end result of your tummy tuck.

Explanation

You will notice swelling and bruising to begin with. This usually disappears after several weeks. Elastic garments can be worn to help reduce the swelling in the first few weeks. However, it may be several months before all the swelling subsides and you see the final result of your tummy tuck.

Your scars may be red or pink in colour and raised for the first several months. After this, your scars tend to fade but most scars will be permanently visible. Some people may find their scars are very faint whereas others may find their scars to be more noticeable. If you smoke, it’s less likely your wounds will heal as well. Speak to your surgeon or nurse about caring for your healing wounds.