Tummy Tuck - Are You a Candidate?

Reviewed by Richard J. Greco, MD, FACS

Abdominoplasty, more commonly referred to as “tummy tuck,” is a cosmetic surgery procedure for men and women who wish to achieve a flatter, firmer midsection. It involves removing excess skin and fat from the stomach and, in many cases, tightening the abdominal muscles with sutures. The result is a tauter, more youthful stomach that looks great even in the most revealing swimwear.

Your Initial Consultation

To find out if you're a good candidate for a tummy tuck, your first step is to schedule a one-on-one consultation with a board-certified plastic surgeon. Be sure to choose a surgeon who is board certified by the American Board of Plastic Surgery. This level of certification ensures that your surgeon has received extensive training and experience and is held in high esteem by his or her colleagues.

During your consultation, your surgeon will ask you to describe concerns about your appearance and discuss your goals for surgery. He or she will also examine your abdominal skin and muscles and tell you what you need to know about tummy tuck. Your surgeon will most likely show you before and after tummy tuck photos to help you gain a clearer understanding of potential outcomes of surgery.

The Tummy Tuck Procedure

Abdominoplasty is typically performed under general anesthesia, though intravenous sedation combined with a local anesthetic may be an option. Your surgeon will help you decide what type of anesthesia is best for you.

Once the anesthesia is administered, your surgeon will make an incision from hip to hip just above your pubic area. An incision around your navel also may be required.

Your surgeon will then disconnect your skin from the underlying tissues, tighten the abdominal muscles with sutures and trim away excess skin and fat. Liposuction may be used to remove fat deposits. Once all these steps are concluded, your surgeon will close the incision. A drainage tube will likely be inserted to prevent the buildup of fluids beneath the skin.

Are You a Candidate?

The first step toward your new, flat belly is a consultation with a board-certified plastic surgeon. This evaluation will determine if you are a good candidate for a tummy tuck.

The surgeon will take a thorough medical history. He or she will review any medications that you are taking, any allergies you have and whether you have had any prior surgeries or pregnancies. The surgeon will also perform a physical exam to measure the extent of excess fat and the degree of loose skin in your abdominal region.

He or she will also assess the condition of your abdominal muscles and skin tone while you are standing up and lying down. The surgeon will likely take some "before" photos during this consultation process.

Your expectations regarding the tummy tuck will also be discussed during this visit.

Once you have decided to undergo a tummy tuck, chosen a surgeon and scheduled your procedure, your doctor will give you a list of preoperative instructions. This will likely include routine blood work and a cardiac work-up if you have any history of heart disease.

In the two weeks leading up to your tummy tuck, your plastic surgeon will likely ask you to stop taking certain medications, including aspirin and other nonsteroidal anti-inflammatory drugs as well as any medicines that thin your blood — all of which can increase bleeding risk.

Certain herbal remedies may also increase the risk of bleeding. Just because a product or preparation is "all-natural" does not mean it is safe. For example, vitamin E, omega-3 fatty acids, green tea and ginkgo biloba all may increase bleeding risk during and after tummy tuck surgery.

Make sure you tell your surgeon about EVERYTHING you are taking, and don't stop taking any medication abruptly without first speaking to your doctor.

The pre-op instructions will also include a list of do's and don'ts about eating and drinking before your tummy tuck.

Most surgeons recommend quitting or reducing your smoking as much as you can before surgery. Ideally, one would stop for at least a month before and after the tummy tuck. Smoking can cause a delay in wound healing as well as skin necrosis (skin death).

Who May Not Be a Good Candidate?

Patients who are not in good health need a complete physical workup before being considered as a candidate. If you are still overweight or have a significant amount of intra-abdominal fat that surrounds your internal organs, you may need to slim down before considering a tummy tuck. Internal or external scars from any previous abdominal surgery may also affect your candidacy.

Women who are not done having children should postpone this surgery until after their final pregnancy because the muscles that are repaired can separate again during pregnancy. There may be other reasons to postpone a tummy tuck procedure, which your doctor can determine after a thorough consultation.

Related Procedures

If you are considering a tummy tuck, your surgeon may recommend other procedures in addition to, or instead of, abdominoplasty, including:

  • Panniculectomy – Some people who have undergone weight-loss surgery may find that despite the success of their procedure, they are left with a large amount of excess skin. In such cases, the plastic surgeon may recommend a panniculectomy, which involves the removal of drooping apron-shaped section of skin from the midsection.

  • Liposuction – In this procedure, a narrow tube known as a cannula is inserted through small incisions in the skin to suck out subcutaneous fat deposits. Liposuction may be used instead of tummy tuck if your abdominal skin retains its elasticity and your underlying muscles are undamaged. It may also be used during tummy tuck for optimal results.

  • Abdominal etching – Abdominal etching is similar to liposuction. However, rather than removing fat deposits, the surgeon uses the cannula to create grooves in abdominal tissue to simulate the appearance of well-defined, "six-pack" abs.

  • Body lift – This procedure involves the removal of excess, sagging skin and fat in the abdomen, sides and back. It differs from many tummy tuck procedures in that it does not include tightening of the abdominal muscles.

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Tummy Tuck: Are Your Expectations Realistic?

It is important that you understand what a tummy tuck can and can't do for you and your life. The repair and tightening of your abdominal muscles, along with the removal of the excess skin, may greatly improve your body contour and appearance, but it won't change any other aspect of your life. If your stomach area has always made you self-conscious, a tummy tuck will help boost your self-esteem and allow you to feel more comfortable with yourself. Feeling better about yourself certainly affects how other people view and treat you, but cosmetic surgery is by no means a panacea for other problems in your life.

You can manage expectations by viewing tummy tuck before and after photos. This will help you understand what to expect and what not to expect from your tummy tuck.

Other factors to consider are tummy tuck cost, tummy tuck risks and tummy tuck recovery. Recovery can take up to three weeks, which may not be realistic given your work or home responsibilities. Make sure your surgeon tells you what your recovery will entail and what the procedure will cost before committing to a surgery date.

Consult a Qualified Plastic Surgeon for Your Tummy Tuck

Before deciding on a tummy tuck, discuss your treatment options and tummy tuck alternatives with a board-certified plastic surgeon. Plastic surgeons should be certified by the American Board of Plastic Surgery. Such certification ensures that your chosen surgeon has had extensive training and is up to date on new technology and techniques. Start your search now.

Tummy Tuck Costs

Cost is likely one of the variables you will weigh when deciding whether to undergo abdominoplasty. Insurance companies typically do not cover elective cosmetic surgery procedures such as tummy tuck. Your insurer may cover a certain percentage if you have a hernia that will be corrected through the procedure or if the surgery is needed as a result of a pregnancy complication.