Tummy tuck (abdominoplasty)

Expert reviewer, Mr Foiz Ahmed, Consultant Plastic and Reconstructive Surgeon
Next review due June 2022

A tummy tuck (abdominoplasty) is surgery to remove excess loose skin and some of the fat from your abdomen (tummy), and to tighten your abdominal muscles. It is sometimes combined with liposuction to help shape the abdomen. The results can be long lasting, particularly if you keep to a healthy weight after your surgery.

An image showing a nurse talking to a patient in hospital

When is a tummy tuck necessary?

People have a tummy tuck for many reasons. Sometimes it’s part of another operation such as a hernia repair. Or you may want one because you have:

  • loose skin after major weight loss
  • slack abdominal skin and muscles after pregnancy
  • abdominal scarring from earlier surgery or injury

Tummy tuck surgery improves the shape of your abdomen by removing excess fat and skin and tightening abdominal muscles. It may be possible to remove some pregnancy stretch marks and make others less noticeable.

This treatment can’t help you lose or control weight, and won’t stop you from gaining weight in the future. 

Getting tummy tuck information and advice

Getting the right advice before having a tummy tuck is important. If you’re thinking about it, talk to your GP. They may be able to refer you to a reputable surgeon or advise you on choosing a hospital.

Before you decide to have a tummy tuck, bear the following in mind.

  • Think about what you want to change and research different types of tummy tuck procedure. Knowing more about them may help you to manage your expectations and understand what can realistically be done.
  • Research potential surgeons – check their qualifications and make sure they regularly do the procedure you want. For more information, see our FAQ, How do I find a surgeon or a tummy tuck?
  • Have at least two thorough consultations with your potential surgeon. It’s your opportunity to ask questions and get more advice.
  • Write down what you want to ask before your consultations so you don’t forget.
  • Take as long as you need to make up your mind. The decision to go ahead must be yours. Don’t feel pressured or influenced by anyone else.
  • Think about managing after surgery. Who will help you day-to-day, walking the dog or lifting things around the house? This is particularly important if you have problems after surgery.

If you go to a clinic, talk to the counsellor or advisor. Also make sure you see the surgeon who will do your operation before signing up. When you see the surgeon, there are quite a lot of areas to cover. They should:

  • fully explain the procedure, including telling you what to expect during your recovery
  • make sure you understand what’s achievable, so you don’t have unrealistic expectations
  • explain all possible risks and complications
  • discuss any other options for you, whether surgical or non-surgical

Plastic surgery is one of the ten main specialities recognised by The Royal College of Surgeons (RCS). Consultant plastic surgeons who work in the NHS must be listed on the General Medical Council (GMC) Specialist Register. For surgeons who only work in the private sector, it's optional.

You should research your surgeon on the General Medical Council (GMC) website to check that they are listed on the specialist register for plastic surgery. You can also ask if they are a member of a professional association such as the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) or the British Association of Aesthetic Plastic Surgeons (BAAPS). This will help you find out if they are a fully trained plastic surgeon.

The RCS run a certification scheme for plastic surgery. Certificated surgeons must provide proof of their skills and training. This Register of Certified Cosmetic Surgeons is available for the public on the RCS website.

Preparing for a tummy tuck

Your surgeon will explain how best to prepare for your operation. If you smoke, you need to stop at least six weeks before surgery. Smoking increases your risk of a chest and wound infection, which can significantly slow your recovery. Coughing from a chest infection will make recovery more painful. Smoking can also slow down wound healing.

Your surgeon may also advise you to:

  • lose excess weight – you should be as close to the ideal weight for your height as possible before your operation
  • stop taking the contraceptive pill four to six weeks before your operation, to reduce the chances of a blood clot (thrombosis) – make sure you use an alternative method of contraception
  • give up smoking at least two weeks before your operation, to reduce the risk of getting an infection – this includes not having nicotine replacement therapy (NRT) because nicotine can cause wound healing complications

You have tummy tuck surgery under general anaesthetic. So you’ll be asleep during the operation. You are normally asked not to eat or drink for six hours beforehand. Your surgeon or anaesthetist will give you specific advice on eating and drinking before your operation.

Your surgeon will explain what will happen before, during and after your operation. There are different procedures, but with a typical tummy tuck, a large incision will be made between your bellybutton and pubic hair. Your surgeon will also tell you what to expect when you wake up and what level of discomfort or pain you might have. This is your opportunity to ask any remaining questions you have about the risks, benefits and alternatives to the procedure. You’ll be asked to sign a consent form, so you need to be fully informed about your options and what will happen.

Your surgeon may ask you to wear compression stockings from the time of your operation until you are fully mobile again. This helps to prevent blood clots forming in the veins in your legs.

What are the alternatives to tummy tuck?

Although not strictly an alternative, you might be able to have liposuction to reshape your abdomen. Your surgeon uses suction to remove excess fat from under your skin.

You can have liposuction on its own instead of a tummy tuck, but it only removes fat, whereas a tummy tuck removes fat and skin. Liposuction might be helpful if you’re not generally overweight, but have localised areas of fat that you want to get rid of. If you’re younger and your skin is still quite elastic, it will shrink back a little after liposuction. But if you have excess skin, or loose skin or muscles before the operation, then liposuction alone won’t help.

Liposuction may sometimes be an added part of a tummy tuck procedure.

As with any medical procedure, liposuction can have side-effects and complications. Your surgeon will tell you about the treatment options available to you and their possible risks and benefits.

What happens during a tummy tuck?

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 discuss this with you and explain which type is most suitable for you. Occasionally, liposuction may be done at the same time as your tummy tuck. Your surgeon will explain if you need this.

Depending on what exactly you’re having done, the operation can take between two and four hours, but this may vary between surgeons.

Standard tummy tuck

Your surgeon will make a cut from hip to hip along your pubic area (in women this is called your bikini line). They’ll make another cut around your belly button to free it from the surrounding skin. After tightening your abdominal muscles and removing excess fat and skin, they pull the remaining skin down and make a new hole, so your belly button is in the correct position.

You’ll have a scar around your belly button and a long curved scar on your abdomen above your pubic area. Because of the normal pattern of pubic hair, the scar is generally higher in men than in women. These scars are usually (but not always) hidden by underwear or swimwear.

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

An image showing the position of the scars after abdominoplasty surgery

Mini tummy tuck

If you only need a small amount of skin or fat removed, you can have a mini tummy tuck. Your surgeon will remove any excess skin and fat from your lower abdomen, leaving your belly button in place. They will usually need to use some liposuction at the same time as part of the procedure to help shape your abdomen. Afterwards, you’ll have a curved scar above your pubic area. This may be slightly shorter than with a standard tummy tuck. Your belly button stays in the same place, but may be a slightly different shape.

What to expect afterwards

Depending on the operation you have, you may be in hospital for up to three days after surgery.

When you wake up, you’ll have dressings covering your lower abdomen. You may also have thin tubes coming out of your wound, to drain fluid. These are usually removed before you go home. Some surgeons may use newer techniques where they carry out the procedure without using drains. You may have a drip in your arm for fluids and medicines. It’s usually taken out as soon as you can drink enough.

Tummy tuck can be quite painful, so your surgeon or anaesthetist will prescribe painkillers. You have these as injections through your drip or as tablets. Do take them if you need to. Controlling pain with regular painkillers will help you to recover more quickly.

While you're in bed, your surgeon may ask you to keep your knees bent, so you don’t strain your muscles and stitches.

You’ll go home with your stitches in. Most surgeons use stitches that dissolve by themselves. Your nurse or doctor will tell you how long this will take, how to care for your wound and if you need to come back to have any non-soluble stitches taken out.

You'll need someone to drive you home. Try to have a friend or relative stay with you for at least 24 hours when you get home after your tummy tuck.

You must not drive, drink alcohol, operate machinery or sign legal documents for 24 hours after a general anaesthetic. 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.

At first, everyone will have pain, bruising and swelling to some extent. This will start to improve within days of your operation. Some longer-term swelling is normal, but this should be completely gone within a few months.

Scars usually fade over time, but won't completely disappear. They’ll be very noticeable for the first few weeks, but will then start to fade and blend in more with your normal skin tone. Some people tend to develop more noticeable scars than others.

Numbness can happen because nerves have been cut during the surgery. Nerves repair very slowly, so this often takes months to get better and can sometimes be permanent.

Recovering from a tummy tuck

After a tummy tuck, it’s important not to do too much too soon. Too much activity too soon can put strain on the wound and cause a stretched scar. It can also slow down healing and increase swelling around your wound. The key is to pace yourself.

It usually takes about six weeks to recover, but this varies between individuals and the technique used, so it's important to follow your surgeon's advice. You’re likely to need about four weeks off work.

When you get home, you may be advised to rest in bed for another day or two, but you should get up to use the toilet. It will help your recovery if you’re up and about as soon as it’s not too painful.

Avoid movements that strain your tummy muscles – roll onto your side to get out of bed.

Don’t do too much too soon. Start with gently walking around at home. You can go up and down stairs if it’s not painful. Then start doing housework that is comfortable, such as making drinks or light meals. Once you’re comfortable around the house, gradually build up to longer walks of five to 10 minutes.

You’ll need to avoid vigorous activity (including sports) or heavy lifting (including shopping) for up to 12 weeks. Your abdominal muscles protect your back when you lift, so you need to take care until they are healed. Don’t have sex for three weeks after surgery or drive for six weeks. Your surgeon will give you specific instructions, depending on the type of operation you have.

If you would like some exercises to help you recover, talk to your physiotherapist or surgeon before you leave hospital. Some are outlined in the next section, Exercises you can do after a tummy tuck. Do remember that every operation and patient is different, so please don’t exercise before checking with your doctor.

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

Your surgeon may ask you to wear a support garment (a type of corset) for up to six weeks after surgery. This helps to ease pain and discomfort and reduce swelling.

Exercises you can do after a tummy tuck

When you first get home, the most important thing is not to overdo it. Follow the advice of your surgeon. You should have information to take home about how much exercise to do and how long it will take to get back to normal. Do ask how best to help your recovery, including asking your surgeon or physiotherapist about suitable exercises and when to start doing them.

At first, gentle walking is the best exercise. Take things slowly and build up gradually. But, if you are doing any exercise that pulls on the scar and feels like its stretching, then you should take it a little slower.

Don’t take part in sports for six to 12 weeks after your operation – ask your surgeon for advice. It’s also really important not to do sit-up type exercises for at least six weeks and then take it slowly. Again, if you feel any type of strain, don’t do it. Take advice from your surgeon as different surgeons will have different procedures, which may vary depending on your type of procedure.

Once you have the go-ahead from your surgeon, there are exercises that can strengthen your abdominal muscles.

Knee rolls

Lie on your back, with knees bent and feet flat on the floor. Keeping your knees bent, slowly lower your knees to one side, but only as far as is comfortable. Bring them back to the centre and repeat on the other side.

Pelvic tilts

Lie on your back, with knees bent and feet flat on the floor. Put your hands in the small of your back. Push down so that your back is flat against your hands, tilting your hips up.

Tightening your abdomen

Lie on your back, with your knees bent and feet flat on the floor. Put your hands on your lower abdomen or hips. Breathe in, and as you breathe out, pull your tummy button down towards the floor. Hold for a count of three, then relax.

The general advice is to do each exercise five times, three times a day, but do ask your physiotherapist or surgeon first.

What are the complications?

Complications are problems that occur during or after the operation. Every procedure has risks, including tummy tuck surgery. We haven’t included the chance of these happening to you because this is different for every person. Your surgeon will give you specific advice and information.

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 antibiotics
  • bleeding under your skin (haematoma) – this may need surgery to stop bleeding and drain the area
  • seroma – a collection of fluid around your wound that may need draining with a needle and syringe
  • unusually red or raised scars – these may take several months to fade
  • a blood clot in your lungs (pulmonary embolus)
  • problems with wound healing – these can slow down your recovery and cause more noticeable scars
  • pins and needles, a burning sensation, numbness or pain on touching the skin – this is because nerves are injured during the operation; the injury may be permanent in a small number of people.

If you smoke, complications after surgery are more likely. Your plastic surgeon may be reluctant to operate if you’re still smoking, because this greatly increases the risk of a significant complication. You’re also more likely to have complications if you have diabetes. People with diabetes have poorer circulation and are less able to fight bacterial infections, which can slow wound healing. To reduce the risk of complications, your surgeon will want to make sure that your diabetes is under control before and after surgery. Talk to your surgeon if you are at all worried.

Frequently asked questions about tummy tucks

  • Scars usually fade over time but won't completely disappear. For the first few weeks they will be very noticeable but should start to fade and blend in more with your normal skin tone. Some people tend to develop more noticeable scars than others.

  • Tummy tuck surgery isn’t suitable if you are a heavy smoker, overweight or have had blood clots in the past.

    Many people want this type of surgery because being overweight or multiple pregnancies have stretched their abdominal skin or muscles. Make sure you have lost as much weight as possible and are not planning any more pregnancies before you go ahead. Otherwise, the benefits of the surgery will be much reduced, and you will have all the risks of the procedure without the longer-term benefits.

    If you’re not sure whether the operation is suitable for you, it’s worth speaking to a plastic surgeon. They won’t recommend surgery if it isn’t right for you.

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  • Reviewed by Marcella McEvoy, Bupa Health Content Team, and Liz Woolf, Freelance Health Editor, June 2019

    Expert reviewer, Mr Foiz Ahmed, Consultant Plastic and Reconstructive Surgeon

    Next review due June 2022