Why do some people have a tummy tuck?
You might want to have a tummy tuck because:
- you have loose skin after major weight loss
- your abdominal skin and muscles might have become slack after pregnancy
- you have abdominal scarring from earlier surgery or injury
- it’s part of another operation that you need, such as hernia repair
Tummy tuck surgery removes excess fat and skin and can tighten your abdominal muscles to improve the shape of your abdomen. Some stretch marks from pregnancy may be removed and others made less noticeable.
Tummy tuck surgery isn’t a treatment to help you lose or control your weight and won’t stop you from gaining weight in the future either.
Getting the right advice before having a tummy tuck is important. If you’re thinking about having a tummy tuck, talk to your GP. They might be able to refer you to a reputable surgeon or advise you on how to choose a hospital to be treated in.
What to think about and do before you decide to have a tummy tuck.
- Think about what you want to change and research the different types of tummy tuck procedures. Understanding the procedures might help you to manage your expectations around what you want and what can realistically be attained.
- Research potential surgeons; check they have the right qualifications and that they regularly do the type of procedure you want. See our FAQ: Finding a surgeon, for more information.
- Have a thorough consultation with your potential surgeon. Your consultation is a great opportunity to get more advice and answers to questions. In the lead up to your consultation, it will help to write any questions down as and when you think of them so you don’t forget. If you go to a clinic and see a ‘counsellor’ or ‘advisor’, make sure you also see the surgeon who will do your operation before signing up.
- Take time to reflect before you make a final decision. The decision to have this treatment must be yours. Don’t feel pressured or be influenced by anyone else. If you need more time, take it.
- Think about your care after your operation. Will there be someone around to help you with your day-to-day responsibilities – taking the dog for a walk or lifting things around the house? This will be particularly important if you have any problems after surgery.
When you see the surgeon to discuss having a tummy tuck, there are quite a lot of areas to cover. The surgeon should:
- fully explain the procedure, including telling you about the recovery period and what to expect
- make sure that you understand what it is possible to achieve and that you don’t have unrealistic expectations
- explain all possible risks and complications
- tell you if there are other options for you, whether surgical or non-surgical
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 up to eight weeks before your surgery. Smoking increases your risk of getting a chest and wound infection, which can significantly slow your recovery. Coughing from a chest infection will make recovery much more painful. Smoking also reduces the amount of blood that reaches your skin, which means your wounds may heal more slowly.
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
You have tummy tuck surgery under a general anaesthetic. This means you’ll be asleep during the operation. Before a general anaesthetic, you are normally asked not to eat or drink for six hours beforehand. Your surgeon or anaesthetist will give you specific advice on what you may or may not eat or drink and for how long before the operation.
Your surgeon will make sure you understand what will happen before, during and after your operation. They’ll also explain 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. This will help you to be informed, so you can give your consent for the operation to go ahead. You’ll be asked to sign a consent form.
Your surgeon may ask you to wear compression stockings from the time of your operation until you are fully up and about again. This helps to prevent blood clots forming in the veins in your legs.
What are the alternatives to tummy tuck?
Although it’s not strictly an alternative, you might be able to have liposuction to reshape your abdomen. This is where your surgeon uses a special machine to suck out excess fat from under your skin.
You can have it on its own instead of a tummy tuck, but it only removes fat, whereas a tummy tuck removes fat and skin. After liposuction, your skin will shrink back a little, if you’re younger and your skin is still quite elastic. But if you have loose skin or muscles before the operation, then liposuction alone won’t be effective.
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 have excess skin, liposuction alone won’t be effective.
Liposuction may occasionally be an added part of a tummy tuck procedure.
As with any medical procedure, liposuction can have side-effects and longer-term complications. Your surgeon will tell you about the potential risks and benefits of tummy tuck and any other treatment options available to you.
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 can take between two and four 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 discuss this with you and explain which type is most suitable for you and why. Occasionally, liposuction may also be done at the same time as your tummy tuck, but your surgeon will explain whether this is needed.
Standard tummy tuck
Your surgeon will make a cut in your abdomen from hip to hip along your pubic area (in women this is also called your bikini line). They’ll make another cut around your belly button to free it from the surrounding skin. Then the repair will tighten your abdominal muscles and remove excess fat and skin. The remaining skin is pulled down and a new hole is made for your belly button so that it 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. You can usually hide these scars with your underwear or with swimwear such as a bikini or shorts, but this may not always be possible.
The picture below shows an example of the position of the scars that you may have after a tummy tuck. This will differ from person to person and on the type of tummy tuck you have. Your surgeon will explain the scars you’re likely to have.
Mini tummy tuck
You can have a mini tummy tuck if you only need to have a small amount of skin or fat removed. Your surgeon will remove excess skin and fat from below your belly button and you usually have liposuction at the same time. Afterwards, you’ll have a curved scar on your abdomen above your pubic area. This may be slightly shorter than with a standard tummy tuck. Your belly button stays in the same place, but it may be a slightly different shape.
What to expect afterwards
Depending on what operation you have, you may need to stay in hospital for up to two to four days after your surgery.
When you wake up, you’ll have dressings covering your lower abdomen. You may also have fine tubes coming out of the wound, to drain fluid. These will usually be removed before you go home. You may have a drip in your arm to keep you hydrated and for medicines. It’s usually taken out as soon as you can drink enough fluid.
Tummy tuck can be quite painful so your surgeon or anaesthetist will prescribe painkillers for you to have as injections through your drip or into muscle, or as tablets. Do take them if you need to. Having your pain well controlled with regular painkillers will help you to get better more quickly.
While you're in bed, your surgeon may ask you to keep your knees bent, so that 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 whether you need to come back to have any non-soluble stitches taken out.
You'll need to arrange for someone to drive you home. Try to have a friend or relative stay with you for the first 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.
Recovering from a tummy tuck
When you’ve had a tummy tuck, it’s important not to do too much too soon. If you're too active, you can slow down healing and may increase swelling around your wound. The key is to pace yourself.
It usually takes about six weeks to make a good recovery, but this varies between individuals and the technique used, so it's important to follow your surgeon's advice. The usual advice is to take about four weeks off work after the surgery.
When you get home, you may be advised to rest in bed for another day or two, but you should get up and go to the toilet. It will help your recovery if you’re up and about as soon as it isn’t too painful.
Avoid movements that put specific stress on your tummy muscles – try rolling sideways to help you to get out of bed.
Don’t try to 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. Only after you’re comfortable around the house should you gradually build up to taking longer walks of five to ten minutes.
Don’t do any vigorous activity (including sports) or heavy lifting (including heavy shopping) for at least six weeks. Your abdominal muscles normally protect your back when you lift so you need to take care until they are healed. 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 the hospital. Some exercises are also outlined in our FAQ: Exercises to do after tummy tuck below. Do remember that every operation and patient is different, so please don’t exercise without checking with your doctor first.
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.
Your surgeon may ask you to wear a support garment (a type of corset) for up to six weeks after your surgery. This helps to ease pain and discomfort and reduce any swelling.
What are the side-effects?
All medical treatments have side-effects. These are unwanted effects that you may get after having the operation. Everyone is different, so we can only give you information on the most common side-effects that are likely to affect everyone having tummy tuck surgery to some extent. You may have:
- numbness or extra sensitivity over the skin of your lower abdomen
At first, everyone will have pain, bruising and swelling to a varying extent. This will start to improve within days of your operation. There will be some longer-term swelling, which 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 red and 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. Because nerves repair very slowly, this often takes a long time to get better and can be permanent in some people.
What are the complications?
Complications are problems that occur during or after the operation. Every procedure has its risks, including tummy tuck surgery. We have not included the chance of these happening to you because this will be different for every person. For specific advice and information, it’s best to talk to your own surgeon.
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 drained 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 your 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 permanent in a small number of people and is because the nerves are injured during the operation
If you smoke, you’re more likely to have complications after surgery. 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 will impair how well their wound heals. Your surgeon will want to make sure that your diabetes is under control before and after your surgery to help reduce the risk of complications. Talk to your surgeon if you are at all worried.
FAQ: How do I find a surgeon for a tummy tuck?
A tummy tuck is cosmetic surgery and is usually carried out by a plastic surgeon.
Plastic surgery is one of the nine main specialities recognised by The Royal College of Surgeons (RCS). Consultant plastic surgeons who work in the NHS must be listed as being fully trained on the General Medical Council (GMC) Specialist Register. For surgeons who only work in the private sector, it's optional. You may wish to ask your surgeon if they are registered and about their experience.
In 2017, the RCS are bringing in a certification scheme for plastic surgery. Surgeons who wish to be certificated will have to provide proof of their skills and training. Once this scheme is up and running, the RCS will be launching a Register that the public can access to find a plastic surgeon.
Before deciding to go ahead with cosmetic surgery, you should meet with your surgeon. Don’t be afraid to ask about their qualifications and experience. Tell them what you’re hoping to gain from the operation and ask what result you can realistically expect. Ask whether they belong to a professional association, such as the British Association of Plastic Reconstructive and Aesthetic Surgeons or the British Association of Aesthetic Plastic Surgeons. Both organisations can help you to find a surgeon.
FAQ: Are there reasons why I can’t have a tummy tuck?
Tummy tuck surgery isn’t suitable for everyone. It may not be for you if:
- you have another medical condition, such as diabetes or heart disease
- you have had previous abdominal surgery or scarring
- you’re a heavy smoker
- you’re very overweight
- you’ve 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 with it. Otherwise, you put yourself at more risk and the benefit of the surgery will be much less.
If you’re not sure about whether the operation is suitable for you, it’s worth speaking to a plastic surgeon. They won’t recommend the surgery if it isn’t right for you.
FAQ: Are there exercises I should do after a tummy tuck?
When you first get home after a tummy tuck, the most important thing is not to overdo it and to follow the advice of your surgeon. You should have information to take home about how much exercise you can take and how long it will take to get back to normal. Do ask what you can do to help your recovery, including asking your surgeon or physiotherapist about suitable exercises and when to start doing them.
To start with, gentle walking is the best exercise. Start with five or 10 minutes and build up gradually from there. You shouldn’t take part in any sports for at least six weeks after your operation. It’s also really important to avoid doing sit-up type exercises for three months after your operation.
Once you have the go-ahead from your surgeon, there are exercises that you can do to strengthen your abdominal muscles. The general advice is to try and do them five times each and repeat two or three times a day, but do ask your physiotherapist or surgeon first.
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.
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 your 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. Try and hold for a count of three, then relax.
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Reviewed by Laura Blanks, Bupa Health Content Team, December 2016
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