Tummy Tuck / Abdominoplasty

A tummy tuck, or abdominoplasty, removes excess skin and fat from the abdominal area and tightens weakened or separated abdominal muscles. This procedure is particularly effective for patients with loose skin after weight loss or pregnancy, enhancing abdominal contour and muscle tone. However, it is not a weight-loss procedure and may be combined with other treatments if additional fat reduction is desired.

Recovery time varies, but generally, most patients can return to light activities within two weeks. Full recovery, allowing for strenuous activities and exercise, typically takes 4-6 weeks. Patients should follow a structured aftercare plan and attend follow-up appointments to monitor healing.

A tummy tuck may remove some stretch marks if they are located on the excess skin that is excised, typically between the pubic area and the navel. However, stretch marks outside the surgical area will likely remain.

Yes, liposuction can often be combined with abdominoplasty to enhance the abdominal contour further. This combination removes stubborn fat deposits around the abdomen and waistline, providing a more sculpted result. Your surgeon will discuss whether this combined approach is suitable for your goals and body type.

Sometimes, liposuction alone may be an option for patients with good skin elasticity and no need for muscle repair or excess skin removal. However, this approach is only suitable for a small number of patients. An abdominoplasty is usually the more appropriate option for those with loose skin or muscle separation. Your surgeon will carefully assess your needs to determine the best procedure.

While it is safe to become pregnant after a tummy tuck, pregnancy may stretch the abdominal skin and muscles, potentially affecting the results of your surgery. For this reason, it’s usually recommended to wait until you are finished with family planning before undergoing a tummy tuck. If pregnancy does occur, a follow-up consultation can help assess any impact on your surgical results.

During a tummy tuck, separated abdominal muscles (diastasis recti) are often repaired, which can improve core stability and strength. However, maintaining these results over the long term requires core-strengthening exercises and a stable weight. Patients should discuss lifestyle considerations with their surgeon to maintain the outcomes.

Tummy tuck scars vary depending on the procedure and individual healing factors. Generally, scars are positioned low on the abdomen, making them easily concealed under clothing. Over time, scars can fade significantly, and certain treatments (such as silicone sheets or laser therapy) may help reduce their visibility.

A tummy tuck offers long-lasting results, especially when combined with a healthy lifestyle and stable weight. However, significant weight fluctuations or pregnancy after surgery can alter the results, so it is recommended to wait until family planning and weight goals are stable.

Most patients see initial improvements soon after surgery, but swelling can take several weeks to subside fully. The final results may take 3-6 months to become apparent as tissues heal and adjust to their new contours.

Many surgeons in the UK use drains during a tummy tuck procedure, and these can remain in place for anything from 1 day to 5 days. The logic behind using drains is to reduce the risk of blood and fluid collecting under the skin. Drains can be uncomfortable for patients and limit mobility. They can delay the time a patient must stay in the hospital. There is little evidence for their use in the published literature.

We looked at 271 patients over a ten year period who had a tummy tuck in our practice. None of the patients had drains as we use a modified technique that we believe limits the risk of bleeding and seroma (fluid collection within the abdomen that is one of the most common side effects of a tummy tuck).

These were some of our findings:

The average age of a patient having a tummy tuck in our practice: 45 years old (range from 20 years to over 60 years)

Average number of previous pregnancies: 2.4 pregnancies

60% of patients had scars on their abdomens from pasts surgery (mostly caesarian sections or hysterectomies)

61% of patients had liposuction of their bellies combined with a tummy tuck

47% of patients had other cosmetic procedures at the same time as their tummy tuck (the most frequent other operation was a breast augmentation/ or breast lift)

Bleeding

1.8% of patients had bleeding after surgery which required them to go back to the theatre to stop the bleeding. This outcome compares very favourably with other studies which used drains. Their bleeding rates that needed a return to the theatre were 0.9%, 3%, 2%, 3.8% and 6.8%.

Seroma

Our seroma rate (which required draining using a needle in the outpatient department) was 7.7%. Again this compares very favourably with other published studies which used drains. The published seroma rates in these studies ranged from 4.5% to 19.2% with most having higher percentages than ourselves.

Wound infection 

Our wound infection rate (infections which required treatment with antibiotics) was 4.5%. Again this compares favourably with other studies.

Our revision rates:

Our revision rate (patients needing a second procedure due to dissatisfaction with the first procedure) was 8.9%. This revision rate was lower than any other published series (range 11% to 34.4%). An extensive series published in the UK  looked at the revision rates of a group of cosmetic surgeons in London and reported a revision rate of  24%.

Our inpatient stay:

On average our patients were in the hospital for 1.7 days. Again this was lower than most other published series bearing in mind that 47% of our patients had other cosmetic procedures carried out at the same time.

Our tummy tuck is no different to a standard tummy tuck in its aim to remove excess skin and fat from the abdomen. The scars are the same (hip to hip), and the abdominal muscles are tightened in the same way when required. The difference is that we leave behind a thin layer of fat (subscarpa fat) over the abdominal wall. This layer of fat is thought to be rich in lymph draining channels that may be important in reducing seroma formation. The thin layer of fat left behind also reduces the amount of space (dead space) when the wounds are closed. Reducing dead space may be helpful in promoting healing and limiting the amount of fluid that can collect.

Our study has shown that tummy tucks can be carried out safely and with low complication rates if drains are not used. Not using drains means less discomfort for patients and earlier discharge from the hospital. We have demonstrated that patients leave the hospital within two days of having surgery (on average) and that our revision rate is low (8.9%)

The no-drain, no-quilt abdominoplasty: a single-surgeon series of 271 patients

Plastic and Reconstructive Surgery 135(3):p 751-760, March 2015