Tummy Tuck Surgery (Abdominoplasty)

Average length of stay: 8 Days

Length of stay in hospital: 2 Days

Operation Duration, 2-4 Hours

Anesthesia, General Anesthesia

Recovery duration: 6 Months

Overview

Over time, the skin becomes more elastic, and the abdominal wall loses elasticity. Even when the muscles are trained, the connective tissue relaxes. This is often the case, especially after weight loss or pregnancy. A toned stomach and a slim waist – this is how many people want their ideal appearance. However, exercise and a healthy diet do not always help you achieve your desired figure. After extreme weight loss or pregnancy, the body often does not reduce the greatly expanded abdominal wall. This is because of slack or torn connective tissue structures in the subcutaneous tissue, which previously gave the abdominal skin support and firmness. The result is wrinkled, hanging flaps of skin ("fat aprons") and visible overstretching of the subcutaneous tissue ("pregnancy marks").

Sagging of the abdominal muscles can also be the result of long-term obesity or pregnancy. In particular, a drifting apart of the vertical rectus abdominal muscles (diastasis recti) leads to a wider waist. Even intensive training cannot reverse this slackening. A tummy tuck can help improve the abdominal region. Sagging tissue is tightened downwards, and excess skin flaps are removed. The belly button is moved accordingly. It is also possible to join the rectus abdominal muscles.

Abdominoplasty is not a way to lose excess weight. It is often performed in addition to liposuction. The best results are achieved in slim, healthy patients whose flabby abdominal tissue does not respond to exercise and diet. During the operation, a long horizontal scar is created over the intimate area, which fades over time but does not become completely invisible. The doctor will talk to you about the placement of the scar. There is also a small scar on her belly button. An additional vertical scar is sometimes required (Fleur de Lis Surgery). The abdominal wall is flatter and more even after the procedure.

Methods

Before the operation, the surgeon measures and marks the excess skin and fat areas. The skin incisions should be made in such a way that they ensure inconspicuous scarring. Extra regions of skin are removed along with the underlying fatty tissue. To do this, the surgeon makes a wave-shaped incision that begins above the pubic hairline and runs along the pelvic bones to the end.

Incision during tummy tuck

The second incision is made around the belly button to separate it from the abdominal skin. The opened abdominal flap can be raised to the costal arch. If necessary, the slack abdominal muscles are also tightened. The loosened skin flap is folded back down and then pulled. The open edges of the wound are closed with precise sutures, and the belly button is repositioned through an incision. The operation is completed by creating small drainage tubes through which excess tissue fluid and small amounts of blood can be drained to the outside. These tubes are removed after approximately one to two days. A compression bandage is applied in the operating room.

A sagging abdominal wall with excess skin can also result from diastasis recti. If this is the case or just a matter of tightening the abdominal muscles, the procedure can also be done endoscopically. Not all skin is lifted during this internal tummy tuck, and the navel can remain in its original position.

Diagnosis and indication

A tummy tuck is indicated if the abdominal area has extreme excess skin. The friction of the skin flap - for example, after massive weight loss - often leads to skin irritations, infections, or ulcers. Even after pregnancy, the flap created by the stretching of the skin often does not return. The abdominal wall is not only stretched during pregnancy but also softened hormonally. The skin flap does not go away in some patients despite extensive abdominal exercises. In the same way, abdominoplasty provides relief for weakening and resulting separation of the rectus abdominal muscles. The muscle weakness results in a bulging of the abdominal contour, which can be eliminated with a tummy tuck. The width of the muscles is also corrected.

The tummy tuck is not intended to reduce fat. If you are generally overweight, dietary measures are required first. The tummy tuck operation can be supplemented with liposuction if stubborn pads remain on the flanks. However, suctioning upper abdominal fat is not without risk.

Surgical methods for tummy tuck

In traditional abdominoplasty, the surgeon removes a transverse, spindle-shaped skin area. The incision is made parallel to the pubic hairline. This means that the later scars are as visible as possible. Towards the sides, the cut rises W and extends to the hip bones.

If necessary, the abdominal skin is loosened from the hip bones over the muscles up to the costal arch. This allows the abdominal wall to be pulled down by around ten centimeters and tightened. The surgeon removes the excess skin. If the abdominal wall is weak, the muscle layer is also sutured. The navel is cut and left in place.

At the lowest points of the operating area, the surgeon inserts suction drainage tubes on the right and left to direct the accumulating tissue fluid and blood residue to the outside. The wound edges are then sutured in several layers. Only at the end is a hole cut into the tightened skin above the remaining navel and the navel sewn into it.

Endoscopic abdominoplasty eliminates weaknesses in the abdominal wall (the rectus abdominal muscles) without removing significant excess skin. The surgeon sutures the abdominal muscles with an endoscope through a small access at the pubic hairline.

A tummy tuck is a significant operation that places much strain on the body. Therefore, it is only possible under general anesthesia. After the operation, the patient must observe strict bed rest for one day. The hospital stay usually lasts one to four days.

Recovery phase & follow-up treatment for a tummy tuck operation

After surgery, a knee roll will be placed in bed to relieve pressure on the surgical suture. The upper body should not be stretched or bent significantly in the first few days after the operation. The patient must remain in bed for one day. Prevention of thrombosis is an important factor due to limited mobility.

The drains are removed after about 48 hours. The stitches around the navel remain for seven days; the surgeon removes the remaining stitches after two weeks. A fitted bodice must be worn after the operation: day and night for six weeks and only during the day for another six weeks. The patient should take two weeks off work or three weeks for physical work. Relaxed swimming and cycling are allowed after two weeks, jogging and fitness after six weeks, and strength training should be avoided for three months.

INDICATIONS FOR A TUMMY TUCK (ABDOMINOPLASTY)

• Remove loose skin (e.g., after significant weight loss)
• Reduce sagging skin due to weak connective tissue
• Restore aesthetic body feeling after pregnancy (overstretched & sagging skin)

METHODS AND TECHNIQUES FOR A TUMMY TUCK AT A GLANCE

• I Minimal laxity (Variable Minimal diastasis)
• Suction-assisted lipectomy
• II Mild laxity (Variable Lower diastasis)
• Mini abdominoplasty
• III Moderate laxity (Variable Lower upper diastasis)
• Modified abdominoplasty
• IV Severe laxity (Variable Complete diastasis)
• Standard abdominoplasty with or without suction lipectomy

MINOR LOWER ABDOMINAL PLASTIC

This method is used for patients with slight skin excess from the pubic border to the navel. During the smaller lower tummy tuck, the muscles are not tightened; the excess skin and fatty tissue are removed, and the wound is closed with a small, fine suture above the pubic area.

This method is known under the term "mini-abdominoplasty" and is mainly used by models, who sometimes have a perfect lower stomach again just eight weeks after pregnancy. The technique is only suitable for very slim patients with small findings.

UPPER AND LOWER TUMMY TIGHTENING

This method is a further developed upper and lower abdomen lift (total abdominoplasty). The technique is ideal for shaping the middle of the body aesthetically and circularly. With this method, several areas can be tightened and shaped at once: the waist and abdominal wall, and the removal of excess skin with simultaneous muscle tightening is possible in one operation. While three operations were previously necessary, namely muscle modulation or abdominal plastic, connective tissue tightening, and the removal of excess skin, this is done during one procedure with the abdominal corset lift. This method also remodels the belly button.

BODY LIFTING

Body lifting is the best method for tightening the stomach, waist, flanks, buttocks, and thighs. The technique, perfected by the American Ted Lockwood, is suitable for patients who have massively reduced their weight. It requires a substantial surgical team and intensive inpatient follow-up care over several days. Therefore, in Türkiye, this procedure is usually covered by health insurance companies and is carried out in larger hospitals with a special department for plastic surgery.

WHAT IS THE TUMMY TUCK?

A tummy tuck (abdominoplasty) is a surgical correction in which excess skin and fat from the lower abdomen are removed, and the muscles of the front abdominal wall are tightened. This procedure can significantly improve the body contour. A toned stomach and a slim waist are part of today's common beauty ideal. However, it is often the case that the tissue has become loose over the years; pregnancy or significant weight loss, as well as frequent weight fluctuations, further increase the loss of elasticity in the skin. At a certain point, this process can no longer be reversed, even with diet and regular exercise. In these cases, a tummy tuck can help improve the shape of the abdominal region. The sagging tissue is tightened downwards, and the excess is removed. A transverse scar is created just above the pubic hairline, which can extend from one hip bone to the other, depending on the findings. The belly button is repositioned accordingly. Especially after pregnancy and weight loss, the rectus abdominal muscles often separate. These can be brought back together during a tummy tuck, which also tightens the stomach.

FAQ

•Abdominoplasty is a severe operation that subjects the body to calculated trauma. As with any surgical procedure, there is a risk of infections and tissue necrosis. Short-term hematomas (bruises) must also be expected in every patient.

•Drainage tubes inserted during the operation prevent the adverse effects of possible secondary bleeding and accumulation of tissue fluid. They are removed after about two days.

•Specific possible complications after tummy tuck surgery include umbilical circulatory disorders and deformities. Small asymmetries in the course of the scar and the contour are challenging to influence.

•The operated skin may initially remain numb, but full sensation returns within six months.

How does a tummy tuck work?

•The operation required for a tummy tuck is a procedure that should not be underestimated. It is carried out exclusively under general anesthesia and lasts one to three hours.

•During the operation, the aesthetic plastic surgeon removes the excess tissue through an incision that is as scar-saving as possible and runs approximately between the belly button and the pelvic bone.

•The resulting scar can usually be easily covered with laundry or bath towels. Immediately after the tummy tuck, the patient receives a special compression bandage in the operating room, which supports wound healing and contributes to an optimal result. Small drains that remain in the body for a few days ensure fluid from the wound can drain away.

What follow-up treatments are necessary after a tummy tuck?

•After a tummy tuck, a short inpatient stay of one to four days is recommended. The surgeon removes the wound drainage during your stay.

•Physical protection is advisable for around two to three weeks after the procedure.

•During check-ups two and three months after the tummy tuck, the specialist checks the progress of the wound healing. The aesthetic plastic surgeon discusses a precise plan for follow-up treatment individually with each patient.

TUMMY TUCK AND SCARS: WILL VISIBLE SCARS ALWAYS REMAIN?

Every operation leaves some scars behind. However, during a cosmetic procedure such as a tummy tuck, these scars are so fine that patients do not find them bothersome. If the scar heals well, only a line-shaped, white scar remains in the area of the slip zone. The fine seam in the belly button usually fades after a few months, so you can present your new body scar-free and toned in a bikini.

However, suppose a significant excess of skin needs to be removed - usually after a substantial weight loss - or if the skin is very loose. In that case, a vertical tightening in the midline area of the front abdomen is carried out in addition to the tummy tuck. Using an inverted T incision or fleur-de-lis technique, a vertical seam is also created that runs downwards around the navel. This incision can be extended as far above the navel as desired.

AFTER-CARE – THIS IS WHAT YOU NEED TO CARE AFTER A TUMMY TUCK

Usually, one day after the tummy tuck, you will be fit enough to leave our private clinic to recover from the procedure in your usual surroundings. Ideally, please arrange for a friend or relative to pick you up from us and bring you home safely. We can also call a taxi for you.

When you get home, please make yourself comfortable and take it easy. Depending on the extent of the operation, we recommend that our patients take between 8 and 14 days of vacation or have their family doctor issue a corresponding sick note. Wear the unique corset or belt to compress the operating area for about two to three weeks – day and night. It is advisable to wear it for the next four to six weeks after consultation. You don't have to worry about pain. Most patients get by with minimal pain medication. Strong painkillers are usually not necessary.

Avoid heavy lifting or straining during bowel movements. Exercise is also taboo in the initial period after the tummy tuck; light walks are possible again after the first week. More minor children can be lifted, provided the belt is fastened.