Abdominoplasty (Tummy Tuck)

Mr Debashis Ghosh

NHS Consultant
GMC Number: 4657664

Medically reviewed by a licensed NHS consultant

Last updated: 15/08/2019

Photo credit: staras / Shutterstock 

Abdominoplasty, more commonly referred to as a tummy tuck, is surgery that helps to create a firmer, flatter and more defined stomach. The procedure removes excess loose skin and fat from your abdomen, to tighten your abdominal muscles to create a stomach with a flatter appearance. Not to be confused with liposuction another type of cosmetic surgery on the stomach with the objective to change the appearance of your midsection.

Table of Contents:

Tummy Tuck Surgery - An Overview:

Procedure time: 2 to 4 hours

Overnight stay:1 - 3 nights

Anaesthetic:General or local with sedation

Recovery time: Around 4 to 6 weeks  

Full results: 6 to 9 months

Average cost: Around £4,500 to £6,000

Deciding if a Tummy Tuck is Right for You

There are a variety of reasons that someone may want to get a tummy tuck. Some of the most common reasons include:

• having loose skin on the stomach after significant weight loss
• stomach skin and muscles might have become loose (particularly after pregnancy)
• you have abdominal scarring from earlier surgery or injury
• it’s part of another operation that you need (e.g. hernia repair)

Suitable Candidates

A tummy tuck procedure is ideal for people who:

• want to lose weight
• want to remove excess skin or fat from their abdomen
• have lose or weak abdominal muscles that need tightening
• are not pregnant or planning to fall pregnant

But, like with any kind of cosmetic surgery procedure, it’s important to think long and hard about whether it is what you want. Before you consider it, ideally you should ensure you fall under the following criteria:

• Physically and emotionally fit for surgery
• Not smoking for at least 6 weeks before the surgery
• Willing to adopt a healthy diet and do regular exercise to maintain results after surgery
• Expecting realistic goals from your operation

Unsuitable Candidates

Weight Loss

If you want to lose weight, tummy tuck surgery is not for you. This procedure does not help to aid weight loss, it can only help to remove suborn fat or excess skin that cannot be removed through exercise or dieting alone.

If you are currently in the process of losing weight, it is advisable to wait until you reach a weight that you can maintain and are happy with, as major weight loss (or gain) after the operation can affect the results of the procedure.

Pregnancy

If you are a female who is planning on becoming pregnant in the future, a tummy tuck procedure may not be suitable for you. The main reason for this owes to the fact that the surgery involves tightening abdominal muscles (which will stretch during pregnancy), resulting in reversing the tummy tuck results.

It’s also worth noting that going ahead with the operation when you haven’t completed your family will also put you at greater risk of developing a hernia if you were to fall pregnant, so surgeons will always advise you to wait and give this careful consideration before going ahead.

Finding a Surgeon

You may be wondering where to get a tummy tuck if you can’t have the operation carried out via an NHS hospital. If you are looking for a tummy tuck in England, you should begin by checking the Care Quality Commission (CQC) website for treatment centres.

All independent clinics and hospitals that provide cosmetic surgery in England must be registered with the CQC, which publishes inspection reports and performance ratings to help people choose care. If somewhere is not registered with the CQC, you should avoid their services – even if they are cheap – as they may end up doing more harm than good.

You should also research the tummy tuck surgeon who is going to carry out your surgery. Like clinics, surgeons must be registered with the CQC and all doctors must be registered with the General Medical Council (GMC). Here you can inspect the doctor’s practice history before going ahead and booking a consultation for the procedure.

In addition, you may also want to look at:

• how many operations they have performed
• if there have been complications during their operations
• their patient satisfaction rates

Questions to ask your surgeon

Once you have found a few surgeons, you should book in for an initial consultation. This is the best opportunity to find out more information about your surgeon and the procedure, and whether they can help you achieve your desired results.

Some notable questions you may want to ask include:

• Am I a good candidate for a tummy tuck?
• Do you think what I want to achieve is realistic?
• What can I do to get the best results?
• Will a tummy tuck last forever?
• Do you have before and after pictures from previous tummy tuck procedures you have done?
• What are the risks and complications of the procedure – am I high risk?

And more... Be sure to list down every possible question you would like to be answered, as this is the perfect opportunity to digest as much information as you can to help you make an informed decision about whether to go ahead with the procedure and decide on a surgeon.

Preparing for surgery

Your surgeon will explain how best to prepare for your operation as this differs from patient to patient. These are some of the general things to consider before surgery.

Before the Surgery

The main aim of the procedure is to remove excess fat and skin on the stomach, whilst simultaneously tightening the abdominal muscles to improve the shape of your abdomen. This is often caused by substantial weight loss, or a pregnancy that stretches the stomach muscles. In these circumstances, the excess skin cannot be removed through exercise, so many people decide to go under the knife to create a more ‘toned’ stomach.

Please note that 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.

There are two types of tummy tuck procedures: a mini tummy tuck and a full tummy tuck. Generally, both are most often carried out under a general anaesthetic. Read more about the difference between a tummy tuck and a mini tummy tuck here.

Consent Form

On the day of the procedure, you will be given a consent form to fill out by your surgeon. This will authorise your surgeon to go ahead with the surgery and ensures the procedure is covered over their insurance.

Once you have given consent, your surgeon will be able to examine your stomach once more, before drawing lines on your abdomen ready for surgery.

Diet & Lifestyle

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

Anaesthetic

Remember, you are normally not allowed to eat or drink for six hours before being administered general anaesthetic. Your surgeon or anaesthetist will give you specific advice on eating and drinking before your operation.

Clothes

Before the operation goes ahead, make sure you have comfortable clothes that are loose, to ensure you are not in any more discomfort than you need to be post-operation. Just in case you need to stay in hospital for three days, be sure to pack a hospital bag with loose clothing, underwear, toiletries (etc.), as well as some compression stockings to help prevent blood clots forming in the veins in your legs due to inactivity.

Travel to/from Surgery

You may not be able to drive for anywhere between 5 days to 2 weeks after your surgery, dependent on the procedure and your surgeon’s advice. You must, therefore, arrange for someone to drop you off and take you home after your surgery.

Work

Before your surgery, you should inform your employer about your decision to go ahead with the tummy tuck procedure in order to get some time off work to recover. This will be around 4 to 6 weeks for the standard tummy tuck procedure but may be more if you work in a particularly strenuous job that requires heavy lifting and bending down.

The Procedure

Surgery Length

The tummy tuck procedure length depends entirely on the individual and the type of tummy tuck and incisions used. Typically, a tummy tuck can take between two and four hours. Be aware that most people stay in hospital for a few nights afterwards (between 1 and 3), to allow the patient to be monitored and be given pain relief.

Anaesthetic

Before the surgery begins, you will be administered anaesthetic by your anaesthetist. For the tummy tuck procedure, this is usually performed under general anaesthetic, but may also be performed under a local anaesthetic with intravenous (IV) sedation too. This is something you will have discussed with your surgeon beforehand – usually in your initial consultation.

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

Incisions

There are several different tummy tuck techniques used by surgeons, which differ depending on the desired results you want, the type of tummy tuck you are having and your body. Commonly, there are four methods:

• Mini (modified) abdominoplasty
• Full abdominoplasty
• Endoscopic abdominoplasty
• Fleur-de-Lis abdominoplasty

- Mini tummy tuck

A mini tummy tuck involves making one large incision across the lower tummy, below the belly button, on the bikini line (which is smaller in size compared to a full tummy tuck) and removing the excess fat and skin, before stitching the remaining skin back together. This procedure often does not require the surgeon to tighten muscles in the abdomen, but this is reviewed on a case-by-case basis.

This method is most common when only a small amount of skin and fat is being removed. As a result, a mini tummy tuck causes less scarring than a full tummy tuck, however it’s worth bearing in mind that the results are not always as effective.

Even though you should avoid tummy tuck surgery altogether if you are planning on falling pregnant in the future, this procedure is the most suitable option. However, after pregnancy you may need revision surgery if you give birth after the procedure.

- Full tummy tuck

A full tummy tuck is the most common method and is often referred to as the ‘classic’ tummy tuck technique. The procedure entails making two incisions to the stomach to target the upper and lower abdomen. First, one large incision is made across the lower stomach from hip-to-hip (just above the pubic area), and then a second incision around the belly button to free the belly button from the tissue that surrounds it.

In this procedure, the skin is separated from the abdomen to work on tightening the abdominal muscles. The surgeon will then remove all excess fat and loose skin from the stomach. Next, a new hole for the belly button is created and the rest of the remaining skin is stitched into its new position. Due to this, the full abdominoplasty surgery will result in a large amount of scarring, however the results are far more effective than a mini or endoscopic tummy tuck.

This evasive procedure is most suitable for people who have recently lost a lot of weight, or women who may have excess skin, stubborn fat and weak muscles after pregnancy. However, as mentioned previously, this procedure is not advisable for patients who are planning on falling pregnant in the future as it will reverse the results of the surgery and can cause a hernia to form.

- Endoscopic abdominoplasty

For an endoscopic tummy tuck, your surgeon will make several incisions to your pubic line and around the base of your belly button. The surgeon will then insert a small camera – known as an “endoscope” – with small surgical instruments attached to it to perform the procedure.

Of all four incision methods for the tummy tuck procedure, this is the least invasive and produces very minimal scarring that can easily be concealed. It is most suitable for candidates with a protruding abdomen and a small amount of excess skin on their stomach, as well as those whose main goal is muscle tightening.

- Fleur-de-Lis abdominoplasty

The Fleur-de-Lis tummy tuck procedure is the most extreme type and is not often used unless the candidate has lost a very large amount of weight, resulting in large amount of excess skin – this may be as a result of a gastric bypass, for example.

This surgical procedure gets is named from its resemblance to the Fleur de Lis symbol because of its horizontal and vertical incision pattern. It entails three incisions being made into the abdomen, including:

• Around the belly button
• Across the bikini line from hip-to-hip
• Vertically down the middle of the stomach

Due to these three incisions being made to the stomach, this type of tummy tuck causes a large amount of scarring to the stomach. However, the Fleur-de-Lis allows for the greatest improvement of all.

Closure of incisions

After your surgeon performs the surgery and is happy with the finished result, they will close the incisions on your abdomen. To do this, your surgeon will stitch up the incision areas before applying some tape and strapping to the stomach. This helps to keep the stomach taught whilst you undergo recovery.

It’s worth noting that sometimes surgeons may insert some drains into your stomach to aid swelling and bruising, so don’t be alarmed if this happens to you.

Aftercare

Depending on the tummy tuck procedure you have, you may be in hospital for up to three days post-operation for close monitoring.

When it’s time to go home, you will still have your stitches in place. Most surgeons use stitches that dissolve by themselves and your surgeon or nurse/doctor will tell you how long this will take and how to care for them in the meantime. However, if your stitches (if they are not dissolvable) and tubes from your abdomen to drain fluid need to be removed, your surgeon will arrange an appointment with you to return a few weeks post-op. You may also be asked to wear a compression garment (which looks like a corset) for up to six weeks post-surgery to help ease pain, discomfort and reduce swelling.

Your surgeon will be able to give you all the details regarding what to expect after you have your tummy tuck procedure, as it will differ depending on what type of tummy tuck you have. It is crucial that you follow their specific tummy tuck post-op care and advice to ensure you recover successfully.

At first, you may find yourself to be in some discomfort due to the bruising and swelling caused by the surgery, but 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. Your surgeon or anaesthetist will prescribe you painkillers which you should take if you need to, as well as over-the-counter painkillers such as paracetamol or ibuprofen – but avoid any medications containing aspirin 2 weeks following surgery. Controlling pain with painkillers regularly, and following their recommended use, will help you to recover more quickly.

You may also feel some loss of sensation in your abdomen area to begin with, but you shouldn’t be alarmed. This can happen as a result of nerves being cut during the surgery. Nerves repair very slowly, so this often takes months to get better – your surgeon or nurse/doctor will discuss this with you.

Recovery Time for a Full Tummy Tuck

All in all, it takes around six weeks to fully recover from a tummy tuck operation, but this varies from person-to-person and the tummy tuck method used. However, it may take a good few weeks before you see the full effect begin to take shape due to the swelling and bruising from the surgery.

Once you return home, you will be advised to rest in bed for a day or two, keeping your knees bent when possible to avoid strain on your stitches. Avoid too much activity too soon, but it is advisable to start by gently taking small steps around your home each day to aid your recovery. This will reduce the likelihood of blood clots forming. Some surgeons also recommend that for the first few days after surgery you should remain flexed at the hips and avoid straightening your torso as much as possible – as this will prevent you from placing extra strain on your stitches – and when getting out of bed, patients must do so carefully by rolling onto their side.

After a few weeks, you will have to return to your surgeon for a wound check to see whether the stiches are healing well. At the six-week mark, you should be able to remove your pressure garment (corset or tummy control pants) and return to most of your normal everyday activities.

You may not be able to drive for 5 days to 2 weeks after your surgery, depending on your surgeon’s advice. You must, therefore, arrange for someone to take you home after your surgery.

Recovery Time for a Mini Tummy Tuck

The recovery period is usually shorter for a mini-tummy tuck, taking around 2 weeks instead of 4 to 6 weeks as it is not major surgery and often doesn’t include tightening the abdominal muscles. However, you will still need to obey many of the same guidelines as if you were having a full tummy tuck, to avoid opening stitches and preventing the swelling from going down. Your surgeon will give you a full breakdown of the guidelines for a mini tummy tuck, but as a general rule you should avoid strenuous activity for at least six weeks after surgery. Bear in mind that recovery time is a common disadvantage of many cosmetic surgery procedures.

It’s worth noting that recovery times vary depending on the individual, as some people can take as little as two to three weeks off work. Ultimately, it is crucial to listen to your body and to not rush back to work if you are not ready – especially if your job involves heavy-lifting or is particularly active. Your surgeon will advise you on what’s best for you depending on the type of tummy tuck surgery you have had.

Post-op Garment

One of the most important parts of your post-op care is the post-op compression garment you must wear on your stomach. This is essentially a tight corset which is worn around your abdomen to reduce swelling after surgery.

Your surgeon will give you guidance over how long you should wear your compression garment for, but as a general rule, most surgeons require patients to wear it day and night for 4 to 6 weeks post-op, only removing it to wash your body.

Showering & Bathing

Your surgeon will be able to give you specific advice on when you will be able to shower and bathe post-op, as this can depend on the type of tummy tuck surgery and surgeon’s preference. Some surgeons allow you to shower right away, but others may ask you to wait up to 2 days after the procedure.

When drying your body after getting wet, you must ensure you carefully dry your stitch lines with a towel to ensure each wound site is completely dry (to avoid possible infection) and healing appropriately. You will be told how to care for your stitches by your surgeon or nurse/doctor at the hospital/clinic, but if you have any questions, be sure to ask.

Please note: You should avoid using hot tubs or saunas for at least 4 weeks post-op, as this can be detrimental to the healing of your stitches.

Scars

To reduce the risk of blood clots developing, you should start light walking as soon as possible. Surgeons also recommend that for the first few days after surgery you remain flexed at the hips and avoid straightening your torso. This will prevent you from placing extra strain on your surgical incision sites.

Returning to Work

Although the recovery time for a tummy tuck isn’t major, it is advisable to take around four to six weeks off work. If you work in an office, surgeons will often advise you to take at least 2 weeks off work and if your job includes physical activity or heavy lifting, you should take at least 3 to 4 weeks of work. Regardless, you should avoid any strenuous activity – or even light duties – for at least 2 to 4 weeks.

Exercise

Your surgeon will be able to advise you on when to resume your regular sporting activities and exercise again post-surgery. However, in general, you should expect guidelines such as the following:

Weeks 1 – 2

• No exercise – even minor aerobic activities.
• Take light walks where possible to prevent blood clots forming.
• Avoid sexual activity for at least 2 weeks post-op.
• Do not raise your arms above your shoulders, lay on your stomach or lift/push anything.

Weeks 2 - 4

• Resume very light cardio activity, such as walking on a treadmill.

Weeks 4 – 8

• Resume more vigorous activity, such as cycling, but nothing than involves heavy lifting or contact sports.

After 8 Weeks

• Resume all sports and activities as usual.

The Final Results

The results of a tummy tuck may be initially concealed by swelling around your abdomen and not being able to stand fully upright until internal healing is complete. However, after two weeks, you should be able to see a pronounced difference in your shape. Your abdominal area should look and feel flatter, firmer and contoured, to fit in proportion to your body type and weight. However, it can take as long as 6 to 9 months to see the full benefits of the tummy tuck procedure.

But unfortunately, the procedure will leave you with permanent scars due to the incisions made to your stomach by your surgeon. Despite the fact the scar usually heals well, for some people it may take up to 18 months or two years for the scar to fade and to reap the full tummy tuck results.

It’s worth noting that if you put on weight in between having your tummy tuck, your abdominal tissue can stretch and change shape, thus reversing the effects of the procedure. If this occurs, you may want to consider getting a tummy tuck revision to restore the results from the original surgery. Speak to your surgeon for more information about this.

Before and After Photo

Photo credit: staras / Shutterstock

Risks & Complications

Whilst the procedure tends to be highly successful, there are various complications that can occur which you must consider before going ahead. This should be made very clear to you by your surgeon during your consultation, as well as how they can be treated if any problems occurred.

As abdominoplasty is a major operation, you must be prepared for the procedure and long recovery period it entails. For example, a tummy tuck can occasionally result in any of the following:

• Thick, evident scars
• Bulges under the skin
• Extra skin at the edges of the scar (known as “dog ears”)
• Wounds failing to heal
• Fluid in the area that was operated on
• A collection of blood under the skin (haematoma)
• Numbness/pain in the stomach or leg
• Stomach cramps or pain
• Breathing problems

As with any operation, there is a small risk of excessive bleeding, developing a blood clot, contracting an infection or having an allergic reaction to the anaesthetic – although this is rare.

Side Effects

As with any medical procedure, some people can expect to experience some side effects. For the abdominoplasty procedure, you would be left with a scar running across your lower stomach or around your belly button, depending on the type of tummy tuck you had.

You will also have to wear a pressure garment over your stomach area, which is usually a corset or tummy control pants. This can be restricting, so may impact your routine for six weeks after the operation.

In addition, it can be common to experience any of the following:

• Pain and bruising
• Numbness in your stomach for a few months/years
• Fluid-filled swelling above the scar (temporary)
• Red raised scars in the first six weeks after the procedure (these eventually fade to white)
• Difficulty standing up straight as your stomach feels tight (this improves over time)

Cost - How Much Does a Tummy Tuck Cost in the UK? 

In the UK, abdominoplasty costs between £4,500 to £6,000 to have an abdominoplasty procedure. However, the price is often increased further when you include any consultations or follow-up care with your surgeon before or after the procedure takes place.

You may be wondering “can you get a tummy tuck on the NHS?”. Unfortunately, abdominoplasty is regarded as a cosmetic surgery procedure, so it is not something the NHS covers. 

NHS England says: “Cosmetic surgery, including abdominoplasty, is rare in the NHS. In rare circumstances, Clinical Commissioning Groups may decide to commission cosmetic surgery. In each circumstance, there would need to be a very strong clinical case for how it would improve a patient’s health, including significant psychological factors.”

Therefore, you will have to consult a plastic surgeon and pay for the operation yourself.

How much does a male tummy tuck cost?

Abdominoplasty isn’t just for women. Contrary to popular belief, the tummy tuck procedure costs exactly the same for both men and women alike. Read our other post for more information about cosmetic surgery finance options that will help in funding your tummy tuck.

Frequently asked questions about abdominoplasty

• Can I have a tummy tuck if I’m overweight?

• I just want to tone my stomach, is a tummy tuck right for me?

• Can you get a tummy tuck on the NHS?

• When is a tummy tuck medically necessary?

• What if I’m not happy with my results?

• How long after a tummy tuck can you get pregnant?

• How long after a C-section can you get a tummy tuck?