What is a tummy tuck surgery? Is the fat gone forever?

During the pandemic, many have experienced considerable life changes wit the extra time at home and social distancing from others.  These changes include both weight gain and weight loss often from new habits.   I believe in part to these changes, I have recently seen an increase in the number of patients interested in tummy tucks.

A tummy tuck surgery, also know as an abdominoplasty, is a cosmetic surgery which removes excess fat and skin around the abdomen to create a smoother shape.  Under a general anesthetic, an incision is made low below an underwear line (similar to a C-section incision) and all of the loose skin and fat from the belly button down is removed all the way down to the abdominal wall. 

Often the abdominal muscles have been stretched out from either weight gain or pregnancies, so the surgeon can tighten the muscles during surgery similarly to a corset.  Sutures, also know as stitches, are used to sew the abdominal muscles back together and repair any diastasis. The belly button actually stays in place but a new home is made for it through the newly tightened skin.  

Often patients will ask about needing to lose weight prior to surgery. This conversation is best to be had between the surgeon and the patient, during a consultation.  In an ideal world, I would prefer for my patients to lose weight first and then the focus of the tummy tuck procedure can be to remove the excess skin.  I explain to my patients, that if they are still actively losing weight, then it is similar to shooting at a moving target. 

In contrast, if the patient has maximized his or her weight loss, and there is still additional fat the patient needs help with, liposuction can be performed simultaneously.  Liposuction is a cosmetic surgery that uses a cannula to suck fat out permanently.  Liposuction can be performed on the abdomen itself, and also on the flanks in order to help contour the patient’s waist.  

Sometimes the patient only has a small amount of lose skin, and a mini tummy tuck can be ordered. In this cosmetic surgery, the belly button often stays in place and only the skin below it is tightened and removed. 

Other cosmetic or plastic surgeries can be performed simultaneously as well.  Many patients will combine their tummy tuck with a breast surgery, such as a breast lift with a breast implant.  When these surgeries are performed together, we commonly call this a “Mommy Makeover”.

Patients often ask if the fat will return after a tummy tuck or liposuction is performed.  The answer is no; however, if the patient continues to gain weight, it will go where the fat cells are.  This could be the arms or legs, or buttocks, or even inside the abdomen to the fat that surrounds the organs. 

Patients also ask if the surgery will remove their stretch marks.  If the stretch marks are in the area of loose skin to be removed by the plastic surgery, then yes they will be removed. However, if they are on the upper abdomen they may not be, but often appear improved when pulled tighter.  

Patients also ask about future pregnancies.  I often advise my patients that if they are planning another child in the near future, I would recommend waiting.  However, should a pregnancy occur after a tummy tuck has been performed, all is not lost. Sometimes the skin will retract well enough on its own, but sometimes a small revisional surgery may be needed. 

Patients often ask about the anticipated recovery after a tummy tuck is performed. I performed this cosmetic surgery in our surgery center at Cosmetic Surgery Affiliates as an out-patient surgery - meaning the patient can go home the same day. The patient is encouraged to be ambulating as early as possible without overdoing it. 

Most patients start to wean off pain medication in 3-5 days and typically “turn the corner” by one week. After the first week, the patient is encouraged to ease back into activity, listening to his or her own body.  Patients are able to shower the next day, but no soaking or swimming until the incisions have healed.

The patient is asked to avoid any heavy lifting or intense exercise for at least 4 weeks.  Most of the swelling is down between 4-6 weeks, and although each day and week the patient will continue to look better and better, a final result should be expected between three and six months. 

If a patient decides to get a mommy makeover, combining a breast surgery with the tummy tuck, the recovery is often similar.  The breast surgery is typically more uncomfortable immediately after surgery due to the stretching of the muscle from the implant, but this discomfort improves very quickly. Within a few days, they are on the same recovery course.

During a consultation, your surgeon should be able to discuss if you are a good candidate for a tummy tuck or other cosmetic surgery. Your medical history should be reviewed, and medications discussed.  You may be asked to start or stop certain medications.  Additionally, smoking cessation it of utmost importance for both safety and healing.

As with any cosmetic procedure or surgery, your surgeon should be able to provide an authoritative and trustworthy answer to any of your questions during your consultation. You can learn more about tummy tucks and see before and after pictures at Cosmetic Surgery Affiliates .