Abdominoplasty (Tummy Tuck)

Abdominoplasty is often called a tummy tuck. During this procedure, extra fat and skin can be removed from your stomach or belly (abdomen). And certain muscles can be repositioned to help with abdominal weakness. Keep in mind that the results will vary for each person. Discuss your treatment goals with your surgeon ahead of time. They can tell you more about what the surgery can do for you.

Preparing for surgery

Prepare for the surgery as you have been told. Also:

• Tell your surgeon about any recent health conditions and all prescription and over-the-counter medicines you take. This includes herbs and other supplements, as well as illegal drugs. It also includes any blood thinners, such as warfarin and certain anti-inflammatory medicines, including aspirin, and clopidogrel. You may need to stop taking some or all of them before surgery.

• Follow any directions you are given for not eating or drinking before surgery. If you have been told to take medicines, take them with a small sip of water.

• Don't smoke or use vaping nicotine products for 1 month before surgery. Smoking reduces the blood flow in the skin and raises the risk of wound healing problems. Nicotine from any source (cigarettes, e-cigarettes, patches, chewing tobacco) slows healing. Your healthcare provider may delay your surgery if you are smoking. Join a stop-smoking program to improve your chances of success.

The day of surgery

The surgery takes about 2 to 3 hours. You may go home the same day. Or you may stay overnight in a hospital or outpatient surgical center.

Before the surgery begins

• An IV (intravenous) line is put into a vein in your arm or hand. This line delivers fluids and medicines.

• To keep you pain free during surgery, you’re given general anesthesia. This medicine puts you into a deep sleep through the surgery. A tube may be inserted into your throat to help you breathe.

During the surgery

• Your surgeon will make an incision in the belly from hipbone to hipbone. This is often along the lower part of the belly just above the pubic hairline. You and your surgeon will choose the exact incision site before surgery. An incision is also made around the bellybutton.

• The skin and fat are lifted to expose the abdominal wall beneath. The abdominal wall includes fascia (fibrous tissue) and muscles.

• If needed, the belly muscles are pulled together to tighten the abdominal wall. Stitches are used down the middle of the belly beneath the skin to hold the muscles in their new position.

• After the abdominal wall is tightened, the skin and fat are pulled back down. Excess fat and skin are then removed from the belly.

• Once the skin and fat are pulled down, the bellybutton may be covered up. In such cases, an incision is made so the bellybutton can be brought back out through the skin. The skin is then sewn into place around the bellybutton.

• Small tubes (drains) may be placed near the incisions. These drain fluid that may build up as the wound heals. You will be directed on how to care for the drains at home.

• Any incisions made during the surgery are closed with stitches, surgical glue, or both. If stitches are used, they may dissolve on their own. Or they may need to be removed by the surgeon at a later date.

After the surgery

You will be taken to the postanesthesia care unit to be watched as you wake up from the anesthesia. You may feel sleepy and nauseated. If a breathing tube was used during the surgery, your throat may be sore at first. You will be given medicines to control pain and nausea. If you need to stay overnight, you may be moved to another room. Once you are ready to go home, you will be released to an adult family member or friend.

Recovering at home

Once home, follow any directions you are given. Your surgeon will tell you when you can return to your normal routine. During your recovery:

• Take any prescribed medicines exactly as directed.

• Don't smoke. Smoking reduces blood flow and slows wound healing.

• Walk slightly bent at the waist, if suggested by your healthcare provider. This helps protect the abdominal wall as it heals. You may also be advised to sleep in this position.

• Care for your incisions and the bandage over them as directed by your healthcare provider.

• Don’t shower for 72 hours after surgery, or as directed by your healthcare provider. Don't swim, take a bath, use a hot tub, or do other activities that cause the incisions to be covered with water until your healthcare provider says it’s OK.

• When you shower, gently wash your incision sites. Then gently pat the incisions dry. Don’t apply lotions, oils, or creams to the incisions until after they are fully healed.

• Don’t lift, push, or pull anything heavier than 10 pounds for at least 14 days or as directed by your provider.

• Don't do strenuous activity, and exercise as directed. Talk to your healthcare provider about light exercise, such as walking, that you can do to maintain your weight until you’re fully healed.

• Don’t drive until you are no longer taking prescription pain medicine and your healthcare provider says it’s OK.

• If advised by your surgeon, use a cold pack wrapped in a thin towel to relieve discomfort and control swelling. It’s important not to leave the cold pack on for too long, or your skin could be damaged. Put the pack over your bandages for no more than 20 minutes at a time or as directed by your provider. Then leave it off for at least 20 minutes or as directed by your provider. Repeat this as often as needed during waking hours until swelling starts to improve. Don’t fall asleep with the cold pack on. If you’re not sure how to safely use the cold pack, ask your surgeon.

When to call your healthcare provider

Call your surgeon right away if any of the following occur:

• A fever of 100.4°F ( 38°C ) or higher, or as directed by your healthcare provider

• Symptoms of infection at an incision site, such as increased redness or swelling, warmth, pain that gets worse, or foul-smelling drainage

• Pain that is not relieved by medicine

• Nothing comes out of your drains for more than 6 hours

• Pain, swelling, redness, or warmth in your leg, calf, or thigh

Call 911

Call 911 if you have chest pain or trouble breathing.

Follow-up

You will have follow-up visits so your surgeon can see how well you’re healing. If needed, stitches or drains will be removed at one of these visits. To maintain the results of your tummy tuck, take steps to prevent gaining weight. Talk to your surgeon if you have questions or concerns.

Risks and possible complications

Risks and possible complications include:

• Bleeding

• Infection

• Blood clots

• Excessive scarring

• Changes in sensation, such as numbness or pain

• Skin discoloration

• Death of fat cells deep in the skin (fat necrosis). Or death of the skin that may result in an open wound

• Damage to nearby nerves, blood vessels, soft tissues, or organs

• Not being happy with how it looks

• Risks of anesthesia. Your anesthesiologist will discuss this with you.