Tummy tuck is a major surgical procedure that tightens abdominal muscles and gets rid of excess skin and fat.

Abdominoplasty is often performed under general anaesthetic (you are asleep through the procedure). It can also be performed using a local anaesthetic (you are awake during the procedure) with a sedative. There may be some discomfort with local anaesthesia. Time in surgery is about two to five hours.

A tummy tuck usually begins with a long incision across the abdomen, from hip bone to hip bone. The shape of the incision is like a V, with a flat bottom. The flat part of the V occurs at the bottom point of the abdomen immediately above the pubic area. The sides of the V form angles along the pelvis up to the top of the hip bone. A second incision is made to free the navel from the abdominal tissue.

The skin is separated from the abdominal wall, up to the ribs, exposing the vertical abdominal muscles (rectus muscles). The rectus muscles are then stitched into a new position, tightening the muscles and reducing the waistline. After the muscles have been repositioned and tightened, the excess skin is stretched and removed.

The remaining skin is redraped over the abdominal area and sutured in place. The hole created by the incision around the belly button is normally removed when the excess skin is cut away, and a new hole is formed to place the navel proportionally.

Tummy tuck is a major surgical procedure — you can expect a considerable recovery time compared with other plastic surgeries. Most people require one to three weeks before returning to work and a normal schedule. Some patients may not need an overnight hospital stay. But many patients spend one or two days in the hospital, depending on the extent of the procedure. Your abdomen will be swollen and sore for the first few days. Your surgeon can prescribe pain medication as needed.

It is a good idea to exercise after surgery, but only after enough healing time has passed so that you can exercise comfortably.
The abdominal scars will appear to worsen during the first three to six months, and may take nine months before they flatten and lighten in color. The scars never completely disappear, but they are located to be easily hidden by clothing.

The ideal candidates for tummy tuck surgery are patients in relatively good physical shape, but have excess skin or fat in the abdominal area that is resistant to exercise.

This includes the laxity of underlying muscles due to pregnancy which makes it very difficult for mothers to return their abdominal area to a flat appearance. For these women, the skin and muscles have stretched beyond the point where they can naturally return to their normal location and shape.

Other candidates can include patients who have lost a lot of weight and have excess skin in the abdominal area. The normal aging process can also cause skin to sag or lose elasticity, making many older patients excellent tummy tuck candidates.

Good candidates understand the procedure and have realistic expectations. The repair and tightening of the abdominal muscles, along with the removal of the excess skin, may greatly improve body contour and appearance. Improved appearance may improve self-confidence and may change the way others interact with you. However, the surgery cannot bring back your youth or create the ideal figure. There is also no guarantee that other people will treat you differently after surgery.

Abdominoplasty does produce a permanent scar, typically across the full width of the bikini line. However, the goal during the procedure is to make the incision in a natural crease and location that is easily hidden by clothing.

Surgeons typically have before-and-after photos so you can see the results of other patients and learn more about your expected outcomes. The surgeon can explain the details of the procedure, the type of anaesthetic to be used, the extent of skin removal and muscle repair, and the expected recovery period

Women who are considering future pregnancies often postpone the surgery until after their final pregnancy. The muscles that are repaired during the tummy tuck procedure can separate again during pregnancy. There may be other reasons to postpone a tummy tuck procedure, which your doctor can determine.

The purpose of tummy tuck plastic surgery is to change your body shape, not to lose weight. If fat is localized in the abdomen, but there is no excessive skin, then liposuction is an alternative to tummy tuck. Liposuction and tummy tuck are not usually done at the same time, because suction of the skin during liposuction may damage the skin that is being stretched and repositioned.

Obese patients, or those who have large amounts of loose excess skin, may undergo a modification of the tummy tuck procedure called panniculectomy or Body Etching..