A tummy tuck surgery or abdominoplasty is a surgical procedure usually performed in women who have had children with redundant skin and fat in their abdomen associated with looseness of the muscles.

• Women who have lost significant weight with redundancy of skin and fat.
• Women after multiple pregnancies and flabby abdomen.
• Women who have completed childbearing.
• Women with incisional hernias.
• Men with skin and fat redundancy after massive weight loss.
• Men with paraumbilical hernias and redundant fat and skin in the abdomen.

A physical evaluation of the patient is needed first. Examination focuses on the extent of skin and fat redundancy in the lower and upper abdomen.
A leg raising test is performed to note the presence of any hernias and to note the divarication of the recti.
If an incisional hernia is present then the gap and the reducibility of the hernia are noted.
The extent of skin resection is calculated by apposition.

• Routine blood tests are recommended prior to surgery to know the anesthetic fitness of the patient.
• Chest X-ray and ECG are also done.
• An ultrasound of the abdominal wall is recommended to visualize any occult hernias.
• In patients with incisional hernias which are large, the hernia is reduced and the patient asked to sleep with legs raised for at least 3 weeks prior to surgery so as to accommodate the diaphragm.
• Incentive spirometry in patients with poor lung function and incisional hernias.
• Smoking should be stopped for at least 3 weeks prior to surgery, same with alcohol.

There are basically 3 main types of abdominoplasty apart from variations. These are:

Standard abdominoplasty targets the abdomen both the region above the belly button as well as below. Excess skin and fat are removed from the midsection and the umbilicus is positioned into its normal anatomical position.
This method employs an incision which starts from the front of one hip to another. The separated abdominal muscles are repaired in this technique to produce a firm appearance to the tummy.

In mini abdominoplasty the contouring is done in the portion below the belly button. The incision employed is smaller compared to a standard abdominoplasty. The separation of the muscles in the lower portion of the abdomen is repaired along with removal of fat and skin from the lower abdomen.

This method employs a longer incision compared to a standard abdominoplasty and addresses sagging in the abdomen and flanks. Tummy, waist and hips are contoured in this technique.

Have a light meal the night before surgery.
If you are feeling anxious, take an anxiolytic.
If you are taking any medications for blood pressure or any other problems you should take those unless prohibited by your surgeon.
Get a good night’s sleep!

Do not take anything by mouth, not even water from the morning of surgery as your surgery would be done under general anesthesia or spinal anesthesia.
You can have a bath if you feel like.
If you are taking any morning medications and have been informed by your surgeon to take the same then take it with a small amount of water.
Go to the surgical facility in time and get admitted and sign all the forms.

Markings would be done first and the final extent of the scar would be demonstrated to the patient.
Any final questions the patient might be having are answered at this stage.
The patient is next put under general or spinal anesthesia and surgery started.
The incisions are made, the excision of skin and fat is done, the muscles are tightened and drains inserted and final closure done.

You will need to stay in the surgical facility for 1-2 days and would be discharged home thereafter.

Oral antibiotics would be given to you and you would need to take these so as to reduce any chances of infection.

Pain killers would be given to you along with antacids and these would be needed to reduce the pain which subsides drastically after the initial 2-3 days.

You would be advised to wear an abdominal belt or another compression garment for a couple of weeks after the procedure: this supports the abdomen and lessens pain.

Drains would be removed after an appropriate time frame usually within a week.

Take rest for the first few days after surgery. Bed rest is not recommended, ambulation is advised.

Avoid strenuous activities for around 2-3 weeks after surgery.

Clean the surgical site 2-3 days after surgery with soap and water and then apply an antibiotic ointment and dressing as advised by your surgeon.

Follow-ups with the surgeon are recommended at appropriate time frames so as to assess healing, once the surgeon is assured that the wounds have healed well, he will then remove the stitches.

Scar lightening gels would be advised to you after the wounds have healed completely.

Similarly massaging your tummy would be of help once the wounds have healed.

Final results usually take around 6 months to be evident completely.

Bleeding under the skin flap which might require emergency intervention and/or blood transfusion.

Infection – rare.

Changes in skin sensation which might take months to recover.

Skin contour irregularities, much of which will resolve with time.

Abnormal scarring – hypertrophic scars and keloids, these are rare.

Asymmetry – due to unequal fat deposits or abnormal muscle tone.

Delayed healing – especially in smokers.

Seroma – which might have to be drained.

Umbilicus – may be unattractive following surgery.

Chronic Pain.

Deep Venous Thrombosis and others.

Kindly view the gallery section to see real pictures of patients.

Correction of a ventral hernia.

Benefits patients with stress urinary incontinence.

Decreases back pain.

Improves posture.

Improves abdominal tone and provides for a sculpted appearance to the abdomen.

Stronger core and enhanced self-esteem of the patient.

As a component of mommy makeover, abdominoplasty restores the pre-pregnancy appearance of the abdomen.

Removal of striae or stretch marks below the umbilicus, stretch marks above the umbilicus will however, persist.

Masculine abdominal appearance in males with elimination of love handles.

1. https://www.plasticsurgery.org/cosmetic-procedures/tummy-tuck#:~:text=Tummy%20tuck%20surgery%2C%20also%20known,through%20exercise%20and%20weight%20control.https://www.plasticsurgery.org/cosmetic-procedures/tummy-tuck#:~:text=Tummy%20tuck%20surgery%2C%20also%20known,through%20exercise%20and%20weight%20control.
2. https://pubmed.ncbi.nlm.nih.gov/28613712/https://pubmed.ncbi.nlm.nih.gov/28613712/