Tummy Tuck Q&A - Dr. Hayes Answers the Most Popular RealSelf Tummy Tuck Questions

Learn how a tummy tuck can restore a pre-pregnancy tummy by flattening your stomach and narrowing your waistline. 

What is a tummy tuck? I've heard about mini , full, and extended tummy tucks, what is the difference?
A tummy tuck refers to removing excess skin from the abdomen and tightening the abdominal wall. The terms mini, full, and extended refer to the length of the incision. 

All tummy tucks use an incision that is placed very low on the abdomen. Key differences include:

• A mini tummy tuck uses a shorter incision, but only tightens the abdominal wall below the belly button.
• A full tummy tuck adds an incision around the belly button, so that more skin can be removed and the abdominal wall is tightened ABOVE the belly button also.
• An extended tummy tuck uses a longer incision, so that extra skin on the sides of the tummy is also removed.

An in-person consultation is used to determine which type of tummy tuck is best for each patient. In general:

• Women who have had a pregnancy do better with a full tummy tuck. This is because their abdominal wall benefits from tightening the top and bottom.
  
• An extended tummy tuck is good for people who have lost a significant amount of weight, and may have more excess skin on the sides of the tummy.
  
• A mini tummy tuck works well if there is only a little excess skin and the person only needs tightening of their abdominal wall below their belly button.

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What is the tummy tuck recovery like?
During a tummy tuck procedure, sutures are placed in the abdominal wall. They tighten the tummy and narrow the waistline. This is commonly referred to as a muscle repair. The muscle repair takes six weeks to heal fully. Because of this repair, my patients are advised to not lift more than 10 pounds for the first six weeks after their surgery.

Here is a common recovery schedule in my practice:

• Week 1: Pain medicine is commonly used for the first week (oxycodone), drains are...
• in place in the tummy, activities like walking are strongly encouraged. I use long-acting local anesthetic (Exparel) to help decrease pain for the first three days after surgery. Patients start wearing a surgical garment to help with swelling and to give their tummy some support.
• Week 2: Drains are removed, patients are increasing their activity and walking more, it is recommended that they do not raise their heart rate or blood pressure, they should not lift anything more than 10lbs (unfortunately this includes children). Patients start to return to work.
• Week 3: Most patients have returned to work, patients note that it's much easier to perform activities, but notice that they're more tired than they expected. They continue to need extra rest. They stop using the surgical garment and start using a lighter compression garment, like Spanx (or Target brand shapewear).
• Week 4: It's okay to raise your heart rate with more vigorous walking, but I ask you to avoid full cardio. Swelling in the areas of liposuction (flanks) is continuing to go down, but is still present. It will take 6-9 months to see the full effect in the areas of liposuction.  
• Week 6: Return to full activities (working out, lifting) without restrictions. Even at six weeks there is still soreness with heavy lifting or working out.
• Weeks 8-12: Patients are getting their strength back and feeling back to normal regarding their day-to-day energy level.

Clinic Visits after Tummy Tuck Surgery:

• 1 day: I see everyone the first day after surgery. I like to be able to check on pain control, make sure there are no issues, and take the opportunity to answer questions that may have come up.
• 1 week: The first drain is removed
• 2 weeks: The second drain is removed, start scar therapy (silicone sheeting or paper tape)
• 6 weeks: Final check-up.

How long does tummy tuck swelling last?
Most of the swelling typically subsides after 2-3 months, although a small amount of residual swelling can be present for longer. The area right above the incision is the last place to develop new lymphatic channels, so this area can stay swollen the longest. I perform liposuction of the love handles (flanks) during my tummy tuck surgeries. The liposuction narrows the waistline and makes the buttocks appear more full and round. Areas of liposuction stay swollen for several months, and the liposuction sites take 6-9 months to see the final results.

Can tummy tuck scars be hidden below your underpants? Can I wear a bikini one year after tummy tuck?
Yes! I keep the scars from my tummy tuck procedures as low as possible. I make sure that the incision is hidden by clothing. I ask patients to bring in underwear or a bathing suit bottom that they would like to wear after the surgery. By marking the borders of the underwear before drawing my incision lines, I make sure that the incision is hidden as much as possible.

Will my C-section scar be removed during a tummy tuck?
A tummy tuck incision is kept very low on the abdomen, so it can be hidden by clothing. The C-section scar is removed along with the extra skin.

Will a tummy tuck remove stretch marks?
An abdominoplasty surgery removes the excess abdominal skin by making an incision on the lower part of the abdomen. The excess skin is trimmed and the incision is sutured closed. The amount of stretch marks that can be removed depends on where they are located on the tummy (top or bottom) and how much excess skin someone has. Typically stretch marks located below the belly button will be removed. Stretch marks on the upper abdomen may move lower down on the tummy, but typically cannot be removed completely.

How long should I wear my binder/garment after a tummy tuck?
Wearing a garment after tummy tuck surgery is not required. However, using a garment for the first six weeks can help the swelling decrease more quickly. Also, a garment or binder, can provide extra support that many patients find more comfortable than going without. I have patients wear a surgical garment for the first three weeks. Then I have them switch into a lighter weight compression garment, such as Spanx.

Can you have a baby after a tummy tuck?
The short answer is yes. However, it's important to understand that having a child after a tummy tuck surgery will change your surgical result. During a tummy tuck, sutures are placed to tighten the abdominal wall. A pregnancy will restretch the abdominal wall and make it loose again. This may cause some of the bulging of the abdomen to return. It's possible to do a revision surgery to retighten the abdomen, but in general I advise patients to finish having children before having their tummy tuck surgery. This gives them the best chance to have a beautiful and long-lasting result.

Should I lose weight before a tummy tuck surgery?
This is a very good question and the answer depends on what someone's goal weight is. In general, someone should reach their goal weight before having a tummy tuck. If they are within 10-15 pounds of their goal, then it's okay to proceed. However, if someone intends to lose even more weight, then it's best to do it before surgery. Large amounts of weight loss after a tummy tuck surgery may create excess skin, causing them to want a revision. Typically their BMI (body mass index) should also be less than 30 when considering a tummy tuck surgery. This helps decrease the risk of complications.

How much does a tummy tuck cost?
The price of an abdominoplasty varies between surgeons and regions of the country. The cost of any cosmetic procedure is determined by three things. It include a surgeon's fee, an anesthesia fee, and the cost of the operating room (facility fee).  An in-person consultation is used to determine the exact amount of time that the procedure will take, which affects the total cost. In my office, the cost is typically $8,000-9000 for a full tummy tuck.

How do I make an appointment?
To book an appointment, or for further information, contact us online or call (503) 297-9340.