Tummy Tuck (Abdominoplasty)
What Is a Tummy Tuck?
An abdominoplasty, or tummy tuck, is a surgical treatment that involves removing unwanted, loose skin utilizing a low-lying incision that can be concealed underneath most bathing suits or undergarments. During the procedure, which can most often be performed on an outpatient basis, the muscles are also tightened—or “plicated”—to restore the often-desired “flatness” that most women yearn for after having kids. This is also complemented with liposuction in the hip or flank areas to restore the feminine curve from the torso to the hip. It is the blend of using liposuction and abdominoplasty together that will recreate the waistline and restore a youthful abdomen. Dr. Boynton combines lipocontouring and abdominoplasty in all cases to get the best results about the waist and torso.
Individuals who have changes from weight loss or pregnancy are often bothered by the appearance of their abdomen. These changes may include loose abdominal skin and stretch marks, extra lipodystrophy (fat deposits), and rectus diastasis (a stretching out of the rectus muscles after pregnancy)—which can even cause back discomfort because of core muscle imbalance and affect the appearance and even function of the abdomen. Even the most slender women do not escape some changes of pregnancy to their abdominal area. There are patients that may be quite thin and have very little extra skin, but their muscles might be stretched out, which can affect their posture as well as how they look in clothing. Women tend to be especially unhappy with these lax muscles when in a seated position due to their tummies having overhanging skin and fullness. Tummy tuck surgery can address these common concerns and renew the appearance of the abdomen with beautiful results.
This photo shows a typical “mom” with changes to her abdomen in the muscular layer – something we medically refer to as “rectus diastasis” or “separation or stretching apart” of the rectus (6-pack muscles) after changes typically from pregnancy (but sometimes also seen after weight loss). The belly button is also stretched out and enlarged. These features are absolutely improved with any version of abdominoplasty (tummy tuck ) or mini tummy tuck) whereby the muscle covering (the fascia) is sutured back together to the midline and tightened. This gives improvement in appearance and aesthetics of the belly button as well, and it also imparts some functional benefit by improving the function of the rectus muscles (part of the core muscles)….many times we see improvements in patients back pain, abdominal exercise tolerance improvement and also even urinary symptom improvement after pregnancy. Tummy tucks are not just about “skin excess”….they are a comprehensive surgical procedure that addresses all three layers of the abdomen – aesthetically – and functionally – the skin, the soft tissue or fatty layer (subcutaneous layer) and the muscular layer. This photo exemplifies someone with no fat and not much skin excess but most of her issues is the muscular layer that will not improve with just exercise….surgical tightening is necessary! – Dr. Boynton
For more information about tummy tuck surgery, please continue reading the detailed information we have provided throughout this page. If you have any additional questions, or if you would like to schedule a consultation with board-certified plastic surgeon James F. Boynton, MD, please feel free to contact our practice online or by phone today.
- Tummy Tuck Benefits
- Tummy Tuck Candidates
- Tummy Tuck Vs. Liposuction
- Tummy Tuck and Pregnancy
- Tummy Tuck and Mommy Makeover
- Tummy Tuck and Stretch Marks
- Tummy Tuck Procedure
- Outpatient Tummy Tuck
- Belly Button Aesthetics
- Tummy Tuck Recovery
- Tummy Tuck Scars
- Tummy Tuck Results
- Non-Surgical Tummy Tuck
- Tummy Tuck Cost
- Additional Tummy Tuck FAQs
What Are the Benefits of Tummy Tuck Surgery?
No matter the reason for an accumulation of diet- and exercise-resistant fat throughout the abdominal region, tummy tuck surgery can be advantageous in numerous ways. Chief benefits of abdominoplasty can include:
- Elimination of extra, hanging abdominal skin
- A reduction of excess fatty tissue (which some studies have shown to be a health benefit)
- A flattened, more toned stomach and waistline
- An improved fit for various pants, shirts, swimsuits (one or two-piece), and other types of clothing
Along with these aesthetic enhancements, one of the greatest benefits of tummy tuck surgery is functional core muscle improvement. Patients who have their rectus musculature (six-pack muscles) tightened/repaired during the procedure—which is done in almost all cases—often experience better core muscle functionality when performing ab exercises, particular workout routines, and certain daily movements. In addition, Dr. Boynton has had patients who, months after their abdominoplasty, say that previous back discomfort was markedly diminished.
Am I a Candidate for Abdominoplasty?
Tummy tuck surgery can be an excellent surgical solution for many individuals who wish to achieve a more toned and contoured midsection. Candidates for abdominoplasty usually include men and women who have lost a considerable quantity of weight and are bothered by:
- Loose, extra skin (with or without localized fat pockets) in the abdominal region
- Lax, torn, and/or displaced abdominal wall musculature
- Stretch marks across the abdomen
It is important to note that women and men who lose more than approximately 80 lbs (either from diet and exercise or from a bariatric surgical procedure such as LAP-BAND®, gastric bypass, or gastric sleeve) still undergo abdominoplasty or extended abdominoplasty. Sometimes, these patients will need other procedures, such as a posterior thigh lift and/or an LTAP (lateral thoracoabdominoplasty), which is a way of removing residual horizontal excess tissues using a “side-seam” incision like a shirt, rather than directly in the midline, which many surgeons perform and is referred to as a Fleur-de-Lis abdominoplasty. Dr. Boynton does “two-stage” body lift procedures in two parts rather than a circumferential “all-at-once” treatment because of the high risk of complications he has seen for years with others performing this particular procedure. He has found it safer to “do the front” first (i.e. the abdominoplasty) and then come back at three or six months and complete the body lift with the backside portion. This gives the wounds more time to heal, less tension, and is typically markedly better and safer. Dr. Boynton tells all of his MWL (massive weight loss) patients that recurrent laxity is common and, sometimes, areas such as the abdomen have to be revisited in these cases (usually patients with a 200 lb. weight loss). Dr. Boynton is also combining monspexy or mons lift/pubic lift with tummy tucks in these cases.
Tummy Tuck Vs. Liposuction
While tummy tuck surgery and liposuction are both advanced procedures that can effectively enhance body contours, it is important to recognize the significant distinctions between these two treatments. Liposuction is designed to help individuals reduce pockets of excess fat that have collected in specific body areas. If your concern is primarily caused by fat pockets in the abdominal area, liposuction may be all that’s necessary to help you achieve your goals. By contrast, tummy tuck surgery is designed to address excess skin and lax muscles in the abdomen. A tummy tuck tightens the abdominal muscles, removes excess tissue, and pulls the remaining skin taut for a firmer, flatter appearance. In many cases, both excess fat and skin are present in the abdomen; therefore, liposuction is used in combination with a tummy tuck. Ultimately, the best option for you will depend on your unique concerns and overall treatment goals. Dr. Boynton will thoroughly evaluate your needs during the initial consultation and talk with you about the most ideal treatment plan.
Tummy Tuck and Pregnancy
It is very important to understand that many of the positive benefits of a tummy tuck surgery can be reversed if an individual becomes pregnant after having undergone the procedure. While it is certainly possible to have a normal pregnancy even if you have already had a tummy tuck, the fact is that the pregnancy will ultimately stretch – and in some cases tear – the muscles of the abdomen, and may also result in an additional collection of excess skin. These effects would likely require another tummy tuck surgery to correct. This is why Dr. Boynton typically advises patients who are considering a future pregnancy, or are not quite sure yet about their future plans, to wait until they have completed their families before undergoing tummy tuck surgery.
Can a Tummy Tuck Be Combined With Other Procedures for a Mommy Makeover?
Tummy tuck surgery is one of the most popular additions to a Mommy Makeover. Designed to combine a number of cosmetic enhancement options for a comprehensive rejuvenation, Mommy Makeover procedures can help women restore and renew their figures after the physical rigors of pregnancy and child-raising have taken a toll. These advanced treatments often include options such as tummy tuck surgery, breast augmentation, breast lift, liposuction, or cosmetic injectables for facial rejuvenation.
Can a Tummy Tuck Get Rid of Stretch Marks?
One of the most common questions we receive about tummy tuck surgery is in regards to whether it is capable of getting rid of stretch marks in the abdominal area. The answer to this question is yes (at least for a significant portion of them), but it depends on where the stretch marks are specifically located. If a full abdominoplasty procedure is being performed, many stretch marks appearing in the lower and perhaps even the central part of the abdomen (around the belly button) will likely be removed since excess skin in this area is typically excised. Those stretch marks above the belly button will be removed simply because of geometry and how much skin and fat are removed with any tummy tuck (usually an ellipse up to, but not much above, the belly button); however, those stretch marks above the belly button will be “on tension” and, in Dr. Boynton’s opinion, stretch marks on tension look much better than they did before. Additionally, stretch marks that were originally above the belly button will now be lower in the abdomen and can often be concealed under a bathing suit or other clothing. For signs of stretch marks in areas that cannot be significantly improved with abdominoplasty, Dr. Boynton can explore other treatment options that may be helpful for minimizing their appearance.
What Does the Tummy Tuck Procedure Involve?
During abdominoplasty, an incision will first be made along the lower abdomen. Compared to many traditional techniques, the incision Dr. Boynton uses is shorter in length and placed further down on the abdomen, usually eliminating any concern of “high-angled” scars that may jut out from underneath swimsuits and/or underwear. Through this low-lying incision, abdominal musculature is tightened and repaired, and extra skin is carefully excised. Dr. Boynton can also perform liposuction to remove stubborn fat buildups, and the belly button can be adjusted using an additional tiny incision made in the navel (if necessary). Once an ideal contour and overall appearance is achieved, the skin will be sewn together with great care to minimize post-operative scarring as much as possible.
Abdominoplasty generally takes about two hours to perform. While some individuals may need to stay one night in our state-of-the-art surgical facility with a private room (depending on the particulars of their procedure) Dr. Boynton has transitioned to performing true “outpatient” tummy tuck surgeries for most patients thanks to revolutionary EXPAREL®—a long-acting numbing medication that can provide 72 hours of pain relief. You can find more information on our outpatient tummy tuck procedures in the section below. Ultimately, Dr. Boynton will never compromise patient safety standards, and the decision as to whether or not an overnight stay is necessary will depend on the specific wishes and medical condition of the patient after surgery.
Can a Tummy Tuck Be Performed On an Outpatient Basis?
A tummy tuck can be performed, and usually is performed, as an outpatient procedure. At this time, all of the tummy tuck procedures at Dr. Boynton’s practice are outpatient procedures that do not require patients to stay overnight in a hospital/surgical facility. In some cases, patients who are having tummy tuck surgery combined with other major plastic surgery procedures in a single operation, as well as those who are having more extensive tummy tucks that necessitate a longer time in surgery, may need an overnight stay; however, those who are undergoing tummy tuck surgery alone do not generally require an inpatient procedure. Patients typically prefer to have outpatient abdominoplasty since it allows them to recover at home, and Dr. Boynton has found that his patients do extremely well with outpatient tummy tuck procedures. This is due in no small part to the addition of EXPAREL®, which is a medication that numbs the treatment area for three days after surgery, allowing for significant pain relief during what has traditionally been the most uncomfortable part of the recovery period.
While many patients would rather undergo tummy tuck surgery as an outpatient, some may actually feel more comfortable with having an overnight stay. The decision will be determined based on individual needs and wishes so that the best and safest treatment plan is designed for each patient.
The Aesthetics of the Belly Button (Navel)
The belly button (navel or “umbilicus”) is the central “aesthetic feature” of the abdomen. Everyone has a different belly button in terms of shape, size, and appearance. The belly button is really just a “scar” from where the umbilical cord was “connected” during pregnancy and prior to birth. In the last 10 years or more, greater aesthetic emphasis has been drawn to the belly button. Belly button “rings” have become quite popular to draw attention to this area. Most women who are considering a tummy tuck have had children and changes to the abdomen, as well as the belly button. Belly buttons can stretch out, become more of an “outie,” become a different size, or even develop a hernia after the changes of pregnancy. Also, many women who may have worn a belly button ring before having kids and are considering a tummy tuck want that “scar” from their old belly button ring to be removed, as well.
The perfect time to reshape and improve the appearance of the belly button is concurrently with a tummy tuck. The belly button can be “sized down,” and the same belly button is brought out through a new “hole.” Dr. Boynton prefers a vertical oval, which has been found to be the most desirable aesthetic shape to the belly button. He has developed a specialized technique to hide the incision inside the belly button and give patients a nice, sexy, well-shadowed belly button with the proper “hooding” on the upper half. This technique is natural in appearance.
In some cases, if patients have a large belly button hernia, the hernia and the tummy tuck / belly button surgery are done together. Other times it is better to do them as separate procedures. Each case is really individualized by Dr. Boynton in order to provide the most optimal results possible.
What Can I Expect During Recovery from Abdominoplasty?
The majority of individuals will experience some temporary bruising, swelling, and/or soreness immediately following abdominoplasty, but these symptoms should resolve with the passage of time. A significant degree of pain is extremely rare, though any discomfort that might occur can often be effectively relieved with medication. Two weeks off of work – any type – is what Dr. Boynton typically recommends, although many patients seem to be okay with just one.
Patients are able to shower the day after surgery, even with the small drain tubes that stay for five days. Dr. Boynton recommends getting up intermittently to walk around and keep blood flowing during the initial stages of recovery. Most men and women feel well enough to return to normal daily routines—such as office jobs, school, etc.—after approximately two weeks, but strenuous activities like sports, vigorous exercise, and heavy lifting should be avoided for at least four weeks to six weeks, particularly if actions place strain on abdominal musculature.
How Noticeable Are the Scars from Tummy Tuck Surgery?
Dr. Boynton is extensively experienced with tummy tuck procedures and employs techniques designed to minimize the appearance of scarring. Our plastic surgeon typically creates an incision that is lower and shorter than those utilized in most traditional tummy tuck techniques, which often makes the residual scar easier to conceal under clothing and swimwear. Dr. Boynton also uses an advanced skin closure system and silicone gel scar cream to allow for improved healing and diminished signs of scarring following the procedure.
Learn more about tummy tuck scars and Dr. Boynton’s precise techniques designed to minimize their appearance.
Is a Tummy Tuck Permanent?
The results of tummy tuck surgery can last many years into the future as long as some basic lifestyle habits are maintained for as long as possible. Limiting weight fluctuations and sticking to a healthy diet and exercise regimen are some of the best ways to extend the outcome of tummy tuck surgery. There is always the possibility of “recurrent laxity,” but that is a condition we usually only see in patients with massive weight loss (greater than 70 lbs). Keeping control of weight with diet and exercise is the key. Reducing consumption of alcohol and beverages that are high in sugar (or eliminating consumption of those entirely) can also be very helpful. The natural process of aging will still have an effect on the elasticity of the skin, but taking some of these steps to maintain a stable weight and live a healthy lifestyle can make a world of difference.
Is a Non-Surgical Tummy Tuck Possible?
It is natural to wonder whether there are any non-surgical alternatives to tummy tuck surgery that can achieve the same results. Due to the nature of the concerns that abdominoplasty is designed to address, the simple answer is that there are no non-surgical methods capable of replicating the outcome of tummy tuck surgery. The “Tummy Tuck Belt®” and other devices or exercises that purport to provide similar results to surgical abdominoplasty cannot remove excess skin, tighten/repair abdominal muscles, or redrape the abdominal skin to provide a firmer feel and a flatter appearance. The goal of tummy tuck surgery is to address those very concerns. That said, there are certainly other options for patients who are experiencing different types of aesthetic conditions. If excess fat rather than loose musculature or inelastic skin in the abdominal region is what is primarily causing the concern, then a procedure such as liposuction may be the recommended treatment. Dr. Boynton can evaluate the condition of your skin and the concerns you are experiencing to determine the most ideal way of achieving your abdominal enhancement goals.
How Much Does Tummy Tuck Surgery Cost?
The cost of a tummy tuck from Boynton Plastic Surgery typically ranges between $13,000-$15,000 at our Outpatient Surgery Center, which is in close proximity to our office. For patients who want (or possibly need) to stay overnight in the hospital, additional costs would apply. Since each abdominoplasty procedure is customized to the patient’s needs, the total price of tummy tuck surgery varies from one individual to another. Factors such as the complexity of the operation and how much time the procedure will take, the surgeon’s fee, the techniques utilized, fees for anesthesia and the surgical facility, and other components will all be taken into account for the overall price. Once your treatment plan is developed during the initial tummy tuck surgery consultation, a member of our team will calculate an estimate of the total cost and go over it with you in detail. Our practice accepts a wide variety of payment methods, and we work with CareCredit®, one of the most well-known plastic surgery financing companies in the nation. CareCredit® offers many flexible low- and no-interest financing plans, making it possible for qualified applicants to pay for their procedure on a convenient monthly basis.
"I've had several procedures done with Dr. Boynton all of which I'm very, very happy with."
Additional Tummy Tuck FAQs
What is the recovery time? Back to work? Working out?
Patients generally need to plan to be off work for two weeks. As far as cardio, working out can often be started at two weeks. Light weights can typically commence at four weeks, and sit-ups or crunches need to wait about six weeks.
How long will I be in the surgery center or hospital?
Patients who do not have this procedure performed on an outpatient basis often simply stay overnight and usually go home by 7 or 8 am the morning after the procedure.
Will I have drains?
Yes. Drains help remove the fluid that the body creates after the surgical “undermining” of the abdomen during the procedure. They are not a big deal and are well-concealed within clothing. Dr. Boynton’s patients are usually able to shower the next day with drains, and they are generally removed five to seven days after surgery. Dr. Boynton has a technique that holds the patient’s drains while they shower without having to involve another person, which can be very helpful for patients.
What will my belly button look like?
The belly button will look a little funny for a few weeks as it heals. Often, it is the slowest part to heal and requires a simple gauze to be placed “in the hole” for a few weeks. The incision heals “inside” the belly button, leaving a natural-appearing belly button after the procedure.
How long will the incision be?
Dr. Boynton utilizes a shorter and lower scar for his tummy tucks than most traditional techniques. Patients who have had tummy tucks complain most about the scars on the sides. Some techniques involve a “high angled” scar that juts out from a swimsuit. Dr. Boynton keeps his low. Some patients with massive weight loss (greater than 80 lbs) might require an “extended” tummy tuck, which may extend a bit farther around if there is loose skin that needs to be addressed on the “side.”
What about a mini-tummy tuck?
Mini tummy tucks are “mini” with their results. This technique only removes a small amount of skin. The lower abdomen is plicated, leaving the upper abdomen loose and often creating a noticeable bulge. It also pulls the belly button down. There are very few “true” candidates for this procedure. Most patients who think they need a “mini” abdominoplasty actually need a full tummy tuck and are not happy with a mini. The recovery is not that much faster, and patients are not often happy with the overall results.
When you tighten up the muscles will they still function normally?
Absolutely. The covering, or “fascia,” of the muscles is tightened in order to centralize the rectus abdominis (six-pack muscles). They actually function better from a physics standpoint since they are back “in place” where they were prior to the weight gain or pregnancy.
When can I resume eating?
Most patients have liquids the day of surgery and resume low-salt, non-spicy or non-greasy solid foods the day after surgery.
Will I ever need a two-stage procedure? With extra liposuction on the top?
Some patients have quite a bit of “fullness” at the top part of the abdominal area. This area cannot be liposuctioned much at the time of a tummy tuck because it can jeopardize the blood supply to the skin and affect healing. So, for safety reasons, when this area needs more correction than can be done with a tummy tuck, a second outpatient procedure is performed to focally address this area at three months after the tummy tuck with liposuction as a one-hour outpatient procedure.
What is a dog ear deformity?
This is a small area of fullness at the corner or end of the incision. If one arises and needs correction, it can usually be done as a minor procedure in the office.
Do you use pain pumps?
Yes. In fact, the original practice for which Dr. Boynton was a part of in 2005 was the first practice to research with pain pumps after tummy tuck surgery and found it to be helpful in lessening pain and discomfort. Now we utilize EXPAREL®, which is effectively an “internal pain pump.” EXPAREL® is a special molecular form of local anesthesia that breaks down over 72 hours, so it delivers pain control for three full days, which can genuinely make a difference in terms of patients getting up and around with significantly less pain medicine, constipation, or even the need for hospitalization when compared to how it was prior to this advancement.
Schedule a Tummy Tuck Surgery Consultation
If you would like to know more about tummy tuck surgery, or if you are interested in combining the procedure with other cosmetic surgeries as part of a Mommy Makeover, please contact Dr. James F. Boynton today. Our plastic surgeon can meet with you for an initial consultation to talk about your goals and answer all of your questions.