Tummy Tuck FAQs

Posted by Laurence Weider on November 11, 2020

Have you tried exercise and diets and are still battling the bulge? If you’ve got too much flab or excess skin in your abdomen that doesn’t respond to diet or exercise, you may be considering a “tummy tuck,” which doctors call “abdominoplasty.”

• When is a good time to have a tummy tuck?

In general, I recommend that patients wait until after they are done having children until having a tummy tuck (or a mommy makeover including a tummy tuck). While there is no risk to the pregnancy from having a tummy tuck and subsequently having a child, a pregnancy after the procedure could compromise your results. One component of most tummy tucks is tightening of the abdominal wall muscles and the surrounding fascia, as they are often stretched out after pregnancy. Often times even intense core exercises after pregnancy won’t tighten the skin and abdominal muscles adequately, and surgery is the only option. If one should become pregnant after a tummy tuck, the fascia and muscles of the abdominal wall could become stretched out again.

• Is a drain necessary after a tummy tuck?

Traditionally, one or two drains are placed during a tummy tuck.  They are removed in the office in five to ten days.  The purpose of the drains is to collect and remove fluid that can accumulate in the space between the fatty tissue below the skin and the abdominal wall muscles. However, the use of Progressive Tension Sutures by the surgeon can mean a drain isn’t needed or it can be removed in a few days. Progressive Tension Sutures are absorbable stitches that reattach the subcutaneous fat to the abdominal muscle layer. In addition to decreasing the need for a drain, they also help by reducing the tension on the incision. Decreased tension often means a thinner, less visible scar. During your consultation, Dr. Weider will discuss whether you will need one drain or if a tummy tuck without a drain is an option for you.

• I have heard that a tummy tuck can hurt a lot. Is that true? Is there anything that can be done to decrease the pain after surgery?

It is true that tummy tucks can be pretty uncomfortable. This is usually due to muscle tightening which is an important part of most tummy tucks. As mentioned above, the abdominal muscles get stretched out from pregnancy and weight fluctuations. The tightening of the muscles and fascia, which is called imbrication, is a necessary step for most women and some men undergoing a tummy tuck. One way to decrease the associated pain is to use a long-acting numbing medicine called Exparel. Exparel can be injected in the abdominal wall muscles where they are tightened. It is a slow-release medication that lasts approximately three days. Dr. Weider typically offers Exparel as an option for anyone undergoing a tummy tuck where muscle tightening is performed.

• I have been told I have diastasis. What is that? Can it be fixed at the time of a tummy tuck?

Diastasis Recti is a separation of the abdominal wall muscles that sometimes occurs during the course of pregnancy. There are two rectus abdominus muscles that run from the bottom of the rib cage to the pubic bone (front of the pelvis). These are the muscles in the abdominal wall on either side of the belly button that create a “six pack” appearance. When diastasis occurs, it can cause a vertical bulge to occur from the top of the abdomen to the bottom. Dr. Weider can fix diastasis at the time of a tummy tuck. This is part of the abdominal wall tightening that is done during most procedures.

• What is done with the belly button during a tummy tuck?

Most of the tummy tucks that Dr. Weider performs are full tummy tucks. That means that the belly button, also called the navel or umbilicus, is released from the adjacent tissue and then reinserted after the excess skin and fat are removed. The navel is a stalk that extends vertically down through the subcutaneous fat and into the abdominal wall muscles. So during a full tummy tuck, a circular incision is made around the edge of the navel and it is separated from the adjacent fat and skin all the way down to the abdominal wall muscle. After this is performed, the skin and subcutaneous fat are freed up all the way to the bottom of the ribs. The patient is then flexed at the waist, and the excess skin and fat are removed. The muscles are then tightened and the navel is reinserted through the skin that was pulled down to connect to the lower incision. The belly button is then sewn into place. Once it heals the incision around the belly button is usually hard to see.

• What is a mini tummy tuck?

A mini tummy tuck differs from a full tummy tuck in that the navel is not released. Instead, excess skin is removed from the lower abdomen above the pubic area, and the abdomen above the navel is contoured with liposuction. A mini tummy tuck is a good option in someone who has a “pooch” or bulging in the lower part of the tummy but whose upper abdomen (above the navel) is relatively flat. Dr. Weider will tell you if a mini tummy tuck is a good option for you.

• Is liposuction part of a tummy tuck?

In most cases, Dr. Weider does liposuction to the flanks (love handles) at the time of a tummy tuck. He sometimes recommends limited liposuction to the upper abdomen as well. As mentioned above, liposuction of the upper abdomen is a component of a mini tummy tuck. In addition, some patients opt to have liposuction in other areas at the time of their tummy tuck as well. Typical areas include the thighs, bra strap area, and under the chin. This can be discussed at the time of your consultation.

• Can a tummy tuck be combined with other procedures?

Yes! A mommy makeover typically means a cosmetic breast procedure such as breast augmentation, breast reduction, or a breast lift done at the same time as a tummy tuck or abdominal liposuction. At the time of your consultation, Dr. Weider will discuss if this is a good option for you. In the meantime, you can contact us here for more info.

• I have heard that I have to stay bent over at the waist after a tummy tuck. Is that true?

For the first five to seven days after a tummy tuck, it is advised that you stay bent at the waist to prevent any disruption of the closure. Each day as the skin relaxes a bit, you will be able to stand up a little straighter. Typically by the end of a week, you will be able to stand up straight again. It is also recommended that for the first week you sleep on your back with your head elevated and with a pillow under your knees.

• I plan to lose weight. Should I have a tummy tuck before or after weight loss?

That depends. If you are planning to lose twenty or more pounds, then it is probably better to lose at least most of that weight prior to undergoing a procedure. However, if you are planning to lose five or ten pounds then it may be fine to have the tummy tuck now and lose the weight later. In addition, if you have a lot of visceral fat, which is fat that lives amongst the internal organs such as the stomach and intestines, Dr. Weider will recommend that you lose weight prior to undergoing the procedure in order to get the best result possible.

Laurence Weider

Dr. Weider, a native of Southern California, is a Board-Certified Plastic Surgeon who has maintained a private practice in Dallas, TX since 1999. After attending Stanford University, he obtained his medical degree (M.D.) from Baylor College of Medicine in Houston. He then completed a one year surgical internship in Los Angeles at Harbor-UCLA Medical Center, followed by a four year general surgery residency in Dallas at Methodist Medical Center, and a two year plastic surgery fellowship in Cleveland at Case Western Reserve University.