Abdominoplasty: what to expect from a tummy tuck

An abdominoplasty (tummy tuck) removes loose skin from the lower abdomen and repairs the abdominal muscles when they have separated. It is an operation for skin and muscle, not for weight.

What it can change — and what it cannot

It can remove the apron of loose skin left after pregnancy or major weight loss, repair separated abdominal muscles (rectus diastasis), flatten the lower abdomen and improve the waistline. Existing stretch marks on the removed skin go with it.

It is not a weight-loss operation. It does not treat fat inside the abdomen — the firm, rounded abdomen that comes from internal fat will not change. It does not prevent weight regain, and it cannot substitute for diet and exercise.

The best results are in people whose weight has been stable for at least six months and who are close to their target weight. If you are still losing weight, or plan another pregnancy, it is usually better to wait.

Assessment and planning

We examine skin quality, the amount of loose skin, whether the muscles have separated, the position of the navel and any previous abdominal scars — including caesarean scars, which often affect the plan. Smoking is the single strongest predictor of wound-healing problems in this operation and should stop several weeks beforehand.

The operation

The incision runs low across the lower abdomen, placed so that underwear covers it. Loose skin is removed, separated muscles are stitched back together, and the navel is repositioned. Liposuction is often combined with it to shape the waist. The operation takes two to four hours under general anaesthesia, with one to two nights in hospital.

The scar is permanent. It is long — usually from hip to hip — and no technique makes it invisible. Anyone who tells you otherwise is not being straight with you.

Recovery, honestly

• First week: you will walk slightly bent forward and this is expected. Drains may be in place for a few days. A compression garment is worn.
• Weeks 2–4: desk work is usually possible at two to three weeks. The garment continues.
• Weeks 6–8: lifting and sport are gradually resumed, on your surgeon's advice.
• Months 6–12: swelling settles and the scar fades from red to pale. Numbness above the scar is normal and may be permanent in a narrow band.

Risks

Risks include bleeding, fluid collection under the skin (seroma), infection, wound separation — particularly at the centre of the scar and in smokers — thick or wide scars, changes in sensation, asymmetry, and blood clots in the legs or lungs. The risk of clots is taken seriously in this operation: you will be asked to walk early and may be given blood-thinning treatment. Anaesthesia carries its own risks, explained separately by the anaesthetist.

Questions worth asking your surgeon

• Do my abdominal muscles need repair, or is this a skin problem only?
• Exactly where will my scar sit, and will my existing caesarean scar be removed?
• Should I wait — because of my weight, or because I may have another pregnancy?
• Will liposuction be combined, and what does that add to the recovery?
• If I travel from abroad: how long must I stay, when can I fly, and who follows me up afterwards?

Abdominoplasty at Medinova is performed within our Plastic, Reconstructive and Aesthetic Surgery department by Surgeon Dr. Deniz Güneş.