Tummy tuck surgery is a highly versatile procedure that can slim down the abdomen, firm up abdominal muscles, and generally enhance the appearance of the midsection. Some procedures remove excess skin and fat from the lower abdomen while others remove an entire ellipse of skin and fat below the belly button as well as tighten the muscles (diastasis recti) in the midline to narrow the waist.
For massive weight loss patients or for those with severe skin laxity, more extensive skin excision along the hips and buttocks may be required, known as an extended tummy tuck or a circumferential tummy tuck. The goal in any tummy tuck surgery is to provide the best contour result with the least amount of scarring.
Liposuction can be combined with these techniques to improve the contour further. Some New York City patients request liposuction alone to treat their abdominal contour problems, but if the patient has significant skin laxity and/or weak abdominal muscles, then liposuction alone will not be sufficient. For more information regarding abdominoplasty, visit our blog.
“I believe true confidence comes from a feeling of self-assuredness from one’s inner self. However, I also believe that it is heavily impacted by a lack of confidence with one’s outside appearance as well. Plastic surgery can help improve confidence in this way.”Steven Wallach, MD
- 1 Before and After Photos
- 2 Candidates
- 3 Procedures
- 4 Endoscopic Abdominoplasty
- 5 Mini-Abdominoplasty (Mini Tummy Tuck)
- 6 Modified Full Abdominoplasty
- 7 Full Abdominoplasty (Traditional Tummy Tuck)
- 8 Circumferential Abdominoplasty (Lower Body Lift)
- 9 Consultation
- 10 Recovery
- 11 Schedule Your Consultation
- 12 FAQ
Before and After Photos
A good candidate for a tummy tuck is someone who is healthy and desires an improvement in the abdominal region. Candidates for any plastic surgery procedure should be generally healthy, be at a stable weight, and have reasonable expectations for their tummy tuck results.
People who are unhappy with excess skin, fat, or weakened muscles after significant weight loss or pregnancy are often good candidates for tummy tuck surgery. The New York tummy tuck procedure is customized to individuals’ specific interests, needs, and conditions.
A tummy tuck is commonly performed under general anesthesia. The abdominal skin is elevated off of the muscle fascia and excess skin is removed. Sometimes liposuction is performed as well to remove excess fat. The muscle weakness can be treated by suturing the edges of the muscle together. The lower incision is closed with absorbable sutures. Drains may be placed as well to prevent fluid buildup in the treatment area.
Most of the abdominoplasty procedures described take between two and three hours to perform with a recuperation time of one to two weeks. The circumferential abdominoplasty (lower body lift) can take four to six hours to perform. Dr. Wallach has presented at national meetings and published journal articles on abdominal contour procedures.
This is for a patient that has very little to no skin laxity or subcutaneous fat, and has mainly midline muscle laxity.
Endoscopic equipment equipped with a small camera is used to gain access to the treatment area through two or three small incisions. This allows Dr. Wallach to visualize the area between the muscle fascia and the overlying subcutaneous tissue so that the midline muscular laxity can be treated. Liposuction can also be performed in conjunction with this procedure if desired.
- Two to three very small limited incisions are used for more favorable scarring. Liposuction of the entire abdomen can be performed at the same time.
- This procedure is performed on very few patients. It cannot treat skin laxity.
Mini-Abdominoplasty (Mini Tummy Tuck)
This is for patients who have excess or loose skin and some subcutaneous fat in the area between the belly button and the pubic region. This does not address muscle tightening in the area above the belly button.
A small ellipse of skin and fat is removed from the lower abdomen. The final incision is not much larger than that of a cesarean section. The belly button is not usually detached from the surrounding tissues. The musculature from the belly button down to the pubic region can be easily tightened. Liposuction can be performed on the entire abdomen and hips.
- A short incision is used. Liposuction of the entire abdomen can be performed in conjunction with this procedure.
- The musculature from the upper midline to the umbilicus can be difficult to tighten with this incision technique. Lax skin around the umbilicus or the upper abdomen is difficult to treat.
Modified Full Abdominoplasty
This is indicated for patients in Manhattan that require a full abdominoplasty but have abdominal incisions from other surgical procedures that may impact the viability of the tissues elevated (i.e. an open gallbladder surgical incision). Most full tummy tuck patients have a lot of skin laxity and may have a significant amount of abdominal subcutaneous fat. There may also be midline muscle laxity. This technique is used when there are previous surgical scars that would impact performing a full abdominoplasty safely.
An ellipse of skin and subcutaneous fat is removed from the lower abdomen. Undermining of the upper abdominal tissues is performed in a limited fashion to maximize the blood supply to the tissues that may have diminished circulation due to the previous surgical incisions. Treatment of muscular laxity is performed. Liposuction can also be done selectively. The belly button is detached from surrounding loose skin and is re-inserted after the upper abdominal skin is re-draped and sutured to the lower abdominal incision.
- The incision may be shorter than a full tummy tuck. Lax skin can be treated better than a mini tummy tuck or endoscopic abdominoplasty. Lax midline muscles can be tightened easily. Laxity around the umbilicus can be treated.
- A longer incision than used for a mini abdominoplasty or endoscopic abdominoplasty is needed, resulting in longer tummy tuck scars. There may be residual skin redundancy because of limited undermining. Liposuction has to be performed selectively to avoid compromising the blood supply to the skin and subcutaneous tissue.
Full Abdominoplasty (Traditional Tummy Tuck)
This is indicated for a patient who has a lot of skin redundancy of both the lower and upper abdomen. The patient also has midline muscular weakness and may or may not have significant subcutaneous abdominal fat.
An ellipse of skin and subcutaneous fat is removed from the lower abdomen. The upper abdominal skin and subcutaneous fat is elevated more extensively than during a modified full abdominoplasty. The midline muscular weakness is tightened. The umbilicus is reinserted into the upper abdominal skin flap after the flap has been re-draped and sutured to the lower abdominal incision. Liposuction can be selectively performed if desired.
- Lax skin from above and below the belly button can be treated successfully with this technique, thus making it a more comprehensive procedure than other approaches. Lax or separated muscles can be tightened easily. Laxity around the belly button can also be treated.
- It requires a long incision along the lower pubic region. Liposuction needs to be performed selectively to maintain the blood supply to the abdominal flap and subcutaneous tissue.
Circumferential Abdominoplasty (Lower Body Lift)
This is a procedure often reserved for patients who have undergone bariatric surgery and have experienced massive weight loss, and thus have a significant amount of excess skin. (see Post-Bariatric surgery treatment)
During a tummy tuck consultation, you will spend a lot of time with Dr. Wallach reviewing your surgical goals. An exam will then be performed and a surgical plan will be discussed with you at length, including preparation, recovery, and results.
Before your procedure, Dr. Wallach will discuss your recovery and aftercare instructions with you at length. Depending on how invasive of a technique is used for your tummy tuck, you may be released the same day or asked to stay overnight for observation. However, before leaving, a member of Dr. Wallach’s team will review with you how to care for any drains that have been placed, symptoms you may notice during recovery, and signs for complications to watch for.
Most patients will need at least a week of rest; however, some light movement or getting up to gently walk is encouraged for circulation. Circulation is important during the healing process in order to avoid blood clots from forming.
Your specific recovery time frame and instructions will be reviewed with you by Dr. Wallach prior to surgery and again afterward before being released.
Schedule Your Consultation
If you would like more information about Dr. Steven Wallach and his success with New York City tummy tuck (abdominoplasty) procedures, don’t hesitate to contact our Manhattan offices at (212) 861-6400 or using our online contact form to request additional details or to schedule your consultation appointment.
Ideally, you want to have a tummy tuck after all your pregnancies. I have had a few patients that went on to get pregnant successfully after a tummy tuck.
If your BMI is over 30, you are at higher risk for complications.
Tummy tucks can improve the appearance of your abdomen.
Yes, an incision is usually low on the abdomen just about at the level of the pubic hairline.
Stomach fat can be decreased by diet and exercise, by liposuction, and by tummy tuck surgery.
You do not have to be skinny to have a tummy tuck, although having a lower BMI will likely give you a nicer result.
A tummy tuck can include a muscle plication to in effect tighten the muscles.
I tell patients that they can have a drink about a week or so after surgery provided that they are healing well and are no longer using pain medications.
Most of the pain from a tummy tuck will diminish significantly after about 7-10 days.
A tummy tuck will give a long-lasting result. Increasing age and weight fluctuation can affect long-term results.
I usually have patients wear a binder for about 3-6 weeks.
You will likely see a weight improvement once the swelling subsides.
It is hard to predict what size you might change to after surgery.
The fee will vary from $8000-$20000.
It is hard to predict how much weight you can lose after a tummy tuck. One kilogram of fat is about 2.2 pounds.
You can have a regular diet after the first night.
You will likely see a weight improvement once the swelling subsides.
A tummy tuck is a procedure to improve the loose skin of the abdomen and to tighten the muscles.
Usually patients can start light aerobics after about 3 weeks and heavy lifting at about 6 weeks.
A tummy tuck can make your stomach flatter by removing the excess skin and by plicating (or suturing) the muscles closer together.
Most patients can go back to regular clothes within a few weeks after surgery.
A good candidate is someone who needs to improve the loose skin of the abdomen and to have their muscles tightened.
This is individualized based upon the extent of the work needed. Sometimes a “mini- tummy tuck” can be performed. Liposuction is performed and residual loose skin from the lower abdomen is removed through a small incision in the pubic region (sometimes only 4-6 inches long). If the lower muscles of the abdomen need to be tightened, then it can be performed as well through this small incision. Patients with more laxity of the tissues and greater weakness of the muscles usually require a longer incision to achieve nice results.
Yes, in fact it is often easier to do other operations at the same time. Harvesting fat for injection to the face can be obtained from the discarded tissue during the abdominoplasty. Sometimes, breast augmentation can be performed through the abdominoplasty incision to avoid incisions on or near the breast. Liposuction of the outer thighs and flanks can be performed through this area as well.
A mini-abdominoplasty is a procedure that treats abdominal contour issues mainly of the lower abdomen. This is best suited for a patient who does not necessarily need muscle plication above the umbilicus and has a slight protuberance below the umbilicus along with some loose skin of the lower abdomen. Because of the limited undermining of soft tissue, liposuction can be combined with the procedure. Sometimes surgeons will “float” or detach the umbilical stalk to move it lower to remove more skin. The incision is often shorter than what one would have with a full tummy tuck. This is often best for thinner patients. A disadvantage of this procedure is that it does not adequately treat the upper abdomen and skin laxity above or around the umbilicus.
The best candidate for liposuction is someone who is not heavy but has isolated areas of fat that they want to remove to improve the contour. Usually younger patients have better quality skin than older patients. That being said, those patients that do better with abdominal liposuction are those with good skin quality and who are not very heavy. Just like a balloon, if it is stretched out too much, due to air or in this case fat, the tissues may not rebound well. Like a balloon’s skin that shrinks after being maximally extended, the abdominal skin may become loose as well after liposuction or decreasing the volume. In most cases, if a patient has had multiple pregnancies or large fluctuations of weight and has loose skin, and/or has a diastasis with weak abdominal muscles, then more than likely a full tummy tuck would be best. There are some patients that are in between the two extremes and sometimes these individuals may be happy with liposuction.
In all likelihood, for someone who is unhappy with the appearance of their abdomen after having children they will more than likely do best with having a full abdominoplasty. The loose skin and fat is removed from the region usually between the umbilicus to the pubic region leaving the remaining incision along the lower abdominal region usually in the bikini of bathing suit line. The muscle weakness is corrected by suturing the midline internally. The laxity in the upper abdomen is usually improved as well from the redraping of the abdominal flap. Liposuction of the flanks can be performed at the same time as well when indicated.
If one has isolated loose skin around the umbilicus, it can be difficult to treat this area in an isolated fashion. I have seen a few isolated excisions of skin around the umbilicus that has caused a very spread out scar around the umbilicus. Sometimes treating the skin can be performed with a mini-tummy tuck, but often it is best treated with a full abdominoplasty.
It is always best to get down to your ideal weight prior to having a surgical procedure. The results of a full abdominoplasty is often better and the surgical risks are reduced as well. That being said, if you are close to your ideal weight that is reasonable as well.
A reverse abdominoplasty is exactly what it sounds like. Instead of elevating the tissue from an incision in the lower abdomen by the pubic hairline, the incision is made under the breast creases and the excess skin is brought out through this region. This is a procedure that is performed in patients that have isolated laxity in the upper abdomen. This may occur after a mini-tummy tuck or even after a full tummy tuck. If the patient has had a previous breast procedure leaving an incision under the breast folds then using these same incisions may be possible.
When a patient has had massive weight loss (more than 100 lbs) through either diet and exercise or surgery, often times their skin is very loose. In some patients a full abdominoplasty is an option. But if the laxity of the tissues is more severe, an extended abdominoplasty, or even a full body lift procedure may be more prudent to give a better result. An in-office evaluation is always best to perform a proper exam and review a patient’s goals.
“Floating” an umbilicus refers to the concept of detaching the umbilical stalk from its underlying abdominal wall attachments but keeping it attached to the surrounding skin to preserve its blood supply. This is most commonly performed during a mini-abdominoplasty when there is some loose skin superior to the umbilicus and the surgeon wants to treat this by pulling it down a bit.
Aggressive liposuction can be performed in some cases when performing a full abdominoplasty. This is most commonly done when full undermining of the abdominal flap is not performed. The undermining of the abdominal flap stops by the lateral row of perforator arteries that feed the overlying abdominal flap. It is undermined just enough to allow for muscle plication in the midline. The abdominal flap is usually separated a bit more around the vessels using a liposuction cannula as well.
The risks of surgery include poor wound healing, infection, seroma, hematoma, dysesthesia, unfavorable scarring, rebound laxity, and need for revision procedures.