TUMMY TUCK / ABDOMINOPLASTY

Dr Chia Hui Ling

A tummy tuck, or abdominoplasty, removes excess loose skin from the abdomen and tightens the underlying muscles that often separate during pregnancy or significant weight change. It is not a substitute for diet and exercise, but for the right person it addresses skin and muscle changes that exercise alone cannot fix.


•      Removes loose, overhanging skin below the belly button

•      Repairs abdominal muscles that have separated in the midline (rectus diastasis)

•      Flattens and smooths the overall abdominal contour

•      Often improves the appearance of stretch marks on the lower abdomen

•      Can be combined with liposuction to refine the waistline

•      May improve lower back comfort in patients with significant muscle laxity

•      At or near a stable, healthy weight for several months

•      Not planning further pregnancies, as this can undo the muscle repair

•      Non-smokers, or willing to stop well before and after surgery

•      In good general health with no uncontrolled medical conditions

•      Comfortable accepting a permanent lower abdominal scar in exchange for the contour change



It helps to be honest with yourself about what this operation can and cannot do. It changes shape and skin quality rather than the number on the scale, and the scar, while usually placed low enough to hide under underwear, is permanent.


TREATMENT

A full tummy tuck is performed under general anaesthesia and typically takes two to four hours, depending on how much skin and muscle work is needed. A shorter, more limited version (a 'mini' tummy tuck) suits those with less skin excess confined to below the navel.

•      Excess skin and fat are removed and the abdominal muscles are stitched together in the midline

•      The belly button is usually repositioned through a new opening in the tightened skin

•      Thin drainage tubes are often left in for several days to reduce fluid build-up

•      Liposuction to the flanks may be performed at the same time to improve overall waistline shape

•      Weeks 1-2: rest at home, walking in a slightly bent posture to protect the repair, drains removed, compression garment worn most of the day

•      Weeks 2-6: gradual return to light daily activity and desk work; no heavy lifting or abdominal exercise

•      Weeks 6-12: gradual return to full exercise, guided by your surgeon

•      Swelling settles slowly, with the final contour usually visible by 6-12 months and the scar continuing to soften over a year or more


  • Preparing for Surgery

    Inform your plastic surgeon of previous pregnancies, abdominal surgery, including c-section, liposuction and laparoscopic (keyhole) surgeries. Discuss the scar placement with your plastic surgeon. Avoid blood-thinning medications, anti-inflammatory drugs or herbal supplementations as they can increase the risk of excessive bleeding during surgery, unless indicated by your doctor.



  • Surgery

    During an abdominoplasty surgery, excess skin is removed via a horizontal incision along the lower abdomen.  It is usually planned such that the scar is concealed under the panty. Fat may be removed using liposuction. Through the incision, the DR separation is repaired using sutures. Additional tightening sutures may be placed at the oblique muscles to improve the waistline further. An umbilicoplasty is also done to re-site and improve the appearance of the umbilicus. If an umbilical hernia is present, it is repaired at the stage. If you have minimal excess skin, a shorter scar (mini-abdominoplasty) or short vertical scar may be suitable.

  • Post-Surgery Care

    After the surgery, you may require drains and / or hospitalisation stay for a few days. The initial swelling will take a few weeks to settle and you may be ask to wear a compression garment. It will take a few months to the see the final result. The abdominal skin may feel numb in the early postoperative period.

FAQs

How painful is recovery?

Most patients describe the first few days as uncomfortable rather than severely painful, especially where the muscles have been tightened, and this is managed with pain medication. Discomfort eases noticeably within the first week, though tightness can linger for several weeks.

Will the scar be visible?

The scar runs low across the abdomen and is designed to sit under most underwear and swimwear, but it is permanent and quite noticeable at first. It typically fades and flattens over 12 to 18 months, though it never disappears completely.

Can a tummy tuck be combined with liposuction?

Yes, this is common and can improve the overall waistline shape. Combining procedures adds some surgical time and may slightly lengthen recovery, so this is worth discussing beforehand.

Will my results last if I gain weight afterwards?

The muscle repair and removed skin are permanent, but significant weight gain can still stretch the remaining skin and affect your result. Maintaining a stable weight afterwards helps preserve the outcome.

How is this different from liposuction alone?

Liposuction removes fat but does not tighten loose skin or repair separated muscles. If skin laxity or muscle separation is the main concern, liposuction alone will not address it.

When can I return to work?

Most people with desk-based jobs return after about two weeks, though physically demanding work usually needs four to six weeks or longer.


COMPLICATIONS

Most people recover from a tummy tuck without major problems, but as with any major operation there are risks worth understanding beforehand.


•      Swelling, bruising and areas of numbness over the lower abdomen, usually improving over months

•      Fluid collection under the skin (seroma) that may need to be drained

•      Wound healing problems, particularly at the ends of the incision or around the belly button

•      Infection, usually settling with antibiotics but occasionally needing further treatment

•      Bleeding requiring a return to theatre (uncommon)

•      Blood clots in the legs or lungs, a reason early walking is encouraged after surgery

•      Visible or thickened scarring, or asymmetry that may need later revision

•      A small chance the muscle repair loosens again over time, especially with future pregnancy or significant weight change