How Is a Tummy Tuck Done?

The patient is marked before surgery.

Female patient being readied for liposuction procedure
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Your surgeon will use a surgical marker to indicate where the incision will be, which is on the lower abdomen just above the pubic area. This part of the procedure is very important. Make sure you agree with the placement of your incision. Specifically, make sure that it is low enough that if you choose to wear low-cut underwear or bikini bottoms, the incision will be hidden.

Anesthesia is administered.

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You will most likely receive general anesthesia for your procedure. Some surgeons also perform tummy tucks with intravenous sedation, also known as "twilight sedation." Which type of anesthesia you receive will be decided by both you and your surgeon.

The surgical site is prepped for surgery.

Prepping For Surgery. Photo © Millicent Odunze, M.D., M.P.H.

The entire abdomen and pubis is made sterile by cleansing the areas with an antibacterial solution. This disinfects the areas and reduces the likelihood of an infection at the incision site.

The incisions are made.

Making of Tummy Tuck Incision
Making of Tummy Tuck Incision. Photo © Millicent Odunze, M.D., M.P.H.

An incision is made low along the bottom of your abdomen just above the pubic area. The incision may be shorter if you’re having a mini tummy tuck or longer if you have excess skin and fat on the sides of your abdomen. If you're having a full tummy tuck, not a mini tummy tuck, another incision is made around the umbilicus (belly button). The belly button stays attached to your abdominal wall.

The skin and fat layer is lifted from the abdominal wall.

Tummy Tuck Flap Elevation
Elevation of the skin-and-fat flap during a tummy tuck.. Photo © Millicent Odunze, M.D., M.P.H.

As one layer, the skin and fat are lifted from off of the abdominal muscles, starting at the incision and going upwards. The skin and fat layer is raised all the way to the xiphoid process.

The diastasis recti is repaired.

Tummy Tuck Plication
Tummy Tuck Plication of Rectus Diastasis. Photo © Millicent Odunze, M.D., M.P.H.

A diastasis recti is a separation of the abdominal muscles at the midline of the body. If a diastasis recti is present, this is repaired by suturing the rectus abdominal muscles together at the midline. This step can be thought of as creating an internal corset.

The excess layer of skin and fat is removed.

Tummy Tuck Skin Excision
Tummy Tuck Skin Excision. Photo © Millicent Odunze, M.D., M.P.H.

Once the skin-fat layer has been lifted off of the abdominal muscles, the top half of the operating room bed is elevated to create a bend at the waist. By doing this, even more skin can be removed than if there were no bend at the waist. The skin-fat layer is pulled down toward the feet to see how much can be removed. The amount removed is carefully measured by your surgeon, as she must be able to close the abdominal incision without excessive pulling or tension.

Drains are placed.

In some cases, drains are placed below the skin-fat layer, but above the abdominal wall, to collect excess fluid that occurs during healing. These drains are easily removed in the office approximately 10 to 14 days after surgery. No additional surgery is needed to remove the drains.

The incisions are closed.

Tummy Tuck Closure
Tummy Tuck Closure. Photo © Millicent Odunze, M.D., M.P.H.

The incisions around the belly button and along the bottom of the abdomen are then closed with sutures. The deepest layer is closed first followed by the more superficial layers.

The incision is then covered with steri-strips.

Immediately After Tummy Tuck
Immediately After Tummy Tuck. Photo © Millicent Odunze, M.D., M.P.H.

After the incision has been closed with suture, steri-strips or their equivalent are placed over the incision. This serves as a protective barrier.

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