What is a Tummy tuck?
Do you have loose hanging skin around your stomach or hips? A Tummy tuck, or Abdominoplasty, is the most effective way to tighten your stomach area and remove excess hanging skin.
The most common types of Tummy tucks are:
- Standard Tummy Tuck
- Mini Tummy Tuck
- Dermolipectomy, aka Panniculectomy
- Extended Tummy tuck
All of these tummy tuck procedures can be performed as an outpatient under IV anesthesia or general anesthesia.
We prefer the use of IV sedation as it almost eliminates the risk of pulmonary embolism which is associated with General anesthesia. It is a milder form of anesthesia with little or no nausea.
What are the different types of Tummy Tucks?
The Tummy tuck addresses the three components of your abdomen: the skin, fat, and muscle. The abdominal muscles are tightened and shut close, and a large segment of skin and fat is removed from your abdomen area.
A Mini tummy tuck is best suited for women who only have a pouch below the belly button. The procedure can be done through an incision in the belly button, or through a C-section scar if the patient wants a little excess skin taken off.
A Dermatolipectomy is only the removal of the excess skin. There is no muscle work. This is also known as a panniculectomy. If you have good muscle tone and a lot of hanging excess skin, this is the procedure for you.
The Extended Tummy Tuck does all the same things as a standard Tummy Tuck, except the incision is extended further out. The incision goes beyond the hips to remove skin over your hips. It does wonders for the buttocks, as it can make your butt appear lifted. For patients who have lost a lot of weight, this is commonly the best option.
What problems does a Tummy tuck address?
There are three problems that the standard tummy tuck procedure addresses. Patients usually have these three complaints:- Loose skin, and stretch marks: This can be a result of aging, pregnancy, or marked weight loss.
- Excess fat tissue: The lower abdomen and flanks (love handles) are the most common areas of fat deposits.
- Abdominal muscle separation: This can occur by itself or as a result of pregnancy. Sit-ups or crunches don't help in this situation as once the muscles relax, they separate and the tummy bulges out.
Finding out if a Tummy tuck is right for you
In this video, I explain how to do a self-examination of your stomach to find out if you have a separated rectus diastasis muscle. If you have this type of muscle separation, no amount of exercise can make your stomach flat. The stomach muscles must be sewn back together so that you can get a flat tummy. Learn more in this article, Flat stomach: More exercise or a Tummy tuck?.
Will a Tummy tuck tighten the skin that hangs over the sides of my hips?
If you have excess skin and fat that hangs over your hips, you should consider an Extended Tummy Tuck or lower Body lift procedure. The body lift includes an Outer thigh lift and Buttock lift, in addition to the abdominoplasty.
How is a Tummy tuck performed?
The standard tummy tuck procedure takes approximately 4 hours of operating room time and is typically an outpatient procedure. I prefer the use of monitored IV sedation instead of General Anesthesia because patients experience much less nausea and quicker recovery.
Surgical markings
On the morning of your procedure, while you are still awake, I make the surgical markings on your stomach with you in front of a mirror. I review the exact incision location with you and make every possible effort to keep the incision below your panty line.
Tummy tuck anesthesia
In my Baltimore surgery center, I prefer to use IV sedation with Tummy tuck procedures. IV sedation provides for a quicker recovery than General anesthesia. Patients have little, if any nausea. In addition, the risk of pulmonary embolism is nearly eliminated with the use of IV anesthesia.
Dr. Todd Hobelmann, one of our board-certified anesthesiologists has a great explanation of the advantages of IV anesthesia in this video filmed at our Surgery Center.
To ensure the highest level of safety for your procedure, I employ only board-certified anesthesiologists in my accredited surgery center in Baltimore.
The incision placement
Once the procedure starts, the first step is to place the incision between the belly button and the top of the pubic hair. I use the surgical markings that I made with you in the morning as my guidelines. The belly button stays in place.
Tighten the rectus diastasis muscle
The muscle is then tightened vertically from the pubic bone to the ribs. The skin above the belly button is then stretched down to the pubic area and stitched in place.
Belly Button
After the skin is pulled down, the belly button incision is made and the belly button is pulled through to its new skin location.
Tissue dissection and Incision closure with the Lockwood technique
I pay special attention to not only the placement of the scar but also the way I close and suture the wound back together. I believe that my closure technique using the Lockwood technique results in a thinner scar.
The technique that I use to dissect the tissue and close the incision is referred to as the Lockwood technique. I now exclusively use the Lockwood technique. In summary, the Lockwood technique does the following:
- reduces hematoma and seromas
- thinner incision and scar (since the scar will spread less with less tension).
To see me explain more, watch the Lockwood Dissection Explained video and this Lockwood method video.
Incision Closure with the Lockwood technique
The Lockwood technique involves closing the wound opening especially so that there is less tension on the incision surface. In this respect, the deeper layers of tissue are closed more tightly than the layers near the surface.
With less tension at the surface, the scar is less likely to spread with time. Therefore you have a thinner scar.
Learn more about avoiding thick scars with the Lockwood technique in this blog post.
Length of the Tummy Tuck Incision: Regular Tummy Tuck or Extended?
Do you have loose skin over your hips? If yes, you will likely need the Extended Tummy tuck. Here is a comparison:Regular Tummy tuck incision
A regular tummy tuck incision goes from hip bone to hip bone, all on the front side. However, if you have loose skin at the hip bone, the surgeon may recommend having an Extended Tummy Tuck.
Extended Tummy tuck incision
For the extended tummy tuck, we remove loose skin to extend to the hip bone or even further around the back. The Extended Tummy Tuck does wonderful things for the buttocks profile, as it can also somewhat lift the buttocks.
Note that the Extended Tummy Tuck does cost more as it takes longer to perform the procedure.
Administration of Exparel pain block at the end of surgery
To help minimize the pain during your post-op recovery, we use Exparel injection, which numbs the area. This injection is given at the end of the procedure. This is now used in place of a pain pump. The numbing medication injected into the incision dramatically reduces the post-operative pain for up to 3 days.
What are the preoperative requirements?
Your Tummy tuck should be performed by a board-certified plastic surgeon at an accredited outpatient surgery center or hospital.
You should have met your surgeon in person at least once, if not twice before your procedure. He/she should have explained alternative treatments and given you a copy of the Informed Consent for Tummy Tuck.
Your BMI must be less than 35
The pre-op Tummy tuck requirements are these:
- Your BMI (Body Mass Index) must be less than 35 kg/m2.
- Quit smoking 2 weeks before surgery
- Physical exam and CBC within 30 days of surgery
- Schedule a pre-op appointment with your surgeon to review the surgical plan
- Read and sign the Informed consent document.
- NPO (nothing to eat or drink) after midnight before surgery
- On the morning of surgery, ask your surgeon WHERE your incision will be located!
What is Tummy tuck Post-Op recovery like?
Following a Tummy tuck, you should plan to take a minimum of 2 weeks off from work. You should not drive for 3 weeks.
Post-Operative recovery instructions
- Day 1 - 5: Bed rest, no showers, do not remove the garment!
- Day 6-7: First post-op office visit to remove pain pump and drains, and change garment
- Day 1 - 14: Wear compression garment 24 hours/ day
- Week 4: Follow up appointment in the office, resume driving, back to FT work
- Week 6: Resume all regular activities
- Month 4: Follow-up appointment in the office
The week-by-week summary of the postoperative period is described in this Tummy Tuck recovery article.
Compression garment
A key component of your Tummy tuck recovery is the compression garment. This garment is important during the postoperative period. It helps the area to heal evenly and smoothly. It is worn continuously for the first two weeks post-operatively.
To learn more please read my article about the compression garment and its importance to a successful tummy tuck result.
What are the risks and possible complications?
Complications can be either minor or major. Minor complications are handled in the office. Major complications may require hospitalization. According to a Feb 2018 article published in Plastic and Reconstructive Journal, the risk of major complications in a Tummy Tuck is 4%.
This 4% complication rate was based on an analysis of 25,478 abdominoplasty patients. The most common major complications outlined by the study were found to be hematoma (1.3%), and infection (1.1%).
The list of all risks and complications of the Tummy tuck procedure includes, but is not limited to:
- scarring
- seroma (fluid collection)
- hematoma
- asymmetry
- infection
- loss of skin
- loss of sensation
- possibility of revision surgery
How much does a Tummy tuck cost?
When evaluating costs, consider the 'total cost' includes the surgeon's fee, operating room fee, anesthesia fee and garments.
To compare apples to apples be sure to know if you are getting a Tummy Tuck or an Extended Tummy Tuck.
Tummy Tuck Total costs for the remainder of 2024 in our Baltimore facility are as follows:
| Type of Tummy tuck with or without Liposuction | 2024 Prices (exp 12/1/24) |
|---|---|
| Tummy Tuck | $8,300 |
| Tummy Tuck + Lipo Love Handles (front flanks) | $9,900 |
| Tummy Tuck + lipo flanks (love handles and back muffin top) | $11,400 |
| Extended Tummy Tuck only | $9,450 to $11,000 |
| Extended Tummy Tuck + lipo flanks (love handles and back muffin top) | $12,300 - $14,400 |
| Mini-Tummy Tuck | $6,500 |
| Dermolipectomy / Panniculectomy | $6,500 |
Does the Extended Tummy Tuck cost more than a standard Tummy Tuck?
Yes, the Extended Tummy Tuck does cost more because it takes longer in the operating room to remove more excess skin around the hip.
Can I finance my Tummy Tuck?
Yes, we work with a number of finance companies so that you can have a low, affordable, monthly payment. Please call the office at 410-494-8100 or see our financing section for more information.
Can I add liposuction to my Tummy Tuck?
Yes! You can add the front flank liposuction (love handles) for a total cost of $9,400. If you want to have liposuction to full flanks, aka lipo 360 (love handles and muffin top above the buttocks), the total cost averages $11,200.
You can also add additional areas of lipo such as your scapular (back), inner thighs, or neck area.
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Board Certified Plastic Surgery, ASPS Member
NOTICE
Patients depicted in our before and after galleries have provided their written consent to display their photos online. Every patient is unique, and surgical results may vary. Please contact us if you have any questions.