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Wesley G. Schooler, M.D., F.A.C.S.
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Tummy Tuck (Abdominoplasty)

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What is a Tummy Tuck?

After the wonderful experiences of losing unwanted weight or having children, many individuals are left with the aftermath of an abdomen that has been stretched out of shape. Patients have trouble returning to the nice flat contour that they desire. This often leads to a common aesthetic concern shared by a diverse range of patients—excess skin and loose muscles in the abdomen resulting from weight fluctuation, pregnancy, or the aging process. While a healthy diet and consistent fitness program are very important in maintaining a great figure, an active lifestyle cannot tighten redundant skin or repair the stretched muscle separation—known as diastasis recti—that occurs after pregnancy or massive weight gain and loss. Many women and men struggle with attaining the flat and smooth look they desire in the abdomen.

While virtually impossible to resolve naturally, loose excess skin in the midsection can be addressed with a tummy tuck (abdominoplasty). The toll of childbearing can be seen in stretched out abdominal muscle layers, causing a look of permanent pregnancy that is often refractory to exercises attempting to strengthen the muscles. Excess subcutaneous fat in the abdomen, hips, and back can be addressed often with liposculpture. Although the tummy tuck procedure is much more comprehensive than liposuction, the two are frequently combined to more effectively re-contour the stomach and torso region. This can allow an all-encompassing surgery to eliminate excess skin and fat as well as to repair the muscle layer, providing a tighter, flatter abdominal appearance so that patients can wear that form-fitting summer dress or show off their six-pack.

What Can a Tummy Tuck Do?

A tummy tuck is considered a highly effective body contouring procedure that can slim the waistline while firming and smoothing the appearance of the midsection. Not only can abdominoplasty remove excess skin, but the procedure is also designed to tighten separated abdominal musculature— this can improve the look of a hanging or protruding abdomen. In general, a tummy tuck is performed to:

  • Tighten muscles in the abdomen for an improved abdominal contour
  • Remove excess skin, creating a smoother and flatter abdomen and waistline
  • Eliminate some degree of stubborn fat in the abdomen
  • Reshape the belly button, if necessary

With the ability to bring together loose or stretched abdominal muscles, a tummy tuck is popularly incorporated into a Mommy Makeover. This customized series of treatments is designed to address the areas commonly affected by pregnancy and nursing, often with the goal of restoring a patient’s pre-pregnancy figure. If you are interested in a Mommy Makeover, Dr. Schooler can examine your concerns and work with you to develop the best treatment plan for your needs.

Is a Tummy Tuck Right for Me?

Tummy tuck surgery can benefit individuals who have a hanging midsection or sagging skin due to the effects of pregnancy, heredity, weight fluctuations, and gravity. This procedure is considered the most powerful and effective treatment to get rid of loose, excess skin disturbing the abdominal contour. It’s very important for men and women considering a tummy tuck to:

  • Be in good general health, with no uncontrolled medical conditions that may interrupt the healing process
  • Have a positive outlook on the procedure and maintain realistic expectations for the outcome of surgery
  • Be near their ideal weight
  • Not have any future plans for pregnancy

For patients left with excess skin after weight loss surgery, post-weight loss body contouring can also be a good option to smooth the lower body contours. Following massive weight loss — whether achieved through dieting and exercise or a bariatric procedure — it’s not uncommon for stretched skin to gather in the abdomen, arms, thighs, and buttocks. With post-weight loss body contouring, Dr. Schooler can create a treatment plan tailored to restore a tighter, more defined look in your areas of concern.

Types of Tummy Tuck Surgery

A tummy tuck, or abdominoplasty, encompasses a spectrum of procedures ranging from a mini tummy tuck to a circumferential body lift, also named a belt lipectomy.

Full Tummy Tuck (Abdominoplasty)

The full tummy tuck is the most commonly performed abdominoplasty, and the procedure of choice for most patients. The procedure starts with a transverse incision just above the pubic area, usually right below an old C-section scar and extends laterally from hip to hip under the bikini line. The hanging loose lower abdominal skin is undermined along the lower abdomen, up to the central upper abdomen. The belly button is reshaped and often reduced to a more aesthetically pleasing shape and size. The abdominal muscle wall is also repaired by plication to pull the muscles to the midline, recreating the “six-pack abs” that were lost from weight gain or pregnancy. A minimal drain technique is employed to reduce or eliminate the need for drains after surgery. The final result is a contoured, toned waistline, repositioned belly button, and flatter abdomen that looks great and has improved function with tighter muscles.

Extended Tummy Tuck

The extended tummy tuck is the same procedure as a full tummy tuck with the addition of a few nuances to further improve the figure in patients who might be larger, experience more extensive weight loss, or have significant mid-abdominal deformity requiring more radical changes to create a beautiful hourglass figure. The lower abdominal scar, which is kept as low as possible and hidden under the bikini line, is extended laterally around the side of the hips to prevent the formation of “dog ears” or outward protrusions of skin and fat that are frequently seen even in form-fitting dresses. The incision is continued laterally in an even fashion onto the back, still hidden under the bikini line to create the best figure possible. Additional advanced plication techniques may often be used to further enhance the figure and create an hourglass waist in more complex cases.

Panniculectomy

Patients who have shed massive weight after a major diet or weight loss surgery often have excessive amounts of excess skin and fat that can present a severe nuisance in clothing, leading to embarrassment, attempts to conceal the abdomen, and even health issues involving skin rashes, sores, and infections. When excess skin folds cause severe medical issues, sometimes insurance may cover a portion of the abdominal skin removal. The panniculectomy addresses the lower abdominal skin excess, and is essentially the same as a mini-tummy tuck but in a person of larger stature. Often 5 to 15 pounds of skin and fat are removed. The belly button and the upper abdomen are not addressed, and liposuction is not used during this functional procedure.

Belt Lipectomy (Circumferential Body Lift)

For patients who have experienced massive weight loss, excess skin and fat can become a significant problem with hygiene, appearances, and health. The circumferential lift can transform the central core of a person who has endured the difficulties of extreme diets or gastric surgery and is unable to show the beauty of their hard work. A circumferential body lift transforms a person by removing a cylinder of fat and skin from the torso, lifting the lateral hips, and removing the excessive pannus, better sculpting the waistline and creating a new, beautiful figure.

Mini Tummy Tuck

The mini tummy tuck is not a true tummy tuck; rather, it is a less invasive procedure that includes removal of excess skin and fat below the belly button only. Patients who have excess pruned, saggy, or stretch-marked skin between the pubis and the umbilicus can have some of it removed, flattening the lower abdomen or removing unattractive C-section scarring. There is usually no reshaping of the belly button, correcting of the abdominal muscles, or improvement of the upper abdomen. In patients who have a very long torso and high belly button, minimal abdominal wall laxity and scarring, or only minor skin laxity in the lower abdomen, this could be a good option. A smaller transverse incision is made, slightly larger than a C-section incision, and the hanging lower skin is removed. This procedure can be a good option for the fit patient who has maximized workouts and weight loss but still has a small amount of hanging lower skin pooch in the lower abdomen.

Diastasis Recti Repair

In the very fit mother who has lost the elasticity of the abdominal muscle connective tissue, known as anterior fascia, but really has no additional hanging skin, another option is diastasis repair. If you can put three or more fingers between the rectus (six-pack) muscles in the midline abdomen with the muscles falling to the side, this is often a sign of diastasis. This is different from a ventral hernia, where the anterior fascia layer has a defect and abdominal contents actually protrude out of the abdomen.

How is the Tummy Tuck Procedure Performed?

The spectrum of procedures that encompass the term “tummy tuck” ranges from very minor procedures to extensive circumferential body lifts. The extent of required surgery to give you a beautiful abdominal contour will be recommended during your consultation, and a personal treatment plan will be created.

Our experienced, board-certified plastic surgeon at the Santa Barbara Plastic Surgery Center, Dr. Wesley Schooler, has continued to incorporate the latest techniques to give you a beautiful abdominal contour with minimal downtime as well as a speedy recovery and return to normal activities. He will create a skin flap along the abdominal region and eliminate the excess skin and fat. He will then tighten the muscles of the abdomen, pulling them taut, and advance the skin flap from the belly button level to the suprapubic area, creating a much firmer and fit-looking appearance. The entire procedure typically lasts three to six hours, depending on the extent of the tummy tuck. This treatment is usually performed on an outpatient basis under general anesthesia.

Belly Button Revision

The belly button can alter its shape over time due to a number of factors, such as weight fluctuation, pregnancy, hernias, stretch marks after pregnancy or other reasons. A belly button revision surgery can reshape its appearance to make the look of the naval more aesthetically favorable. Belly button reshaping is an integral part of a tummy tuck. Occasionally, an isolated belly button reshaping procedure is a good option. If interested, our plastic surgeon can transform “outies” into “innies” with this effective procedure.

Combining a Tummy Tuck with Other Procedures

As techniques have advanced, tummy tuck surgery and many other exciting aesthetic techniques have become more popular. Body sculpting SAFELipo® is frequently combined with the tummy tuck procedure. We have also combined fat grafting with the Brazilian butt lift in women and abdominal muscle enhancement in men with great results. Dr. Schooler will give you a personalized assessment and recommendations for good combination procedures for you.

What is Recovery From a Tummy Tuck Like?

We measure you and order a custom garment to help with edema management and post-operative body shaping. Your safety as a patient is the greatest priority immediately after surgery. We usually use a binder to help shape the abdomen while ensuring it’s not too tight to improve circulation of the torso. Our surgical team also sends you home with sequential compression devices, or leg squeezers for the legs to prevent deep venous thrombosis. We use Exparel®, a long-acting injectable medication to decrease post-operative pain for the first 24 hours. We use the minimal or no-drain technique and employ several other approaches to minimize drains. For the first 1 to 2 days after surgery, you are provided a compression garment, which is worn to reduce swelling and facilitate the healing of your new body contours. Dr. Schooler will sometimes encourage oral supplements such as Arnica® to reduce bruising, and prescribe medications for excessive post-operative swelling as well as analgesics for discomfort. We employ the latest rapid recovery protocols to facilitate a speedy recovery with minimal pain and minimal narcotic use. Immediately after the tummy tuck, patients are encouraged to sit on a recliner in a beach chair position or sleep with 2 to 3 pillows elevating the head for the first week. While plenty of rest is strongly encouraged after a tummy tuck, walking around periodically and light ambulation four times per day can help prevent blood clots during the healing process. When getting around, you may need to walk with a slight bend in the hips for the first few days. Most patients can return to their normal schedules within 10 days to two weeks; however, exercise and strenuous activity should be avoided for at least four weeks, and heavy core workouts held for 6 weeks. Dr. Schooler will discuss your unique recovery strategy in more detail with you in person.

How Much Does a Tummy Tuck Cost?

A tummy tuck is customized according to the extent of your individual anatomy and concerns, with the cost of the procedure similarly personalized. Factors that often affect the price of a tummy tuck include the technique used, the amount of surgical work to be done, and your aesthetic goals, as well as fees for the surgeon, anesthesia, and operating facility. Any hernias identified before or during surgery are addressed at the same time as surgery, and that portion of the procedure is considered a separate procedure subject to standard insurance practices. Once Dr. Schooler assesses your needs in a consultation, our Patient Care Coordinator will be able to provide you with a personalized quote of your aesthetic procedure.

We offer a number of different payment options, including plastic surgery financing through trusted healthcare lending companies such as CareCredit® and Alphaeon™ Credit. These leading financial institutions allow qualified applicants to choose from a range of low- to no-interest payment plans for the option that suits their budget most ideally. If you would like to learn more about the cost of a tummy tuck, please contact our practice to speak to a member of our team.

Your Tummy Tuck Consultation

During your tummy tuck (abdominoplasty) consultation, our plastic surgeon will meet with you on a one-on-one basis to discuss all aspects of the procedure and your individual goals. The consultation will include photographic analysis and a 3D virtual reality simulation to visualize your post-operative potential. Our surgeon encourages you to ask any questions you may have and will address all of your concerns. With any type of surgery, you should be certain that you are working with a skilled, experienced, board-certified aesthetic plastic surgeon. Dr. Schooler is excited to discuss your goals with you and ensure you feel confident you’re in the right hands.

How Long Do Tummy Tuck Results Last?

A tummy tuck permanently removes excess skin from the abdominal area, resulting in a flatter and firmer abdomen. While the aging process will continue, the outcome of the procedure can last indefinitely as long as patients maintain a stable weight. Certain factors, such as weight gain and pregnancy, can re-stretch the skin and weaken the abdominal musculature; therefore, undergoing a tummy tuck only after you’re at your ideal weight and have no future plans for pregnancy is key to preserving abdominoplasty results.

No matter what type of tummy tuck procedure was performed, the best way to prolong the longevity of your tummy tuck is to live an active lifestyle. Weight gain can cause fat to accumulate around the midsection and potentially alter the sleek body contours achieved after surgery. Exercising and keeping up with a healthy diet can help manage weight and ensure the shape of the abdomen remains stable in the future.

Will I Have a Visible Tummy Tuck Scar?

The shape and size of your tummy tuck scar will depend on which procedure was the most optimal technique to achieve your goals. For example, a mini tummy tuck requires shorter incisions than a full abdominoplasty, so the resulting scar will be less extensive when compared to a standard tummy tuck. While all surgical procedures will produce some amount of scarring, the scars left after a tummy tuck can easily be covered by a swimsuit bottom or underwear. Dr. Schooler will show you where your scars are most likely to appear so you know what to expect after the procedure. He will also provide you with detailed aftercare instructions that can promote the best possible healing of your incisions, thereby maximizing the appearance of your scars and encouraging them to lighten somewhat over time.

For more information on tummy tuck surgery or body reshaping, or if you would like to schedule a consultation, please contact us today.