Abdominoplasty or "tummy tuck" is a cosmetic surgery procedure used to make the abdomen

Abdomen

In vertebrates such as mammals the abdomen constitutes the part of the body between the thorax and pelvis. The region enclosed by the abdomen is termed the abdominal cavity...

 more firm. The surgery involves the removal of excess skin

Skin

-Dermis:The dermis is the layer of skin beneath the epidermis that consists of connective tissue and cushions the body from stress and strain. The dermis is tightly connected to the epidermis by a basement membrane. It also harbors many Mechanoreceptors that provide the sense of touch and heat...

 and fat

Fat

Fats consist of a wide group of compounds that are generally soluble in organic solvents and generally insoluble in water. Chemically, fats are triglycerides, triesters of glycerol and any of several fatty acids. Fats may be either solid or liquid at room temperature, depending on their structure...

 from the middle and lower abdomen in order to tighten the muscle

Muscle

Muscle is a contractile tissue of animals and is derived from the mesodermal layer of embryonic germ cells. Muscle cells contain contractile filaments that move past each other and change the size of the cell. They are classified as skeletal, cardiac, or smooth muscles. Their function is to...

 and fascia

Fascia

A fascia is a layer of fibrous tissue that permeates the human body. A fascia is a connective tissue that surrounds muscles, groups of muscles, blood vessels, and nerves, binding those structures together in much the same manner as plastic wrap can be used to hold the contents of sandwiches...

 of the abdominal wall. This type of surgery is usually sought by patients with loose tissues after pregnancy or individuals with sagging after major weight loss.

Procedures

Abdominoplasty operations vary in scope and are frequently subdivided into categories. Depending on the extent of the surgery, a complete abdominoplasty can take 1 to 5 hours. A partial abdominoplasty (Mini-Tuck Abdominoplasty) can be completed between 1 to 2 hours.

Complete abdominoplasty

In general, a complete (or full) abdominoplasty follows these steps:

1. An incision is made from hip to hip just above the pubic area.
2. Another incision is made to free the navel
   Navel
   The navel is a scar on the abdomen caused when the umbilical cord is removed from a newborn baby...
   
    from the surrounding skin.
3. The skin is detached from the abdominal wall to reveal the muscles and fascia to be tightened. The muscle fascia wall is tightened with sutures.
4. Liposuction is often used to refine the transition zones of the abdominal sculpture.
5. A dressing and sometimes a compression garment
   Compression garment
   Compression garments are pieces of clothing such as socks, pantyhose, sleeves, etc, that provide support that is especially useful for people who have to stand for long periods, or people with poor circulation. The garments can come in varying degrees of compression. The higher degrees require a...
   
    are applied and any excess fluid from the site is drained.

Partial abdominoplasty

A partial (or mini) abdominoplasty proceeds as follows:

1. A smaller incision is made.
2. The skin and fat of the lower abdomen are detached in a more limited fashion from the muscle fascia. The skin is stretched down and excess skin removed.
3. Sometimes the belly button stalk is divided from the muscle below and the belly button slid down lower on the abdominal wall.
4. Sometimes a portion of the abdominal muscle fascia wall is tightened.
5. Liposuction is often used to contour the transition zone.
6. The flap is stitched back into place.

Extended abdominoplasty

An extended abdominoplasty is a complete abdominoplasty plus a lateral thigh lift. The resulting scar runs from the posterior axillary line (when placing you open hands on your hips, the thumbs lie along the posterior axillary line.) The operation does all of the abdominal contouring of a complete abdominoplasty plus allows further improvement of the flank (waist), as well as smoothing the contour of the upper lateral thigh.

High lateral tension tummy tuck

This is an advanced technique that takes a little more than four and half hours to perform. Conventional abdominoplasty tightens muscles in a vertical line. In this new method, known as high lateral tension abdominoplasty, in addition to vertical-line tightening, muscles are tightened horizontally. The final result with this technique is a dramatically flat abdomen with significantly better-defined waistline.

Circumferential abdominoplasty

An circumferential abdominoplasty is an extended abdominoplasty plus a buttock lift. The resulting scar runs all the way around the body, and the operation is also called a Belt Lipectomy or Body Lift. This operation is most appropriate for patients who have undergone massive weight loss.

Combination procedures

An abdominoplasty is a component of a lower body lift

Lower body lift

A belt lipectomy is a surgical procedure that reshapes the patient's abdomen, hips, thighs, and buttocks....

 and can be combined with liposuction

Liposuction

Liposuction, also known as lipoplasty , liposculpture suction lipectomy or simply lipo is a cosmetic surgery operation that removes fat from many different sites on the human body...

 contouring, breast reduction

Breast reduction

Reduction mammoplasty is the plastic surgery procedure for correcting over-sized breasts...

, breast lift

Breast lift

Mastopexy is the mammoplasty procedure for correcting the size, contour, and elevation of sagging breasts upon the chest...

, or occasionally hysterectomy

Hysterectomy

A hysterectomy is the surgical removal of the uterus, usually performed by a gynecologist. Hysterectomy may be total or partial...

, depending on the reason for the hysterectomy. A popular name for breast enhancement procedures performed in conjunction with an abdominoplasty is a "mommy makeover". Recent literature in MEDLINE

MEDLINE

MEDLINE is a bibliographic database of life sciences and biomedical information. It includes bibliographic information for articles from academic journals covering medicine, nursing, pharmacy, dentistry, veterinary medicine, and health care...

 also has noted implementation of barbed suture

Barbed suture

A barbed suture is a type of knotless surgical suture that has barbs on its surface. While suturing tissue, these barbs penetrate inside the tissue and lock them in place, eliminating the need for knots to tie the suture. Conventional sutures rely on a surgeon's ability to to tie secure knots,...

 in these procedures.

Recovery

• Depends on the problem to be treated, surgical technique(s), and other factors. Can take one to four weeks and patients are advised to take at least a portion of this recovery time off from work.
• Heavy activity especially is best avoided during this time.
• Initially there may be bruising and discomfort.
• A supportive abdominal binder or compression garment
  Compression garment
  Compression garments are pieces of clothing such as socks, pantyhose, sleeves, etc, that provide support that is especially useful for people who have to stand for long periods, or people with poor circulation. The garments can come in varying degrees of compression. The higher degrees require a...
  
   can minimize swelling / bruising, and support the repaired tissues.
• Patients are advised to avoid all forms of nicotine for a month or longer prior to surgery and also during the recovery period.
• Full recovery takes 3 – 6 months, with further fading of scars thereafter.

Risks

Abdominoplasty carries certain risks that may be serious or life-threatening. When taking the decision to undergo such a procedure it is recommended to compare the benefits with the potential risks and complications. Hence, all patients must be informed on all the risks they are exposing themselves to.

Although "tummy tucks" are considered safe procedures, as with any other type of surgery, different complications may arise. The majority of the risks can be avoided if the patients follow carefully the instructions they receive from their surgeon. Severe complications occur however in rare cases and these include blood clots, thrombosis

Thrombosis

Thrombosis is the formation of a blood clot inside a blood vessel, obstructing the flow of blood through the circulatory system. When a blood vessel is injured, the body uses platelets and fibrin to form a blood clot to prevent blood loss...

, cardiac and pulmonary complications or infection

Infection

An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...

.

Infection and blood clots are a serious potential risk after abdominoplasty, but which occur rarely. Infection is usually treated with antibiotics and drainage

Drainage

Drainage is the natural or artificial removal of surface and sub-surface water from an area. Many agricultural soils need drainage to improve production or to manage water supplies.-Early history:...

. Patients are recommended to move around as soon as possible after surgery to minimize their risks of developing blood clots. Pulmonary embolism

Pulmonary embolism

Pulmonary embolism is a blockage of the main artery of the lung or one of its branches by a substance that has travelled from elsewhere in the body through the bloodstream . Usually this is due to embolism of a thrombus from the deep veins in the legs, a process termed venous thromboembolism...

, heart attack or stroke

Stroke

A stroke, previously known medically as a cerebrovascular accident , is the rapidly developing loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia caused by blockage , or a hemorrhage...

 are very rare complications that may result after any type of surgery due to immobility after surgery which results in blood clots that may travel to the heart

Heart

The heart is a myogenic muscular organ found in all animals with a circulatory system , that is responsible for pumping blood throughout the blood vessels by repeated, rhythmic contractions...

, lung

Lung

The lung is the essential respiration organ in many air-breathing animals, including most tetrapods, a few fish and a few snails. In mammals and the more complex life forms, the two lungs are located near the backbone on either side of the heart...

 or brain

Brain

The brain is the center of the nervous system in all vertebrate and most invertebrate animals—only a few primitive invertebrates such as sponges, jellyfish, sea squirts and starfishes do not have one. It is located in the head, usually close to primary sensory apparatus such as vision, hearing,...

. Thus, pulmonary embolism is a serious risk after "tummy tuck" procedure and if they occur, they commonly happen within 3 weeks of the surgery, but more commonly within the first 72 hours after the procedure has been performed.

If complications occur, they usually delay the healing process. In rare cases, another surgery is needed to fix a potential complication. Skin necrosis

Necrosis

Necrosis is the premature death of cells in living tissue. Necrosis is caused by factors external to the cell or tissue, such as infection, toxins, or trauma. This is in contrast to apoptosis, which is a naturally occurring cause of cellular death...

 is one of the complications that may require another procedure as the dead skin must be replaced by a skin graft. Although necrosis is extremely rare, smokers have an increased risk to develop skin necrosis. Stopping nicotine use and smoking several weeks before and several weeks after surgery cleans the body and improves the chance of an uneventful recovery.

One of the more common problems after an abdominoplasty is collection of fluid under the skin after the drains have been removed.A surgeon can aspirate the fluid with a needle. The drainage stops within a month and does not affect the final results.

The scars resulting from abdominoplasty are long, brutal in appearance, and permanent. The size of the scar depends on the amount of skin that has been cut-off, the techniques used for the surgery, the surgeon's skills, and the body's ability to recover. Although this scar will never become invisible, it is usually placed under the swimsuit

Swimsuit

A swimsuit, bathing suit, or swimming costume is an item of clothing designed to be worn by men, women or children while they are engaging in a water-based activity or water sports, such as swimming, water polo, diving, surfing, water skiing, or during activities in the sun, such as sun bathing.A...

 line so it is covered by clothes. It normally takes 9 months to a year before scars flatten out and lighten in color.

Possible risks of abdominoplasty include:

• Bleeding
  Bleeding
  Bleeding, technically known as hemorrhaging or haemorrhaging is the loss of blood or blood escape from the circulatory system...
  
  
• Fluid accumulation
• Poor wound healing
• Skin loss
• Numbness or other changes in skin sensation
• Anesthesia complications
• Skin discoloration and/or prolonged swelling
• Fatty tissue found deep in the skin might die (fat necrosis)
• Major wound separation
• Asymmetry
  Asymmetry
  Asymmetry is the absence of, or a violation of, symmetry.-In organisms:Due to how cells divide in organisms, asymmetry in organisms is fairly usual in at least one dimension, with biological symmetry also being common in at least one dimension....
  
  
• Recurrent looseness of skin
• Pain, which may persist
• Persistent swelling
  Swelling (medical)
  In medical parlance, swelling is the transient enlargement or protuberance in the body and may include tumors. According to cause, it may be congenital, traumatic, inflammatory, neoplastic or miscellaneous....
  
   in the legs
• Nerve
  Nerve
  A peripheral nerve, or simply nerve, is an enclosed, cable-like bundle of peripheral axons . A nerve provides a common pathway for the electrochemical nerve impulses that are transmitted along each of the axons. Nerves are found only in the peripheral nervous system...
  
   damage
• Possibility of revisional surgery
• Hematoma
  Hematoma
  A hematoma, or haematoma, is a localized collection of blood outside the blood vessels, usually in liquid form within the tissue. This distinguishes it from an ecchymosis, which is the spread of blood under the skin in a thin layer, commonly called a bruise...
  
   (may occur in 3 to 4% of cases)
• Keloid
  Keloid
  A keloid is a type of scar, which depending on its maturity, is composed mainly of either type III or type I collagen. It is a result of an overgrowth of granulation tissue at the site of a healed skin injury which is then slowly replaced by collagen type 1...
  
   (heavy scar)
• Seroma
  Seroma
  A seroma is a pocket of clear serous fluid that sometimes develops in the body after surgery. When small blood vessels are ruptured, blood plasma can seep out; inflammation caused by dying injured cells also contributes to the fluid....
  
  
• Suture rupture
• Swelling
• Visible scar
• Death

Cost

The cost of a "tummy tuck" varies from country to country and even within locales of countries. As with most cosmetic surgery operations, the cost depends on a variety of factors like the age of the patient, their weight and the state of their health. Depending on the individuals, there may also be other costs involved after the operation. This does not include the follow-up visits as required by some doctors.

On average in the United States

United States

The United States of America is a federal constitutional republic comprising fifty states and a federal district...

, this procedure can cost from USD

United States dollar

The United States dollar , also referred to as the American dollar, is the official currency of the United States of America. It is divided into 100 smaller units called cents or pennies....

$4,000 to as much as $20,000.

The pre-operative and post-operative care, facility fees, anesthesia, and medications must be taken into consideration when reviewing surgery costs. No surgeries are a guaranteed success and therefore a second procedure or a touch-up may be required to achieve the desired appearance. These costs are typically not included in the original cost.

Related procedures

Liposuction, also known as lipoplasty, is a cosmetic surgical procedure that slims and reshapes specific areas of the body by removing excess fat deposits, improving the body's contours and proportion, and ultimately, enhancing the patient's self-image. Liposuction involves the use of a small stainless steel tube, called a cannula

Cannula

A cannula or canula is a tube that can be inserted into the body, often for the delivery or removal of fluid or for the gathering of data...

. The cannula is connected to a powerful suction pump and inserted into the fat through small incisions in the skin. Fat removal is accomplished as the suction cannula creates tiny tunnels through the fatty layers. Liposuction can be performed on both men and women. Ideal for this type of procedure are non-smokers, healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing, adults within 30% of their ideal weight who have firm and elastic skin.

Body contouring is a general term that refers to various plastic surgeries performed to different parts of the body with the aim of improving the shape and tone of the underlying tissue that supports fat. It is a common procedure performed for people who have undergone major weight loss. It may be performed in both men and women.

Breast reduction, or reduction mammoplasty, is the cosmetic surgery used in resizing the breast, in women with oversized breasts and men who suffer from gynecomastia

Gynecomastia

Gynecomastia or Gynaecomastia, , is the abnormal development of large mammary glands in males resulting in breast enlargement. The term comes from the Greek γυνή gyné meaning "woman" and μαστός mastós meaning "breast"...

. It is an overall safe procedure and most of the patients are pleased with the results. This type of surgery is performed to treat a breast condition known as hypertrophy

Hypertrophy

Hypertrophy is the increase in the volume of an organ or tissue due to the enlargement of its component cells. It should be distinguished from hyperplasia, in which the cells remain approximately the same size but increase in number...

, which refers to oversized breasts. This condition usually occurs in both breasts and commonly develops at puberty

Puberty

Puberty is the process of physical changes by which a child's body matures into an adult body capable of reproduction, as initiated by hormonal signals from the brain to the gonads; the ovaries in a girl, the testes in a boy...

 or immediately after.

Breast lift, also referred to as mastopexy, is the surgical procedure that removes the excess skin and tightens the surrounding tissue of the breast, resulting in raising and firming the breast. Mastopexies carry a certain degree of risks as any other type of surgery does. They are however safe procedures and the risks are minimized if the patients follow the surgeon's instructions.

Hysterectomies are sometimes performed with abdominoplasty. A hysterectomy consists in removing the uterus

Uterus

The uterus or womb is a major female hormone-responsive reproductive sex organ of most mammals including humans. One end, the cervix, opens into the vagina, while the other is connected to one or both fallopian tubes, depending on the species...

 and it may be complete (when the body, fundus and cervix are removed) or partial (when only the uterine body is surgically removed). This procedure is normally performed by gynecologists and it is one of the most common gynecological surgeries. This type of surgery is used to treat some benign tumors, cancers of the ovaries, uterus or cervix, endometriosis and are also performed in transmen.