(Tummy Tuck)

Abdominoplasty is more commonly called a tummy tuck. This is a surgery to remove excess skin and fat over the lower portion of your abdomen. A key benefit that can be achieved together with this procedure is tightening of the underlying abdominal muscle (divarication of the recti). The contours of the flanks can also be improved with liposuction at the same time. Should you also suffer from an umbilical hernia, it can be repaired concurrently. Stretch marks over the lower portion of the abdominal skin will also be removed together with the abdominoplasty.

What is Abdominoplasty?

Abdominoplasty is a body contouring procedure that improves the flatness and firmness of your abdomen, commonly known as a tummy tuck. The pinchable excessive skin and fat over the lower portion of your abdomen (often under the umbilicus) is the area of interest.

Stretch marks found under the umbilicus will also be removed concurrently. Underlying abdominal muscle laxity, divarication of the recti and umbilical hernia can be repaired at the same time. In exchange for these benefits and improvements, a well-hidden scar is strategically placed at the lowest portion of the abdomen, easily concealed even in a bikini.

Who is suitable for a Tummy Tuck?

There are many reasons for people who decide for abdominoplasty surgery, these are some of the more common reasons:

Obese patients following bariatric surgery, resulting in massive weight loss and a drop in BMI. Leaving excessive and loose skin as a result of the weight loss (this is often a Medisave claimable condition)

Personal weight loss efforts resulting in excessive and loose skin

Women post pregnancies with excess skin, fat, stretch marks and divarication of recti – also commonly known as a mummy makeover

Abdominal / umbilical hernia

Any men or women who desires aesthetic improvement of their abdominal contour

As this is a cosmetic procedure, you should be in good health and assessed to be in the low anaesthetic risk profile. Smoking should also be stopped (ideally 6 weeks prior to and after the surgery) as it will affect wound healing and overall results of the abdominoplasty.  We will understand your medical history thoroughly and may also conduct several blood investigations before the procedure.

What type of Abdominoplasty are available?

The abdominoplasty suitable for you will be dependent on the total areas of excessive skin and fat. This is best discussed with you after the consultation and examination. Here are the options available:

Mini-abdominoplasty – shorter than one hip bone to the other

Standard abdominoplasty – incision is generally from one hip bone to the other

Extended abdominoplasty – incisions extend further behind each hip bone

Circumferential / belt body lift – the entire lower abdomen

When should I have Abdominoplasty Surgery done?

This will depend on the original reason leading you to have an abdominoplasty.

For patients who have had bariatric surgery losing massive amounts of weight, or patients who lose weight with their own efforts, it is ideal only when you have achieved your target weight. Your body weight should not yo-yo further and your BMI is ideally less than 30 for the best results.

For mummies who are bothered by the excessive skin and fat, stretch marks, divarication of recti or umbilical hernia, and are looking to get a mummy makeover. It is best to complete your family before embarking on this journey.

For the other group who desires improvement in their abdominal contour, there is no specific timeframe.

Another consideration is the recovery process.  Generally, about 2-3 weeks is adequate for you to comfortably return to work. Do ensure that your work commitments allow for this.

Can diverication of the recti (ectus diastasis) and back pain be improved with Abdominoplasty?

Yes. Diverication of the recti happens during pregnancy, when the pressure from the fetus stretches the rectus muscle apart. This weakens the core muscle. Some improvements can be achieved after delivery with core strengthening exercises like Pilates, which strengthens the rectus muscle and reduces the gap of the diverication.

However, the diverication of the recti does not fully recover in some women even with exercises. Surgical repair of the diverication during abdominoplasty will tighten the muscles, reduce the gap and strengthen the abdominal musculature wall.

Can umbilical hernia be repaired at the same time as Abdominoplasty?

Yes. Umbilical hernia or belly button hernia forms during pregnancy. The umbilical hernia presents fullness around your umbilicus (belly button), especially during certain activities like coughing or exerting yourself. This fullness can often be pushed back (reduced) when you lie flat. The cause of the umbilical hernia is due to a weakening of the fascia that normally lines the rectus abdominal muscle or a gap between the rectus muscle that allows a portion of the intestines to come through the gap.

Similarly, during an abdominoplasty, the weakness in the abdominal fascia and protruding intestines can be repaired at the same time.  The repair of the belly button hernia is a medical condition and most of the time can be claimed under medisave or insurance coverage.

What does the Consultation Process include?

At the consultation, Dr Lee will first find out your medical history, long-term medications or supplements, previous surgeries will also be discussed. Previous pregnancies and future plans for pregnancy will also be discussed. If you are still planning for future pregnancy, it is best to hold off the abdominoplasty till you have completed your family.

An assessment for the abdominal region, presence of belly button hernia, weakness of the abdominal wall, presence of divarication of the recti, location of stretch marks (if any) and adiposities will be assessed. Following this, the suitability of various types of abdominoplasties will be discussed.

Location and placement of the scar from the abdominoplasty will also be discussed. The recovery process and care will be explained in detail.

How is the Surgery done?

An abdominoplasty is done under general anaesthesia.  Generally, the surgery takes about 3-4 hours. Most of the time, abdominal skin under the umbilicus will be resected, allowing for the remaining skin to be pulled down for closure. This is done by elevating the abdominal skin flap all the way up to the xiphoid and costal margins. This allows the skin to be stretched and re-draped downwards to tighten and improve the contour.

At the same time, Dr Lee will assess for weakness of the fascia, divarication of the recti muscle or umbilical hernia, if present, they will be repaired at the same time. Sometimes, limited liposuction is performed over the flanks to improve the overall contour and results of the tummy tuck.

With abdominoplasty, the mons pubis will also be lifted up simultaneously, which will also help rejuvenate the perineal region. Abdominal drains will be inserted after surgery to ensure that any retained blood or seroma fluid will be drained out. Your compression garment will be worn after the surgery is done to help with support of the wound and reduction of swelling.

Are there any alternatives to Abdominoplasty?

Liposuction may be an alternative to Abdominoplasty if the amount of loose skin is limited. This is a commonly asked question by patients who are deciding between liposuction or a formal abdominoplasty.

With liposuction, the adiposities under the skin will be removed together was some contraction of the skin. The overall results may be ideal for certain patients. Skin contraction can be improved with the use of VASER liposuction or Bodytite/Morpheus8.

Also, with Microaire liposuction, the abdominal wall can be etched to give the appearance of a more athletic contour. The benefit of liposuction is tiny well-hidden scars that are less than 1cm with faster recovery period.

Click here to learn more about Liposuction Surgery.

What is the recovery and downtime like?

After abdominoplasty, it will take about 2-4 weeks for downtime and recovery. You will initially experience tightness over the abdominal region which gradually relaxes as the skin stretches out and improve over the first 4 weeks of recovery. You will be assisted with ward nurses or physiotherapy to start walking 1-2 days after surgery.

There will be surgical drains placed after abdominoplasty to ensure that any blood and seroma produced will be safely drained out. This generally stays for about 1-2 weeks. Before discharge, we will teach you how to care for the drains at home.

Compression garment should be worn for about 4-6 weeks to aid with the swelling, bruising and tightness.

Scar management will be started once the wound has healed and continued till the scar becomes barely visible.

Are there any limitations?

The result of abdominoplasty is most ideal if BMI is less than 30. The thickness of the abdominal skin also affects the overall results of the abdominoplasty. When the skin flap is thinner and looser, it will re-drape over the underlying muscle smoothly. If the BMI is over 35, it may be ideal to postpone the abdominoplasty while continuing on efforts to reduce BMI, occasionally bariatric surgery maybe considered.

Certain medical conditions may affect wound healing and delay recovery. Do discuss with your plastic surgeon of your medical conditions and medications.

Frequently Asked Questions about
Abdominoplasty (Tummy Tuck)

Frequently Asked Questions about Abdominoplasty (Tummy Tuck)

Common complications of a tummy tuck procedure include swelling, tightness, and discomfort. These generally resolve over the next 2-4 weeks. There will be some numbness and firmness and these sensory disturbances generally improve over 2-3 months. 

There are some less common complications, they include seroma (fluid produced by the body after surgery), this is reduced by keeping the surgical drains until they are minimal and using progressive tension sutures during the wound closure. Bleeding and haematoma are other possible complications that can be managed with surgical drains. Wound healing issues and wound dehiscence is another concern. This happens more commonly in patients with diabetes, immunosuppressed states and smokers. Scars will form over the lower abdominal region but sometimes poor scaring like hypertrophic or keloid scars.

Some rarer complications include deep vein thrombosis, pulmonary embolism and risk related to anaesthesia like heart attack, stroke or death.

Before any surgery, any pre-existing medical conditions should be optimized, for example if you have diabetes, your blood sugar control and blood test results should be optimal.  You should also have stopped smoking for at least 2 weeks prior to surgery. Minimally 2 weeks off work after the tummy tuck procedure is also recommended.

Most abdominoplasty are considered cosmetic surgery and not covered. Only if the abdominoplasty is a result of massive weight loss following bariatric surgery, the procedure can potentially be covered by Medisave and Insurance coverage.

View our Insurance Partners here

After abdominoplasty, you can start light activities like brisk walking after about 6-8 weeks. It is best to wait till 6 months later before starting heavier gym weights and activities.

Yes, there will be scars after the surgery.  One of the scars is the lower abdominal scar which generally runs from one hip bone to the other hip bone. These scars are very well hidden within the bikini line and once they fully heal, it should be a barely visible pale and flat scar. All scars as a result of surgery or trauma are permanent, however with good scar management and care and time, the scars will heal well and will be barely visible.

Stretch marks do form over the abdominal skin after pregnancies. Most of the time, they are found over the skin under the umbilicus (belly button), however sometimes these stretch marks extend to the skin above the umbilicus. During abdominoplasty, the skin under the umbilicus is usually resected and it will remove the stretch marks found there. However, stretch marks that are above the umbilicus will not be removed and during closure of the wound, these stretch marks will be pulled down towards the scar, placing them in a less obvious location. 

Yes, men are just as suitable for abdominoplasty as women. The management and postop care are similar.

You do not have to worry about your pre-existing C-section scar. During the abdominoplasty, this scar will be removed. There will not be two separate scars. The old scar will be incorporated into the new scar.

Abdominoplasty is often performed together with breast augmentation or breast lift as part of a mummy makeover. This allows a complete rejuvenation of the body and one recovery period.

View our Breast Augmentation Procedures: