Interest in plastic surgery is at an all-time high, but stigma and misinformation still surround the industry and patients. Welcome to Life in Plastic, a series by Allure that aims to explain cosmetic procedures and provide all the information you'll need to make the decision that is right for your body — no judgment, just the facts. Here, we're covering everything you need to know about the tummy tuck.
Despite the popularity of noninvasive plastic surgery procedures — Instagram-filter fillers, nonsurgical nose jobs, even nonsurgical butt lifts — invasive plastic surgery is still on the rise.
Partly, that may be because do-it-on-your-lunch-break options don't offer the same level of results as a traditional surgical procedure, like a tummy tuck, which is still an incredibly popular surgery even in the age of body-contouring procedures like CoolSculpting. "A tummy tuck is designed to restore a youthful, toned appearance to the abdomen," says Darren Smith, a board-certified plastic surgeon in New York City, of a cosmetic goal that has stood the test of time.
We asked the experts to break down everything you've ever wanted to know about a tummy tuck, including whether a noninvasive option can give you the results you're looking for.
What Is a Tummy Tuck?
A "tummy tuck," aka an abdominoplasty, targets two main issues: excess skin and a separation between the abdominal muscles. As a bonus, it also takes care of excess fat. "It doesn't really matter how much fat you have," Alan Matarasso, a board-certified plastic surgeon and current president of the American Society of Plastic Surgeons, tells Allure. "What really matters for this procedure is the skin and the muscle."
While also removing excess fat via liposuction (more on that later), the first differentiating factor of a tummy tuck is that it can help target the excess skin or stretch marks from pregnancy or a significant weight loss. In fact, experts say a tummy tuck may be the only way to get rid of loose, sagging skin. Matarasso likens it to stretched-out elastic. "Once the elastic gets too loose, you can put a safety pin in it, but by and large," he says, "the elastic is shot."
Then there's the muscle issue. "We're all born with a little separation between both sides of the rectus muscle, [aka your 'six pack'] — maybe a half an inch or so. But with age, certain lifestyle factors, and definitely pregnancy, that muscle separates further," Matarasso explains. The result is like the loosening of a corset. Unfortunately, once these muscles spread, the only true way to "bring them back" is via surgery. "A tummy tuck brings the muscle edges together, which acts like an internal corset, pulling your belly in," Matarasso says.
The Steps of a Tummy Tuck
First, a surgeon "will make an incision, which stretches across your bikini line," Melissa Doft, a board-certified plastic surgeon in New York City, tells Allure. "Through this incision, your surgeon will not only be able to remove skin but will also be able to tighten your abdominal muscles," she explains. "The surgeon will lift your skin away from the underlying muscles and then stitch the muscles together, restoring the tightness."
Next, the surgeon will address the skin, pulling it tight and removing any excess. To picture this, think of your stomach as a football field running from your chest to the top of your pubic hair — "Your belly button is the middle of it, at the 50-yard line," Matarasso says. In a full tummy tuck, "the skin that's above the belly button gets pulled down and does double duty to cover the upper and lower abdomen. So if you have a mole above your belly button before the operation, it's going to be below it after."
Speaking of belly buttons, don't worry, it's not suddenly going to be sitting on your bikini line. "The surgeon will make a new hole for your belly button to emerge from," adds Doft.
Mini vs. Full Tummy Tuck
How involved this whole process gets depends on the type of tummy tuck in question — a "mini" or a full: A mini runs from inner thigh to inner thigh and a full spans the stomach from hip to hip. "The difference between the two procedures is the length of the incision," Doft explains, "thus the amount of skin that can be removed." (One other difference: In a mini tummy tuck, the surgeon usually only stitches up the lower half of the rectus muscles.)
While they're in there, surgeons might also address any excess fat, removing it the way they would during traditional liposuction.
Before finishing the procedure, the surgeon places drains in your stomach to remove any extra fluid that accumulates as you heal, allowing the newly stretched skin to stick to the muscle. (The drains will be removed by your surgeon after about a week.)
The Recovery Process
Even though it's major surgery — you'll be under anesthesia for the two-and-a-half to four hours it takes to perform — tummy tucks are technically out-patient procedures, meaning you can go home after spending a couple hours in the recovery room, says Doft.
But you will have to do a lot of recouping after you get home. "I generally advise my patients to take two weeks off of work," Smith says. Light walking right after surgery is advised, but no hitting the gym for at least two weeks. "By about five weeks, the patient can usually return to normal activities depending on their individual progress."
The recovery process can be painful. "It will take a few days to a week before you feel comfortable standing fully erect," Doft says. "Patients often walk slightly bent over due to the tightness of their abdomens."
Who Is a Candidate?
Not everyone is a tummy tuck candidate. "This procedure is most commonly performed on women in their 40s and 50s, after they have finished having children," says Smith.
Remember, it has nothing to do with fat. The muscle repair and skin removal are the differentiating factors of the surgery. So, for those who might have excess fat, but not muscle separation or loose skin, or for those who plan on having children, doctors don't recommend a tummy tuck. "I looked at large volumes of statistics, and about 55 percent of women that come in the door [with concerns about their stomach] have liposuction, while about 45 percent need a tummy tuck," Matarasso says. "In males, it's about 90 percent that end up needing liposuction and only about 10 percent that are better candidates for tummy tucks."
Identifying which procedure is right for you — noninvasive body-sculpting, liposuction, mini or full tummy tuck — can be tricky, unless you're a board-certified plastic surgeon. "There are different roles for each procedure," says Matarasso.
How Does the Tummy Tuck Compare to Body-Sculpting Procedures?
If you're hoping to get tummy tuck-like results on your lunch break, you're out of luck, according to the experts. "Noninvasive procedures can't come close to achieving the results of a tummy tuck," says Smith. In short, body-contouring procedures, like CoolSculpting and SculpSure, are surface level. They work by either freezing or heating fat cells to kill them off, which is great for stubborn squishy spots no amount of diet and exercise seem to effect, but won't do anything to address the sagging skin or underlying muscle separation the tummy tuck targets.
"If a patient's primary issue is excess fat, noninvasive options can usually reduce superficial fat by 25 percent, on average," Smith explains. "So, for someone who does not need dramatic fat reduction, non-invasive options may be reasonable."
But what about lipo? Liposuction can remove significantly more fat than noninvasive body contouring, but that's all it can do. "Liposuction will only remove fat," reiterates Doft. "It will not tighten loose muscles." Plus, if you're concerned about loose skin, liposuction can actually make the problem worse, she says.
"I think many patients look to new technology hoping to avoid surgical costs and downtime," Doft says, "but patients who would really benefit from a tummy tuck will be frustrated by how limited the difference is."
On the fence? Talk to a board-certified plastic surgeon about all of your options; go to a surgeon practiced in all three procedures so that they can give you the best recommendation of what will work best for you, advises Matarasso. "Make a diagnosis before you make a treatment," he says. "Have a discussion with your doctor as to what bothers you, what's causing it, what your options are, and what the most appropriate treatment is."
When it comes to results, Doft says, invasive procedures tend to be the clear favorite: "It is the gold standard of body contouring."
Unlike a lot of noninvasive procedures, a tummy tuck most likely won't need to be "refreshed" after a few years. "The results should be considered fairly stable and long-lasting," says Smith. The one exception? If you get pregnant post-tummy tuck, it will stretch out the rectus muscles and the skin, essentially undoing the entire process, he adds.
As with any surgery, having a tummy tuck carries some risks — bleeding and infection are the most common. While very rare, tummy tucks do carry a slightly higher risk of blood clots that can travel to the lungs. It's nothing to panic over, but it does underscore the importance of taking the operation seriously, says Doft: "Make sure to seek out a board-certified plastic surgeon to perform the operation whose aesthetic you trust."