Tummy Tuck (Abdominoplasty)

A tummy tuck is a body plastic surgery procedure designed to address loose skin and separated musculature in the abdomen for a smoother, tighter abdominal contour. A hanging or protruding abdomen is a common aesthetic concern for patients who have undergone pregnancy, experienced fluctuating weight, or who have loose skin in the midsection due to aging or genetics. Dr. John Ayala, our  board-certified plastic surgeon in San Antonio, can make the abdomen appear firmer and more taut by bringing together stretched muscles as well as removing redundant skin. Liposuction can also be performed in conjunction with a tummy tuck to smooth pockets of excess fat for comprehensive improvement of your body contour.

A tummy tuck can remove excess skin and restore weakened or separated abdominal muscles, often minimizing the appearance of a hanging abdomen. Depending on your goals, patients who undergo a tummy tuck commonly achieve a smoother and firmer abdominal profile. Bulges caused by isolated fatty deposits can also be treated by combining the procedure with liposuction, if desired. In cases wherein the abdomen has stretched from pregnancy and/or weight fluctuation, a tummy tuck is frequently incorporated into a Mommy Makeover treatment plan for full restoration of a patient’s pre-pregnancy figure.

If you would like to firm and tighten the abdomen, you may be considering either a tummy tuck or liposuction (or both) to make your ideal appearance a reality. These procedures can both certainly improve your abdominal contour, but learning what distinguishes a tummy tuck from liposuction may help you get a better idea of the best treatment option for your needs. 

Simply put, a tummy tuck is usually performed to target excess skin while liposuction is only capable of addressing excess fat. Therefore, determining whether your concerns involve redundant skin or fatty tissue may help you ascertain the most optimal procedure to improve your abdomen. If you have a hanging abdomen that does not improve despite healthy eating habits and regular exercise, this can also be an indication that your abdominal muscles are stretched or separated. In these cases, abdominoplasty is the only procedure that can repair loose musculature. However, if you generally have good skin tone and would simply like to smooth bulges of fat, liposuction alone can often provide the desired results. Most patients struggle with both loose skin and stubborn fat to some extent, so it’s not uncommon for patients to combine tummy tuck surgery and liposuction.

Unfortunately, the powerful results achieved after a tummy tuck are only possible with surgery. In order to produce a leaner and smoother abdomen, Dr. Ayala must utilize techniques that are not usually feasible with minimally invasive technologies, such as using sutures to tighten separated abdominal muscles and excising loose, overhanging skin. Although non-surgical treatments like CoolSculpting® can help attain improvement by smoothing fat bulges affecting the abdomen, tummy tuck surgery is the only effective treatment option that can address the skin and musculature. 

Dr. Ayala encourages patients to be cautious when considering products that claim to non-surgically reproduce tummy tuck results. Compression garments and girdles like the Tummy Tuck Belt® are marketed to achieve the same aesthetic effects as a tummy tuck by simply wearing the “belt” for a given length of time each day, but there is no reputable scientific evidence to support these claims. Needless to say, the only way to truly repair a hanging, protruding, or bulging abdomen caused by weakened underlying musculature is through surgical means.  

Since belly fat often accompanies loose abdominal skin, a large majority of patients add liposuction to their tummy tuck in order to further reshape their midsection. This can help slim the waistline and flanks, often resulting in a leaner and flatter abdomen. Breast procedures are also commonly performed with tummy tuck surgery to enhance contours in both the breasts and body. Depending on which procedures you’re interested in, abdominoplasty and any complementary surgeries may be performed in stages to provide the best, most long-lasting outcome. This is more common when combining more extensive procedures; however, minimally invasive treatments, such as liposuction, can often be performed at the same time as a tummy tuck. 

With so many different providers in San Antonio, it can be difficult to narrow down your choice of tummy tuck surgeon. Finding the best plastic surgeon for your unique needs can be overwhelming, but there are many ways to gauge someone’s level of experience and quality of care. The following section outlines a few tips that can help you make a decision during the research process: 

• Always select a board-certified plastic surgeon. When someone is accredited by the American Board of Plastic Surgery (ABPS), you know that he or she has completed rigorous post-graduate training specifically in aesthetic procedures. 
• Research their experience, credentials, and professional memberships. It can be helpful to learn about a prospective surgeon’s educational background, residencies, and fellowships. In addition to a strong educational pedigree, involvement in professional organizations, as well as any recognitions or awards, can give you an idea of his or her level of experience. 
• View before-and-after photos from the procedures you’re interested in. A patient gallery can be a good indication of the outcomes you can expect from a plastic surgeon. Therefore, it’s important to determine whether the photos showcased align with your aesthetic desires. 
• Read online reviews before selecting your aesthetic surgeon. Reviews can be an excellent way to learn about the experiences of previous patients and often provide insight into a plastic surgeon’s bedside manner and level of care. 

Ultimately, scheduling a consultation with a prospective surgeon is the only way to determine whether he or she can achieve the types of results you desire. These initial visits are also important to establish a rapport with your plastic surgeon and ascertain how comfortable you are under their care.

• Why do some people get seromas after tummy tuck surgery?

  A seroma, which refers to a fluid-filled lump or bump, is a common reaction to major surgeries such as  abdominoplasty, C-sections, or a hysterectomy. Seromas typically develop due to a buildup of fluid or “serum” under the skin following a procedure in which large amounts of tissue were removed or disrupted. If they develop, seromas typically appear a few weeks after surgery near the incision site(s). A seroma is typically harmless and often resolves on its own as the body reabsorbs the fluid; however, patients should seek medical attention if signs of an infection are present, such as redness, increasing pain, or fever-like symptoms.

• Does a tummy tuck affect pregnancy?

  A tummy tuck does not affect the ability to get pregnant. However, Dr. Ayala recommends pursuing abdominoplasty only after all plans for pregnancy have been completed. From an aesthetic standpoint, pregnancy after a tummy tuck will likely re-separate the abdominal muscles that a tummy tuck originally sought to repair. Consequently, individuals who get pregnant after tummy tuck surgery may recreate the very aesthetic concerns that they wished to resolve in the first place.

• How should I sleep after abdominoplasty?

  For the first couple of weeks after tummy tuck surgery, it’s generally recommended to sleep in a reclined position with the head and knees slightly elevated. This can be achieved by using pillows to provide support for your head and knees, thereby increasing blood circulation and limiting tension on your incisions. Sleeping in this position can not only optimize the healing process, but it may also improve the appearance of scarring after your procedure. We advise patients to avoid sleeping on their stomach until Dr. Ayala instructs otherwise.

• What’s the difference between a tummy tuck and a panniculectomy?

  While both procedures are designed to remove loose, overhanging abdominal skin, a tummy tuck is usually performed for cosmetic reasons while a panniculectomy is performed out of medical necessity. A panniculectomy is intended to eliminate hanging skin that may be causing chafing or skin irritation after major weight loss. Unlike a tummy tuck, a panniculectomy only addresses the skin. In contrast, a tummy tuck treats both the skin and musculature to achieve aesthetic goals such as a smoother abdomen and a leaner body contour.

• Can a tummy tuck get rid of a C-section scar?

  If you have a scar from a previous C-section, Dr. Ayala can often reuse the same incision that was made during your surgery to perform a tummy tuck. This can help you avoid the appearance of additional scarring. Dr. Ayala will assess all possible incision options after he evaluates your concerns in a consultation. In some cases, a C-section scar may need to be extended slightly in order to accommodate the nature of the tummy tuck procedure. Dr. Ayala will inform you of what you can expect before your tummy tuck.