TUMMY TUCK

Pros

• Tummy tuck surgery trims the waistline and creates a smoother, firmer, more contoured abdominal profile.  
• You’ll look better and feel more confident in clothes and swimwear, since you won’t have to choose outfits to accommodate your belly.  
• The procedure removes or reduces pregnancy stretch marks from the lower abdomen as well as other lower abdominal scars (from a C-section or hysterectomy, for example). 
• You may notice less lower back pain and urinary incontinence, once strength and stability are restored to the abdominal core. 
• Repairing abdominal muscle separation can also strengthen the core, making exercise easier and more productive.   
• Results are very long-lasting and potentially permanent, unless you gain a lot of weight or become pregnant.

Cons

• It's a major surgery with a long recovery. You'll need two weeks of downtime, and the full healing process can take three months to a year.  
• It has a relatively high complication rate (see more about risks).  
• The surgery leaves a permanent, albeit well-hidden scar that extends across the lower abdomen, from hip to hip.  
• It's not cheap, and insurance likely won’t cover it.
• You may need touch-ups to fine-tune your results.

RealSelf Tip: You can expect to lose a few pounds during a tummy tuck from the removal of extra skin and fat deposits—but it’s not a weight-loss procedure.

Related: Here's Exactly What to Look for in Tummy Tuck Before and After Photos

• Average Cost:
• $12,115

• Range:
• $5,000 - $24,000

The price you pay will depend on the complexity of your procedure, the experience level of your surgeon, their practice location, and any additional costs.

Abdominoplasty surgery is considered a cosmetic procedure, so insurance typically doesn't cover it. However, a portion of your fees may be covered if your procedure involves hernia repair.

Most surgeons offer monthly payment plans or accept third-party financing options, such as CareCredit.

• Learn how much seven real patients paid for tummy tuck surgery
• See our complete guide to tummy tuck costs

As you're choosing your plastic surgeon, look for tummy tuck before and after pictures that show a well-contoured abdomen, a natural-looking belly button, and a low, inconspicuous scar.

The tummy tuck photos in our gallery have been shared by the surgeon who performed the procedure, with the patient's consent.

Over 5,790 patients who recently reviewed the procedure on RealSelf give tummy tuck surgery an impressive 95% Worth It Rating.

Tummy tucks are particularly popular for mothers seeking to reclaim their body after having children, and most are thrilled with how the surgery transforms their body. 

Many happy patients report a positive impact on body image and a major boost in self-esteem. “My body changed so much with each pregnancy, with stretch marks and loose skin that no gym can fix,” says a abdul in her review. After surgery, “when I looked in the mirror, I couldn’t believe I had my body back.”

Opting for this surgery after extreme weight loss is often seen as the final step in people’s weight-loss journey. Such was the case with Resourceful3, who lost 110 pounds and had excess skin he wanted to get rid of. “Everytime I look at myself in the mirror, I smile,” he says. 

Satisfaction isn’t guaranteed, however. Among reviewers on RealSelf who say tummy tuck surgery isn’t worth it, several cite poor results (including asymmetry and scars) and complications. 

To reduce your chance of being disappointed,find a board-certified plastic surgeon who regularly performs the procedure. Look closely at their patient reviews and photo gallery. Ideally, you’ll see dozens of before-and-after photos taken from multiple views. 

With a well-done tummy tuck, surgical scars can be hidden under a swimsuit or underwear. You should see a mostly flat abdominal contour with some degree of muscle definition, a narrower waist, smooth skin, and a natural-looking belly button. This kind of result requires careful preoperative planning and attention to detail in the operating room.

The best candidates for a full tummy tuck have these things in common.

Excess abdominal skin. “If you sit up straight and have hanging skin, you’re a good candidate for a tummy tuck,” says Dr. Casas.

Being in generally good health. Conditions like advanced cardiopulmonary disease, cirrhosis, and uncontrolled diabetes, are risk factors, so most patients need medical clearance before undertaking surgery.

Not smoking. Cigarette smokers are considered poor candidates, since nicotine consumption constricts blood flow and increases the risk of poor healing. If you smoke, plan to stop a minimum of two weeks prior to surgery (ideally six weeks in advance) and avoid smoking during the months-long healing process.

Being at a stable weight. Dramatic weight fluctuations A common concern of people contemplating a tummy tuck is whether they need to lose weight to qualify for the surgery. The answer varies by surgeon, but the most common stance is that you should be within 10–15 pounds of your goal weight. Many surgeons won’t operate on someone with a body mass index (BMI) higher than 30, due to a commonly held belief about an increased risk of complications. 

A 2019 study published in Plastic and Reconstructive Surgery concluded that "Tummy tuck surgery (abdominoplasty) can be safely performed in obese patients, with no increase in complications compared to non-obese patients." According to Dr. Rodriguez, "surgery in patients with BMI up to 35 can be carried out safely, when combined with a program of dietary counseling and a waiting period to verify the patient is achieving fitness and dietary goals.”

Having realistic expectations. A perfectly flat tummy isn't always possible. Many patients don’t realize that a big component of the belly protrusion may be the visceral or “mesenteric fat” inside the abdomen. In these cases, even the best muscle repair and skin tightening will result in a rounded abdomen because of the bulky mesenteric fat, notes Dr. Rodriguez.

Related: What Real Women Who Had a Tummy Tuck Wish They'd Done Differently

Make arrangements in advance to have someone help out for the first week after surgery. You’ll need assistance to do even the most basic things, such as get in and out of bed, go to the bathroom, bathe, and get dressed. Most surgeons advise against lifting anything for six weeks, so having a friend or family member staying under the same roof is especially important if you have kids and pets. 

To make recovery easier, stock up on supplies beforehand, including food.

• Stock your kitchen with healthy fare—fruit, vegetables, and lots of protein for healing. In case you have trouble keeping food down at first, protein shakes can help keep you hydrated, full, and energized. 
• Scale down to pint- and quart-sized containers of milk or juice. You won’t be able to lift gallon-sized containers.
• Consider cooking meals and freezing them ahead of time, so you have them at the ready. 

As your surgery date nears, adjust your medication and supplement regimen as directed by your doctor.

Many surgeons will provide patients with an appropriate post-operative garment, but you may want to have an extra, in case one becomes soiled with blood or fluid. 

Other supplies you’ll need to have on hand include:

• Feminine pads to absorb fluid that leaks from your drains or incisions. 
• Stool softeners. Pain medication can cause constipation and put unwanted strain on your abdominal muscles.  
• Compression socks. You may be instructed to wear compression stockings for a short time after your tummy tuck to improve circulation and help prevent blood clots. After that, you may want to switch to wearing socks with grips on the bottom. Early on after surgery, you won’t be steady on your feet, so no-slip socks are a wise precaution. 
• A recliner for more comfortable sleep. Most providers on RealSelf don’t recommend spending additional money on a recliner, but many patients say it’s worth it to rent one. “Anything that keeps you in the ‘beach chair’ position will work,” says Dr. Richard Wellington Swift, a board-certified plastic surgeon in New York City. You can achieve similar results by placing pillows behind your back and under your knees.  
• A toilet seat riser. Again, it’s not a must, but it’s worth the minimal expense to make it much more comfortable to use the toilet—something that requires you to engage your ab muscles. 
• A lanyard to hold your drains. It’s difficult to pull out drains (they’re usually stitched into place), but clipping drains onto a lanyard or loose string around your neck can keep them out of the way while showering. 

Taking these extra steps a few days pre-op will help make your recovery go even more smoothly.

• Clean your house thoroughly. You’ll need to avoid vacuuming and other strenuous tasks during recovery, so it’s nice to have that done ahead of time. 
• Make your bed with old sheets and stage older (clean) towels for showering. There’s no reason to get your best linens messy.
• Read all of your plastic surgeon’s instructions thoroughly, and have your caretaker do the same. Following all post-op instructions will help you avoid complications.

Line up entertainment. It’s not uncommon for people who have tummy tucks to experience severe mood swings, ranging from depression to elation (which may lead to over-activity), warns Dr. Tom Pousti, a board-certified plastic surgeon in La Mesa, California. Being prepared to distract your mind with books, magazines, and movies can help you handle the emotional hurdles of the surgery.

A complete abdominoplasty takes between 90 minutes and five hours, depending on the complexity of the treatment plan and surgeon’s technique. 

This major procedure is usually performed under general anesthesia (so the patient is fully asleep), although it can be performed under IV sedation and tumescent anesthesia. Check with your surgeon to see if this alternative is available, as the recovery is easier and faster, according to Dr. Rodriguez.

Here's what happens during the procedure.

• Your surgeon will start by making a long horizontal incision, just within or above the pubic area and below the bikini line. They may also make a second incision around the belly button. 
• They will then separate the skin and underlying tissue from the muscles up to the bottom of the sternum, and possibly over the rib cage, before lifting the skin to repair and tighten the underlying abdominal muscles. 
• Once the muscle repairs are complete, the upper abdominal skin is pulled down, and the pelvic tissue (including the vulva) is pulled up, to create tighter abdominal skin when sitting. 
• A new opening for the belly button is created in the midline and anchored to the abdominal wall.  
• Excess fat is removed from the skin around the new belly button opening, giving it an attractive "innie" look. (If your surgeon isn't able to preserve your navel for any reason, a belly button tattoo can look natural.) 
• Excess abdominal skin is trimmed. 
• The remaining skin is smoothed, and the incision is sutured closed. 
• Gauze or other surgical dressings may be applied to your abdomen and covered with tape or an elastic bandage. 
• Your surgeon may insert surgical drains, to stop fluid from building up in and around the incision during healing. These clear plastic tubes are placed through small incisions below the main surgical incision. 
• You may also be placed in a compression garment. If so, you'll be asked to wear it for up to 24 hours a day (except when showering) for at least the first week, to reduce swelling and encourage tissue adhesion as you heal. 

Most surgeons use dissolvable internal sutures, except in the muscle repair. If sutures are used on the surface of the skin, they should be removed at your first follow-up appointment, within a week of your surgery.

Dr. Schlesinger routinely removes all external stitches and staples on the third postoperative day and all drains on the fifth postoperative day. Other surgeons may leave drains in longer.

RealSelf Tip: Some surgeons perform drainless tummy tucks using a suturing method that restricts fluid accumulation. Although patients report less pain, it’s a longer procedure, with greater potential for indentations or irregularities.

Related: 10 Things I Wish I Knew Before My Tummy Tuck

You won’t feel any pain during tummy tuck surgery, thanks to the anesthesia. Tummy tuck recovery, on the other hand, can be uncomfortable, with significant tightness in the abdominal area. 

According to doctors on RealSelf, patients vary in how much pain they experience: some have significant pain, while others find it’s not as bad as they expect. 

Most of the pain from the operation comes from the tightening of the intra-abdominal muscles. “Patients who’ve had a C-section have said that the pain is similar to a tummy tuck, but that the recovery is easier because they don't have a newborn to take care of,” says Dr. Lisa Peters, a board-certified plastic surgeon in Forest Park, Illinois. 

The first few days after tummy tuck surgery are the most uncomfortable. After that, the pain diminishes rapidly. 

In addition to prescription and over-the-counter pain medication, surgeons rely on these strategies to minimize the pain:

• Exparel, a long-acting non-opioid numbing agent. “I highly recommend that you find a surgeon who uses Exparel. It significantly reduces the discomfort for the first few days after a tummy tuck,” says Dr. Richard Baxter, a board-certified plastic surgeon in Mountlake Terrace, Washington. It’s typically placed via a TAP (transversus abdominis plane) block, a technique used to inject anesthesia into your abdominal muscles before the procedure is complete. “Since the pain is reduced at the source, you need fewer pain pills, which can have side effects, and your recovery gets a boost because you feel better,” Dr. Baxter says.
• A pain pump to deliver local anesthesia, like novocaine, to the abdominal area for a few days after surgery. “It helps to blunt the pain when it's at its worst and make it more manageable,” says Dr. Peters.
• Muscle relaxers to treat the muscle spasms (involuntary contractions) that are common following a tummy tuck, as the abdominal muscles get used to their tightened state. 

Each surgeon will have their own protocol for post-op pain relief. Talking to your provider during your consultation about how they’ll help manage your pain will help relieve your anxiety, which may even help minimize the amount of pain you experience. 

There’s no getting around the fact that a tummy tuck will hurt to some degree. The good news, says Dr. Peters, is that it’s “happy surgery. Patients are excited to achieve the improvements for which they've been hoping, and that makes a few days of pain well worth it in the end.”

Plan on needing at least two weeks of downtime before you go back to work, and up to six weeks of total recovery time before you’ll be healthy enough for strenuous activity or exercise after a tummy tuck.

If you can take more than two weeks off work, do it. You won't regret having the extra time to heal and get your energy back.

Here's what to expect during and after that time:

• Your provider will prescribe pain medication for the first several days of your recovery. 
• Expect swelling, bruising, and tenderness around the incision sites, especially during the first three days.  
• Even though you may not feel like getting out of bed, you’ll be encouraged to get up and move around a few times a day, to increase circulation and to prevent blood clots. 
• You'll be hunched over for a week or two after surgery before you can start standing up straighter again. “There’s significant tightness across the abdomen,” says Dr. Eddy Dona, a board-certified plastic surgeon in Sydney.
• You're going to need support for your daily activities for at least the first week after tummy tuck surgery. “The recovery is indeed difficult,” says Covetcleavage in her RealSelf review. “The first five days, I needed assistance to sit, stand, everything.” You might also need help getting in and out of your compression garment to bathe, as well as with fastening it again afterward.  
• Emotional support is equally essential after a tummy tuck. Have a cheerleader on your team, advises Dr. Robert J. Schwartz, a board-certified plastic surgeon in Plano, Texas. “Tell a trustworthy friend that you’re having surgery,” he says. “Share your reasons for having it, so they can understand, provide emotional support, and help you stay focused on your goals on those days when you’re not feeling 100%.” 
• Sleeping position is important. During the first two to three weeks after a tummy tuck, it's best to sleep on your back, with your torso and head elevated so your body is slightly bent. Using pillows or sleeping in a recliner are two good options for elevating your upper body, to help avoid putting tension on your incisions or stretching your abdominal tissues and muscles while they're still healing.
• You may begin to resume your normal activities within two weeks following your surgery, but you’ll need to take things slowly. “You can’t push the recovery process, because you’ll hurt the result. This surgery wasn’t cheap, so don’t ruin it,” says kylzmom in her RealSelf review.
• Doctors recommend not lifting anything heavy (like a small child) for the first four to six weeks of your recovery. 
• Some doctors on RealSelf also recommend waiting up to six weeks before resuming sexual activity, which raises your heart rate and blood pressure. Others say to wait at least two weeks and then take a “passive” role during sex for the next month, to reduce the chance of complications.

Related: Your Tummy Tuck Recovery Timeline: What’s Normal and What’s Not, at Every Stage

Tummy tuck surgery is generally considered safe when performed by an experienced, board-certified plastic surgeon. Most patients experience only minor side effects, including bruising, swelling, and temporary numbness along the incision site. 

However, this is a major surgery, with a high complication rate compared to other cosmetic procedures.

In one 2015 study published in the journal Plastic and Reconstructive Surgery, the complication rate of abdominoplasty was double that of other cosmetic surgeries—3% versus 1.5%. These were most common major complications and tummy tuck complications:

• hematoma (blood collecting under the skin) 
• seroma (a build-up of clear fluid inside the body) 
• infections  
• thrombosis (blood clots)   

Patients can also experience pulmonary thromboembolism (blood clots reaching the lungs), but this is rare. The use of IV sedation and tumescent anesthesia further reduces this risk.

Tummy tucks also have a higher mortality rate than most other cosmetic surgeries. But as board-certified plastic surgeon Dr. Richard Tholen of Minneapolis notes, “Published mortality rates associated with tummy tuck range from 0.02% to 0.16%. To put this in perspective, the death rate for elective C-section delivery is about 0.02%.”

Not following your surgeon’s recommended guidelines for rest and movement after a tummy tuck procedure can result in increased pain, delayed wound healing, damage to your incision, or even skin necrosis, leading to a longer recovery time, more scarring, or the potential need for corrective surgery.

However, some movement as you heal can help prevent blood clots, so talk with your surgeon about how soon you should start walking and how to do that safely.

Related: 5 Scary Tummy Tuck Complications—and What Happens If You Experience Them

Swelling after abdominoplasty can last up to three months.

Once all swelling in the abdominal area has subsided, you'll be able to see your final results.

Those who’ve had significant excess skin and fat prior to surgery will almost immediately be able to see a “massive” change after surgery, says Dr. Dona, but the final result will initially be obscured by swelling.

You’ll see much of your outcome within a few weeks, but it may take three months or more to see your final results.

Related: The 10 Most Popular Tummy Tuck Before and Afters on RealSelf

Tummy tuck results can be long-lasting: 10—20 years and sometimes much longer, according to doctors on RealSelf. 

The longevity of your result depends on whether you maintain a healthy lifestyle and avoid significant weight gain, as both can contribute to an early loss of your result.  

“Proper diet and exercise are necessary to maintain your surgical result, so be sure that these habits are in place prior to having a tummy tuck,” says Dr. Casas.

Skin quality prior to surgery, as well as changes that occur naturally with aging, can also impact the results of your tummy tuck. In the future, you may want to consider a nonsurgical body contouring treatment such as Emsculpt, in addition to a healthy diet and regular exercise.

Tummy tuck surgery leaves a scar that runs horizontally, from hip bone to hip bone. The scar is typically very low, just above the pubic area, so it’s easily concealed by underwear or a bikini bottom.

You can talk with your surgeon about placement and length, but there’s no guarantee that your tummy tuck incision won’t need to be longer than you hoped. If you have a lot of excess skin, your surgeon may also need to make a vertical incision.

To get an idea of how far your tummy tuck scar will extend, try this trick from Dr. Casas:

• Sit up straight and engage your core muscles tightly.  
• Pinch any excess skin with both hands, starting at your belly and working your way out toward your hip bone.  
• Wherever you’re able to stop pinching is where your scar will likely end. 

An abdominoplasty scar will never completely go away, but it will fade over time and become less noticeable. Your surgeon will give you instructions to care for your incision, which should help minimize and fade the scar. They might also recommend laser therapy or a topical scar treatment.

Related: 5 Effective Ways to Treat Your Tummy Tuck Scars

Most plastic surgeons agree that it’s safe to have a baby after an abdominoplasty, but any future pregnancies will inevitably stretch the skin and muscles.

There's no guarantee you’ll need revision surgery, but plan for the possibility if you become pregnant following your surgery.

Waiting on a tummy tuck until after you've completed your family comes with other benefits. According to a study published in February 2018 by the American Society of Plastic Surgeons (ASPS), abdominoplasty can “improve back pain and urinary incontinence after childbearing.”

Related: 5 Questions About Getting Pregnant After a Tummy Tuck, Answered

Many doctors on RealSelf consider three to six weeks an appropriate amount of time to wear a compression garment, though some surgeons don’t recommend one at all or prefer a shorter stint. 

Dr. Schlesinger recommends two weeks in a surgical garment provided by your surgeon followed by four to eight weeks of commercial garments, such as Spanx. 

Seattle plastic surgeon Dr. Shahram Salemy says, “I place my patients in a binder right after surgery, then switch over to Spanx or a similar over-the-counter binder at the first-week visit. I have them wear it night and day, except when showering, for the next three weeks and then during the day only for two more weeks. After the drains are removed, at around 10 days or so, they seem to do fine with the binder on and say it actually feels a bit better with it on for the first month.”

Related: Everything You Need to Know About Compression Garments

Some patients choose to have lymphatic massage during their recovery, to stimulate the flow of lymph and help purge waste and fluids from tissue.

Doctors on RealSelf agree that it’s not necessary, and if you choose to have a lymphatic massage, wait until you’re properly healed in order to avoid complications.

Consult with your surgeon before you decide to have lymphatic massage.

A full tummy tuck is the most effective way to get rid of excess fat and skin around your stomach while tightening your muscles. “There’s nothing on the market that will tighten the muscles of the abdominal wall and remove loose skin in the way that a tummy tuck will,” says Dr. Schwartz.

If you’re mostly concerned about the lower “pooch” area, a mini abdominoplasty, or mini tummy tuck, may be a good option. Be aware, however, that the procedure removes loose skin only in the lower abdominal area. “A mini tummy tuck produces mini results that would benefit only a small percentage of women—maybe 2%,” says Dr. Schlesinger.

You may have also heard of a Tummy Tuck belt. This compression garment (similar to a girdle) claims to burn extra fat via a combination of topical cream and your body’s own abdominal contractions, with the belt creating a “thermal fat-burning effect.” Its website touts that it typically results in a reduction of approximately 0.35 inch the first week and 1 inch in 30 days. It also claims that the belt has been jointly tested by two universities but doesn’t list their names—nor does it provide any medical evidence to back up the claims. 

Wherever the truth lies, it’s safe to say that any results from a belt will be far less dramatic than what you’d get with plastic surgery, in terms of excess fat and skin removal and muscle tightening.

Related: Tummy Tuck vs. Liposuction: What’s the Difference?