What does "undermining" mean when referring to a tummy tuck?

Doctor Answers 17


What this means is the the skin and fatty tissue layer are elevated off of the abdominal wall so they can be pulled down to tighten the abdomen.

Fort Myers Plastic Surgeon
4.9 out of 5 stars 62 reviews

Definition of undermining

Undermining means to erode the base or foundation. It also means to damage or weaken. This is true in surgery as well as in other things. When plastic surgeons undermine an area , we weaken or divide the connection between the skin and the body wall. It allows us to lift the skin and stretch it down. But the other part of the definition is also true. The more you divide and lift the skin, the more you divide the nerve and blood supply. If the nerve supply is out, you are numb. If the blood supply is out, the skin dies. So, where's the balance?
Any thoughtful plastic surgeon will divide only that which has to be divided to get a good result. That's also why operating on smokers or those with other causes of poor circulation can be a really bad idea. 
That, by the way, was one of the big reasons that liposuction was often limited with abdominoplasty. The technique of lipo-abdominoplasty has shown us that it can all be done safely but with intentionally limited undermining.

Peter D. Geldner, MD
Chicago Plastic Surgeon
4.6 out of 5 stars 28 reviews

What does "undermining" mean?

"Undermining" is a surgical term used to describe dissection below the skin that takes place beyond the location of the incision.  The technique is used to facilitate advancement of the tissue from where the undermining took place.  In reference to a tummy tuck, the dissection takes place from the lower abdominal incision up towards the rib cage to lift the skin and fat off the abdominal muscles.  This allows the abdominal skin to be pulled down tight to optimize your results.  Without the undermining, it would be very difficult to pull the abdominal skin down due to the attachments to your muscles.

Erik Miles, MD, FACS
Charlotte Plastic Surgeon
5.0 out of 5 stars 29 reviews

What does "undermining" mean with a tummy tuck?

When we do a tummy tuck, we make an incision through the skin and cut straight down through the skin and fat to the muscle layer.  We then lift the skin and fat off the muscle heading upwards towards the chest.  This is what is known as undermining the skin.  When we have freed up the skin and fat from the muscle, we can then pull the extra skin/fat down like a window shade and trim off the excess skin/fat before we put it back down and sew it into place.

Edwin C. Pound, III, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 24 reviews

Undermining simple means opening a pocket

Undermining simple means opening a pocket between the skin and fat layer and the underlying muscle layer.  This is how we get access to the muscle fascia for repair in an abdominoplasty

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

What does "undermining" mean when referring to a tummy tuck?

Thank you for the question. Undermining in a tummy tuck is the process in which the surgeon cuts in the layer between the fat and the muscular fascia of the abdomen. In this the surgeon is not just elevating your skin and fat from the belly wall but also releasing the fibrous septae which keep your skin adherent to the underlying muscle wall.  In this way the skin and fat are "mobilized" so as to allow maximal advancement of the skin and fat and therefore maximal removal of same. I hope this helps.

Pedro M. Soler, Jr., MD
Tampa Plastic Surgeon
4.9 out of 5 stars 39 reviews

What is "undermining" in regards to a #tummytuck

Hi Spev, Thank you for sharing your tummy tuck question.  The term undermining refers to when the incision is placed low on the abdomen, but all of the skin on the front of the abdomen (belly) instead of just going stright down it goes up all the way to the rib cage. Then the skin on top is like a blanket and slides down as if you're making your bed, and the wrinkles get smoothed out. I hope this explaination is helpful and wish you all the best.

Brian S. Coan, MD, FACS

Brian Coan, MD, FACS
Raleigh-Durham Plastic Surgeon
4.9 out of 5 stars 58 reviews


It describes lifting the skin up from near the pubis upto the rib cage areas.  That then allows extra skin to be pulled down and removed.

Harry T. Haramis, MD, FACS
Montclair Plastic Surgeon
3.7 out of 5 stars 19 reviews

Undermining is the region where the surgeon "lifts up" the skin

There are different techniques of performing an abdominoplasty. A traditional technique is where the surgeon removes an ellipse of skin (think of a flattened football shape) from the belly button down to the hair-bearing region. The skin from the belly button up to the ribcage is "lifted" off of the abdominal wall (all blood vessels and nerves are cut during this process. This is what is called "undermining".) Now that the skin is free from attachments, it can be stretched down to cover the area where the ellipse was removed.)

I hope that makes sense. Please look at the video on my link, as it has an animation that will help explain the term. (Don't worry, it doesn’t' show any real surgery or blood.)

Michael A. Bogdan, MD, FACS
Dallas Plastic Surgeon
4.9 out of 5 stars 67 reviews

What is undermining mean in tummy tuck.

Thanks for your question. In tummy tuck surgery the abdominal skin and fat is lifted of the underlying  abdominal wall muscles. We are getting under it. By elevating the skin we are able to stretch it further  downwards, removing more and making it tighter. 

I use the analogy -- It is like lifting up a bed sheet and pulling it down nice and snug then tucking it in again.

Hope this helps.

Adam Tattelbaum, MD
Washington DC Plastic Surgeon
5.0 out of 5 stars 103 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.