Tummy tuck and sitting up.

I have more skin lax when I'm sitting, when I lay flat the skin disappears I think this is the reason I was unhappy with my first abdominoplasty. Please note I am a massive weight loss patient so skin quality isn't great. Would it be rude if I ask my next PS to sit me up in the OR before closing me up to make sure the skin is tight and there are no bulges or excess skin! Would it even be possible to sit a patient up in the O.R? Would you as a plastic surgeon do this request if a patient asked?

Doctor Answers 5

Loose skin and tummy tuck

It is usually the standard to have the patient flexed or bent at the hip when a tummy tuck is performed. This allows more skin to be removed while still being able to close the incision. Sitting completely up at a 90 degree angle may be a little on the extreme side though. If you remove too much skin, you will not be able to stand up and eventually when you do, the tension on the scar will result in a wider scar or a scar that rides high on your abdomen which is much more noticeable. You should definitely feel comfortable in letting your plastic surgeon know that you would prefer him or her to err on the the "more" skin removed than less! Hope this helps!!

Johnson C. Lee, MD Plastic Surgery

Beverly Hills Physician
5.0 out of 5 stars 12 reviews

#abdominoplasty #tummytuck


I think its a great question! You should definitely discuss with you plastic surgeon but typically the operating room bed is flexed for final closure.  You don't want it to be too tight however, this can lead to wound breakdown and worse scar.

Dr. Daniel Barrett

Plastic Surgery

Beverly Hills, CA

Daniel Barrett, MD
Beverly Hills Physician
5.0 out of 5 stars 36 reviews

Remaining skin laxity after TT

One of the consequences of extensive body weight loss is a loss of skin elasticity and retraction. When doing  a TT surgery surgeon tries to remove as much skin as possible considering skin blood supply, skin elasticity and body shape. However, even after visible initial improvement that may last for several weeks or months, patient who  has a poor skin tone and elasticity will demonstrate some degree of laxity. This is due to inherent quality of their skin which, unfortunately, can not be changed with surgery. Sometimes additional skin excision may bring improvement. 

Zoran Potparic, MD
Fort Lauderdale Plastic Surgeon
5.0 out of 5 stars 14 reviews

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Tummy Tuck

Not only would that not be rude, but that is the norm. We always flex the operating table to take out the maximum amount of skin. It is then very hard for the patient to stand up straight for several days but as the skin relaxes they can stand up straight. However, you must understand that when you fold your body forward you will fold your skin, it will not ever be tight when you are bent over

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 reviews

Tummy tuck and sitting up

Your situation and observations are surprisingly common, not only for individuals after weight loss, but after childbirth and aging as well.  It's skin elasticity, variable among individuals, among parts of the body, and over time.  Skin elasticity CANNOT be changed by surgery.  Only molecular biological research may help us manage situations like yours more successfully in the future.

Think for a moment though:  Say your surgeon DOES sit you up, and DOES remove all loose skin in the sitting position, and does close your remaining skin tightly.  You're correct in assuming, if you remain sitting during the entire duration of healing, excess skin will be gone.  Your abdomen will look great sitting up.  But what happens when you try to stand up?

Steve Laverson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 46 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.