Are you not seeing the abs you want from sit-ups, crunches, or pilates? Sometimes too much excess skin or stretched-out muscles from child birthing can make it impossible to get a flat stomach through diet and exercise alone.

Tummy tuck surgery, also referred to as an abdominoplasty, restores weakened muscles and removes excess skin and fat, making your abdomen smooth and firm. Dr. Matthew Nykiel at Butts by Design is a board-certified plastic surgeon with experience in every aspect of body contouring, including tummy tuck surgery. In fact, Dr. Nykiel is an international body contouring trainer!

What Is a Tummy Tuck?

Tummy tuck surgery flattens the stomach by removing extra skin and fat while pulling the abdominal wall taut. Typically, abdominoplasty is done after pregnancy or extensive weight loss, when the patient’s skin and abdominal muscles have become stretched out. In some cases, tummy tucks are performed on men who have lost a lot of weight; this is often referred to as a “male tummy tuck.”

Traditional tummy tuck surgery is a two-step process. First, there is an advanced repair of the muscle separation caused by extra weight or pregnancy. In the second step, there is removal of extra skin and fat from the lower stomach. The remaining skin is then pulled down and the belly button is repositioned, making the stomach much flatter and tighter. In more severe cases, a new belly button is reconstructed through a surgery known as umbilicoplasty.

Traditional tummy tucks address excess fat and skin in your entire abdomen, above and below your belly button. Another common tummy tuck procedure is the “mini tummy tuck,” which uses shorter incisions to address the “pooch” below the belly button. Mini tummy tucks are generally recommended for patients with minimal excess fat.

Tummy tucks are often completed as part of mommy makeover procedures, or used for comprehensive body sculpting with liposuction and breast augmentation.

Do I Need a Tummy Tuck or Exercise?

A healthy lifestyle, including a balanced diet and regular exercise, is imperative whether considering plastic surgery or not. A tummy tuck is never a substitute for exercise. However, exercise cannot repair muscle separation (diastasis recti) or excess hanging abdominal skin (pannus). Only a tummy tuck will treat these issues.

Exercise will decrease abdominal volume by reducing fat and toning the abdominal muscles. Patients should ideally be close to their goal weight before undergoing a tummy tuck procedure.

Who Is a Candidate for Tummy Tuck?

Most men and women in good health are eligible candidates for a tummy tuck. However, some patients are more appropriate candidates than others. For instance, it’s important to remember that a tummy tuck is not a weight loss surgery or a substitute for diet and exercise programs.

Tummy tuck surgery is a good solution for candidates who:

  • Are physically healthy at a steady weight
  • Realistic about their surgical expectations
  • Have stretched out skin around the stomach
  • Have loose skin
  • Have extra stomach fat, even after diet and exercising
  • Are unhappy with the appearance of the belly button
  • Are unhappy with the look of the abdomen

If you smoke, you must stop your nicotine consumption for about four weeks before and after your surgery. Smoking tobacco can hinder your healing process or cause severe complications.

Benefits of Abdominoplasty

Abdominoplasty can provide a lot of cosmetic and medical benefits. First and foremost, it makes your abdomen flatter, firmer and more appealing. Beyond the cosmetic benefits, it also provides the following medical and emotional benefits:

Improved Self-Confidence and Appearance

A tummy tuck re-centers the core muscles (rectus plication) and removes excess abdominal skin and fat. This creates a more youthful, desirable and aesthetically pleasing shape that results in increased confidence. According to RealSelf, the tummy tuck receives a 95% “Worth It” rating!

Reduced Stress Urinary Incontinence

After giving birth vaginally, women sometimes develop Stress Urinary Incontinence (SUI). SUI is a bladder control problem that causes uncontrolled leakage from coughing, sneezing, exercising and even laughing.

SUI is often treatable without surgery. However, for some patients with severe cases of SUI, a tummy tuck can improve the condition by removing soft tissue in the pelvic area and creating a slight bladder obstruction.

Improved Posture From Enhanced Abdominal Tone

After substantial weight loss or multiple pregnancies, stomach muscles can become stretched out to the point that diet and exercise cannot help. Weak abdominal muscles are often correlated to sway back. After a tummy tuck tightens the abdominal muscles, patients often have improved posture and more spinal support. The procedure can also relieve back pain.

Ventral Hernia Correction

It’s not uncommon for women to experience ventral hernias after C-sections or appendectomies. Ventral hernias happen when the abdominal tissue or the intestine break through the abdominal wall, forming pockets. In addition, some individuals develop an umbilical hernia. Weak abdominal muscles are the primary cause of ventral hernias.

After hernia surgery, abdominoplasty corrects the weakened abdominal muscles to keep a hernia from reforming. In this practice, Dr. Nykiel repairs small umbilical and ventral hernias at the same time as the abdominoplasty. Large hernias are best repaired by a general surgeon separately. Then, after healing from the hernia repair (typically six weeks), Dr. Nykiel performs the abdominoplasty.

Preparing for a Tummy Tuck

Part of having a healthy recovery from your tummy tuck surgery is the preparation you do before your surgery. After the procedure, you will need to rest to give yourself time to heal. Expect to take about two weeks away from work and family responsibilities.

A tummy tuck is an outpatient procedure, meaning you will go home after the surgery. You will need to arrange for a ride home and someone to help you for at least the first five to seven days after surgery.

You should also make sure that you are stocked up on essential postoperative materials. For instance, make sure that you have compression garments, sequential compression devices (SCDs), pain medications, stool softeners, oral rehydration fluids (Pedialyte) and healthy foods.

Dr. Nykiel will help you prepare for your tummy tuck surgery during your initial consultation and preoperative appointment by giving you more essential advice for your unique surgery. We recommend the person taking care of you comes to the preoperative appointment to ensure you receive excellent care after surgery.

Recovering From a Tummy Tuck

The recovery experience after your tummy tuck will depend on your individual health and the extent of your surgery. Some patients are able to return to non-strenuous work after one to two weeks, with full activity release after six weeks.

Swelling is a major part of recovery from body contouring surgery. Compressive garments (i.e. fajas, Spanx) are worn for three months after surgery. The initial garments are sized for you during your preoperative appointment. We also incorporate lymphatic massage and self-massage into your recovery plan to decrease scarring and swelling. Depending on the patient, swelling typically subsides after several weeks or sometimes several months.

One of the most critical aspects of your recovery will be the activity restrictions and the lifting restriction of 15lbs for six weeks. These restrictions allow your muscles to heal after the tummy tuck.

How Long Will I Walk Bent Over After a Tummy Tuck?

You may experience a slight bend when walking for the first week after surgery. When sleeping, your position is extremely important. You should not lay flat because this will put significant tension on your abdomen. Instead, you should sleep with your back at approximately 45 degrees (about 3 to 4 pillows behind your back) and knees bent by 30 degrees (about 2 to 3 pillows under your knees). You will sleep in this position, called the semi-fowler position, for three to four weeks.

How Painful Is a Tummy Tuck?

In general, individuals describe the pain from a tummy tuck as mild to moderate. You should plan for two weeks off from work and responsibility (including family/children) and plan to sleep in a semi-fowler position for three to four weeks after surgery to minimize tension and pressure on the tummy tuck.

All of our tummy tucks include the medication Exparel, a major evolution in pain control. Exparel is a local anesthetic (Marcaine, also known as bupivacaine) that slowly releases over three to five days. Previous solutions that slowly administered bupivacaine, such as pain pumps, required inconvenient extra drains, lines, bags, etc. Exparel is injected into the surgical area during surgery and slowly releases the pain medication — this means there are no tubes, pumps or lines that need to be maintained. This also means we can deliver the medication right to the anatomical areas where we did the surgery!

In addition to the use of Exparell, Dr. Nykiel developed and implemented a revolutionary protocol that decreases pain. All surgeries come with some recovery pains, but this protocol helps to minimize the discomfort and create a more positive experience.

How Is Pain Managed After a Tummy Tuck?

Our understanding of pain has evolved. We now understand pain is multifaceted and may be triggered by different pathways. As such, Dr. Nykiel’s pain protocol addresses multiple pathways.

We begin in the preoperative area. Starting pain medications before we even go into surgery is shown to improve pain control after surgery significantly.

During surgery, we will utilize Exparel to numb the surgical areas. The numb feeling lasts for approximately three to five days.

After surgery, we will implement a pain regimen based on: decreasing inflammation and decreasing nerve signaled pain (neuropathic pain), muscular pain and general discomfort. In general, we utilize:

  • Gabapentin (brand name Neurontin) – treats nerve pain
  • Diazepam (Valium) – treats muscular pain
  • Celecoxib (Celebrex) – treats inflammation and cellular signaling pain
  • Hydrocone (Norco) – treats general pain and discomfort
  • Tylenol – treats cellular signaling pain.

With the implementation of a multifaceted pain control protocol tailored to your specific surgery and medical history, the majority of our patients now describe pain from a tummy tuck as minimal to mild!

What Hurts Worse, a C-Section or a Tummy Tuck?

In general, a tummy tuck is an easier recovery than a C-section. The C-section typically involves more manipulation of the abdominal muscles, which results in a more painful recovery. In addition, a C-section recovery typically does not include numbing medication like Exparel.   

How Many Sizes Do You Lose With a Tummy Tuck?

The size lost with a tummy tuck varies with each patient. On average, with a standard or full tummy tuck:

  • Three to five pounds are lost
  • Dress size decreases by three sizes
  • Pant size decreases by two to three sizes

Adding liposuction with a tummy tuck leads to an even greater decrease in dress and pant sizes because the tummy tuck reduces abdominal volume and the liposuction reduces waist and back volume.

What Does Your Stomach Look Like After a Tummy Tuck?

A tummy tuck re-aligns your tummy muscles (rectus plication) and removes excess skin and fat. Overall, this results in a flatter and tighter appearing abdomen.

The scar from an abdominoplasty is placed roughly two inches from the top of the vagina or base of the penis. The scar pattern mirrors a bikini line. Occasionally, a scar may be present from the old belly button.

Can You Get a Six-Pack After a Tummy Tuck?

A tummy tuck reconstructs and re-centralizes the abdominal muscles, also called the six-pack muscles. While this is needed to help define the six-pack muscles, the only way a six-pack will be present is through a healthy lifestyle: a balanced diet and regular exercise. The old adage, “Abs are made in the kitchen,” is still true, even after a tummy tuck.        

What Is Better, Liposuction or a Tummy Tuck?

The answer to this question is based on your goals and issues. In general, most patients’ goal is a flatter tummy. During your consultation, Dr. Nykiel will examine what is causing your tummy to bulge. Is the bulge from fat? Extra skin? Loose tummy muscles (diastasis recti)? Or maybe a combination of all the above?

Liposuction treats fat only. If the tummy bulge is from extra weight or fat, then liposuction alone will work. The typical patient for liposuction-only is 35 or younger and has not had children.

Renuvion causes soft tissue coagulation. On average, Liposuction with Renuvion will improve soft tissue laxity by 30 percent. However, Renuvion does not fix or improve loose abdominal muscles (diastasis recti) or hanging loose skin (pannus).

A tummy tuck is required to fix loose abdominal muscles and/or loose, hanging skin. We typically combine liposuction with a tummy tuck to remove additional fat and sculpt the waist and back.     

What Is the Typical Cost of a Tummy Tuck?

A tummy tuck cost depends on the type of abdominoplasty: Mini, Modified, Standard, Extended or Circumferential. The aforementioned names describe the length of the scar from the surgery. The price also depends on whether the tummy tuck is combined with other procedures.

In general, the average price for a tummy tuck is $11,500. When liposuction is combined with the tummy tuck, the average price ranges from $15,000 to $20,000. The prices include anesthesia, operating room facilities and surgeon fees.

How Much Does a Mini Tummy Tuck Cost?

A mini or modified tummy tuck average price is $8,000 to $10,000.

What Is the Cost Difference of a Tummy Tuck vs Liposuction?

Average pricing is as follows:

  • A standard or full tummy tuck is $11,500
  • Liposuction only of the abdomen is $6,500
  • Liposuction360 (abdomen, waist and back is $11,500

A combination of a standard tummy tuck and liposuction of the waist and back ranges from $15,000 to $20,000 depending on the size of the tummy tuck and the amount of fat to liposuction.

How Can I Get My Insurance to Pay for a Tummy Tuck Surgery?

The short answer is: your medical health insurance will not cover an elective cosmetic procedure. Health insurance may cover the removal of hanging abdominal skin (pannus) and abdominal or umbilical (belly button) hernia repairs, but these are not tummy tucks (abdominoplasty).

Our office does not accept medical health insurance as a form of payment.    

How Long Does a Tummy Tuck Last?

Nothing is forever in life, but tummy tucks are a long-lasting procedure on the order of decades when appropriate care is performed. Luckily, many controllable lifestyle factors will improve and solidify a long-lasting result from a tummy tuck. These factors are: balanced diet, healthy exercise, minimal sun exposure (sunscreen), and maintenance of weight.    

Does Fat Grow Back After a Tummy Tuck?

Fat may grow back after any cosmetic procedure. Fat volume is based on calories taken in (diet) and calories expended (exercise and activity). A long-standing myth on the internet is that fat cells cannot return after being removed. Like many things on the internet, this is a half-truth. New fat cells (also called adipose cells or adipose tissue) are not made after puberty, and therefore fat cell removal is permanent.

However, and this a BIG however, we cannot remove every single fat cell, and fat cells are unique because they can expand infinitely. This means that the remaining fat cells can continue to grow in size and expand into the locations of the previously removed fat cells.

Maintenance of surgical results and fat growth or loss is based on lifestyle (diet and exercise). Tummy tucks and/or liposuction should never be viewed as weight loss procedures.

Is Getting a Tummy Tuck Worth It?

Almost all patients are happy with their decision to undergo this procedure. Tummy tuck surgery has a 95% “Worth it” rating on the website RealSelf, a website dedicated to providing transparent information on cosmetic surgery.

Schedule an Appointment for a Tummy Tuck

Take the next step in feeling more confident, healthier and firm. Dr. Matthew Nykiel is a board-certified plastic surgeon with exceptional training and education in body contouring and tummy tuck surgery. Dr. Nykiel is an international body contouring surgical trainer for doctors throughout the world.

Our offices are located in Orange County, CA, in Newport Beach or in the Inland Empire in Upland, CA. Fill out our contact form online or call our friendly office staff today at 949-416-0038.