“Tummy tuck” is the common term used to refer to the surgical procedure known as an abdominoplasty. The procedure can be a very effective method to restore a smooth, flat tummy in patients whose fit appearance has been altered by pregnancy, weight change, or age. The success of the procedure is due to its comprehensive nature, as changes to all of the tissue layers are addressed: muscles are tightened, abdominal fat is removed, and skin is excised and redraped. Results can be further enhanced by sculpting the torso with liposuction, or adding complementary procedures such as breast surgery.
The popularity of abdominoplasty continues to grow with over 160,000 cases performed last year by Board Certified Plastic Surgeons, according to the American Society of Aesthetic Plastic Surgeons. Your neighbor, sister, boss, or even your personal trainer may have had a tummy tuck! But despite the popularity, some misconceptions persist.
1. If I work out enough, I will not need a tummy tuck
Simply put, life happens to all of us! We gain weight and lose weight. We may have a baby. We may have a few. We age and our muscles change. How (and where) we store fat changes, and how (and where) we burn off fat may change. Our skin ages and loses elasticity. While diet and exercise are critical to healthy aging, they cannot prevent or reverse all the changes life and genetics have in store for us.
Some of these effects can be mitigated by a healthy lifestyle. Exercise can tone muscles, but cannot be restored if they have been separated by pregnancy. Reducing body fat is healthy, but unfortunately, skin that is stretched out will not regain tone through physical activity. Consequently, abdominoplasty can be an ideal adjunct to a healthy lifestyle by removing excess fat and loose skin to regain a healthy, fit appearance.
2. Tummy tucks are only for women
While it is true that many women desire a tummy tuck after experiencing body changes, it is also true that both genders share the desire to look great and feel confident! Statistics confirm that male plastic surgery has been on the rise for years, as men recognize the importance of looking healthy and fit in their personal and professional lives. Furthermore, as men age they often struggle to obtain a flat belly, even with a fitness regimen, due to genetics. It simply is a “problem area” for men, much like outer thighs may be for women. More and more men are now recognizing that there may be surgical solutions, and with their abdominoplasties they are considering liposuction of the “love handles” for a more complete transformation. Adding to the trend is the large number of both men and women that have been successful with massive weight loss, with or without bariatric procedures. As important, plastic surgeons are altering elements of the operative procedure, such as the position of the incision and the shape of the belly button to be more complementary to the masculine form.
3. Abdominoplasty is a weight loss procedure
While patients sometimes want to judge the success of the procedure by looking at their scale, surgeons emphasize that the result really should be judged in the mirror. Tummy tucks, as with most plastic surgery procedures, are about shapes, contours, and silhouettes, not pounds and ounces. Consider that body weight is primarily water, then muscle and bone. Removing skin and fat from the abdomen can produce notable changes in appearance, but these tissues simply are not that dense, consequently producing limited affects on weight. Unfortunately, there are no substitutes for healthy eating and regular exercise to drop those pounds!
4. I need to wait to have all my children before considering a tummy tuck
While this statement may have had more validity years ago, in this age of bariatric surgery, many women are choosing to undergo procedures before having children. In this practice, it is not uncommon to see relatively young female patients who have achieved weight loss exceeding 100 lbs. While proud of their accomplishments, many have replaced their concern and embarrassment about obesity, with concern and embarrassment about loose skin. Despite enjoying better health and fitness, they may still limit social activity and many express fears about intimacy. More and more of these patients are choosing to address these concerns, and to embrace a better quality of life, prior to having children. They seek to have the life they truly imagined when they contemplated weight loss. While future pregnancy may affect the results of their surgery, these individuals often believe, rightly so, that even postpartum, they will have a better figure than they do after weight loss and prior to body contouring. Many acknowledge that they may choose to have additional surgery in the future after having kids.
5. I’m too old to have a tummy tuck
The quality of health care that we currently enjoy is better now than at any time in the past, and our population is living longer and enjoying better health later in life. With advances in monitoring and pharmacology, chronic medical conditions can often be managed and even minimized. But despite excellent health, age still has its influence and many individuals find that it is harder to maintain their desired appearance. As we get older, it may be more difficult to exercise, and genetically, it may be more difficult to obtain a flat tummy. Fortunately, select older individuals may be candidates for elective surgery. Nothing substitutes for good judgment, and patients need to be carefully screened and assessed. Health problems need to be medically supervised and controlled, but most surgeons care more about a patients “physiologic age” than “chronologic age.” A 65 year old that walks the mall for an hour a day may be a better surgical candidate that a 45 year old smoker with diabetes!
An abdominoplasty can be transformative to a patient’s life and sense of well-being, but it is also a serious operation. Proper preparation, thoughtful surgical care, and supervised postoperative care are critically important to ensure safe outcomes and to optimize results. This kind of surgery should only be performed by an experienced Board Certified Plastic Surgeon.
Larry H. Lickstein, MD, FACS