Common Questions

Tummy Tuck Common Questions

Who is a candidate for a tummy tuck?

Most tummy tuck patients have had a child and have some combination of extra skin on the abdomen, excess fat, and separation of the muscles in the center of the abdomen.  Some people have just one issue and some have all issues.  Patients who have lost a lot of weight can have any of those same issues and are frequently candidates for tummy tucks.  It is a procedure that both men and women benefit from.

What are the most important factors to consider when deciding whether or not to have a tummy tuck?

A tummy tuck is a big procedure; it is relatively painful, expensive, has a long recovery, and a significant scar.  But the results are dramatic.  Each patient has to weigh these risks versus the benefits.

How will you determine what is the best tummy tuck for my body?

Dr. Teitelbuam will examine you standing, sitting, and bending over.  Some tummies look nearly perfect standing, but demonstrate significant laxity when the patient sits.  When examining before and after photos of tummy tuck, it is critical to look at the patients in all three positions: standing, bending over, and sitting down.

How will you determine if I need a tummy tuck or abdominal liposuction?

A tummy tuck is necessary if there is loose or redundant skin, if there are significant rolls of loose skin noted when sitting, or if there is a separation of your muscles.  It is very uncommon for someone who has had a baby to be a candidate for liposuction.  Liposuction of the tummy is reserve for cases in which the skin is very thick and tight and the fat itself feels firm.  Abdominal liposuction is one of the most over-performed procedures, in part due to the fact that many women do not want the scares of a tummy tuck and think that the tummy tuck may adequately satisfy their wishes.

Will I still have stretch marks after my tummy tuck?

With a full tummy tuck all of the stretch marks beneath the belly button will be removed.  Depending upon how loose the skin is, some of the stretch marks above the belly button will be removed.  Even if the upper stretch marks are not removed, they are at least shifted strongly downward.  Though a stretch mark is actually a scar, which means that it is an indelible mark in the skin, by tightening the skin with an abdominoplasty the stretch mark becomes taught and thereby is typically much less visible.

Should I have a tummy tuck if I plan on getting pregnant in the future?

The short answer is that it is okay to get pregnant again after having a tummy tuck; the skin will and muscles are able to accommodate the baby.  Dr. Teitelbaum has performed many tummy tucks on women who have already had children, may have gotten divorced and would like to have more children, but have no idea when that might happen.  But it is unusual for a woman in a marriage to have a tummy tuck between children; they usually wait until they know that they are done making babies.

Are the results of a tummy tuck permanent?

Tummy tuck is one of the few operations in all of plastic surgery that almost never needs a revision.  Even women who get pregnant again tend not to loosen up as much as they did with their earlier pregnancies, however their muscles still may separate.  Patients who have lost large amounts of weight and have terrible thin skin that has lost its elasticity is more predisposed to stretch again in the future.

If I gain weight after surgery will my stomach look abnormal?

The point of the tummy tuck is not so much to remove fat – though it does – but to tighten muscle and/or remove extra skin.  So if someone gains weight after a tummy tuck, they simply look like they have gained weight; there is no specific damage to the procedure and there is no deformity.

What is Dr. Teitelbaum’s expertise in tummy tucks?

Dr. Teitelbaum has performed hundreds of tummy tucks.  Moreover, he has written two book chapters and an article about tummy tucks.  He has also lectured to other plastic surgeons about tummy tucks.

What form of anesthesia does Dr. Teitelbaum suggest for a tummy tuck?

Most plastic surgeons use general anesthesia for a tummy tuck.  Dr. Teitelbaum works with a fantastic anesthesiologist.  Together they have performed many tummy tucks which allows them to coordinate anesthesia with surgery to optimize the balance of anesthetic medicines to be sure a patient has enough anesthesia but not too much.

Where is the incision made for the tummy tuck?

The incision is in a gentle arc just within the panty line.  Dr. Teitelbaum asks patients to bring in underwear or a two-piece bathing suit bottom for him to use to plan the incision at the level the patient wants.  The width is determined by where the laxity is.  Patients pressure plastic surgeons to limit the width of the scars. But if you sit straight up and look down, it becomes apparent that skin will only be tightened for as wide as the scar is.  An incision is typically made around the belly button with a full tummy tuck, but it is usually not done with a mini-tummy tucks.

Will there be scars?

Anywhere there is an incision there will be a scar.  It amazes Dr. Teitelbaum how he can use the same techniques on two consecutive patients and one will end up with scars that are barely visible and the other will have scars that are thick and red.  Much remains to be known about scarring.  Despite the best techniques, some patients will have prominent scars.  That is why Dr. Teitelbaum puts so much effort into concealing the scars within the lines of a woman’s preferred underwear or bikini bottom style.

Can I have other procedures done at the same time as a tummy tuck?

One of the current controversies among plastic surgeons is identifying when it is prudent to perform another procedure along with a tummy tuck.  For years this was a routine practice, but studies in recent years have shown that adding significant procedures to a tummy tuck substantially increases the risk of catastrophic complications, though such complications are extremely rare.  The risk may have to do with the size of the tummy tuck, whether the muscle is being tightened, how mobile the patient will be early after surgery, etc.  Dr. Teitelbaum is extremely conservative when it comes to making these decisions.  He is on plastic surgery society task force examining these issues and has lectured about them to other plastic surgeons.  He will be able to discuss the latest data on this topic when he meets you for a consultation.

Does insurance cover tummy tucks?

Insurance does not cover tummy tucks.  But if there is a bonafide hernia then insurance should cover a portion of the hernia repair.

Do I need to go to an aftercare facility after my surgery?

An abdominoplasty is one of the few procedures for which Dr. Teitelbaum requires a stay at the recovery center.  Two nights is a minimum, and most patients will stay just two nights.  Many patients will stay for a third and a fourth night, depending upon expenses and the amount of peace and quiet they will be able to get at home.  The recovery center is great because it has hospital beds that can be bent to make you comfortable, you can get pain shots if necessary, and simply the nurses know exactly what to do to make you comfortable as well as looking out for any possible problems.  And since the recovery center is across the street form Dr. Teitelbaum’s office, he and his nurse can pop by if there is ever an issue during the day.  And since Dr. Teitelbaum lives nearby, he can always be reached to see you if you have an issue.

Will I get a phone call from the doctor the night of my surgery?

Dr. Teitelbaum checks regularly with his abdominoplasty patients’ nurses at Serenity.  He and his nurse will stop in to visit you the evening of your surgery and again the next day.  On the second day after surgery patients will be driven across the street to Dr. Teitelbaum’s office.

How painful is the recovery?

A tummy tuck is one of the more uncomfortable operations routinely performed by a plastic surgeon.  Some patients who have also had C-sections will say it is about as bad as a C-section, but some will say it is worse. But Dr. Teitelbaum will give you plenty of pain medications so patients never suffer after the procedure.  Pain builds gradually and responds promptly to medicine, so there should not be anxiety about pain going in to the surgery.  Patients who do not have their muscles tightened have a much easier recovery.

How soon can I go to work?

When you feel ready to do your job is highly individualized.  After a tummy tuck, most patients wouldn’t go to work for twelve to fourteen days.

When can I drive?

Most patients will drive about ten days after a tummy tuck.  But this is highly variable based upon your body type and what was done.

When can I resume exercise?

Exercise can begin about one month after a tummy tuck.  Sit-ups should be delayed for about three months (no one has ever complained about that!)

What will my post-operative appointment schedule be like?

What will my post-operative appointment schedule be like?

How long does the swelling last?

Swelling increases after surgery, usually peaking about 5-6 days after surgery.  After that, the swelling will subside, rapidly at first, and then gradually.  After one month, you’ll think the swelling is gone, but it will still go down more at three months, and even more at six months and even a year, though at that point changes are subtle.

Will I have a special garment to wear after surgery? How long will I have to wear it?

Most patients are given a garment to wear after surgery.  Many patients will soon switch to wearing spanx.  There is no specific time for which it has to be worn; in general, the more it is worn the less the swelling builds up and the faster the swelling resolve.

What do I have to do to care for the incision?

There will be steri-strip tapes on your abdominoplasty incision after surgery.  These will start to peel off after about a week.  You are then ready to put on scar treatment formulas. Dr. Teitelbaum will discuss options for scar treatment with you.

Do I need to take shots to prevent blood clots?

An area of controversy in plastic surgery is when to give tummy tuck patients blood thinners to prevent blood clots after surgery.  When this needs to be done, patients will commonly start these once a day shots the day after surgery.  When they leave the recovery center, they will continue at home for a week.  Dr. Teitelbaum has lectured on this subject and will discuss the latest information on this subject and suggest what he thinks is most appropriate for you to do.

When do the stitches need to be removed?

There are stitches around the belly button that are removed 5 days after surgery, but the stitches along the panty line incision are all dissolvable.  There are usually two drains to remove fluid that come out of the groin area on each side.  These are removed from five to eight days after surgery, just depending upon the quantity of fluid coming through the drains.

What should I do to prevent scarring?

Usually the liposuction scars are small and heal very well. The bottom line is that the fate of your scar is mostly determined by your own genetics and by the surgery itself.  It is not clear the extent to which putting things on scars will influence their final appearance.  However, most patients want to do something.  There has never been a direct comparison between the various products.  Patient feedback has been the most positive from three sorts of things: Scar Guard, which is a liquid containing steroid, Vitamin E, and silicone that you brush on like nail polish; Silicone gel strips (such as Neosporin scar strips); and silicone ointment (such as Scar Fade.)  You can get these from the office or the pharmacy, and you can start putting them on once the glue or the steri strip is off, following the instructions on the packaging.

What do I need to watch out for?

You will be given detailed post op instructions by Dr. Teitelbaum and his staff both before and after surgery.  There are two points that deserve emphasis.  Sudden and painful swelling can be a sign of bleeding and the doctor should be alerted right away.  Patients have drains after surgery, and one of the signs if this may be that the drains get filled with clots and stop draining.  Another important thing to look out for is any sign of a blood clot.  Calf pain, swelling of one leg, and shortness of breath are all extremely serious signs and you should be seen immediately if any of these occur.  Shortness of breath mandates an immediate call to 911.

Who is a candidate for a tummy tuck?

Most tummy tuck patients have had a child and have some combination of extra skin on the abdomen, excess fat, and separation of the muscles in the center of the abdomen.  Some people have just one issue and some have all issues.  Patients who have lost a lot of weight can have any of those same issues and are frequently candidates for tummy tucks.  It is a procedure that both men and women benefit from.

What are the most important factors to consider when deciding whether or not to have a tummy tuck?

A tummy tuck is a big procedure; it is relatively painful, expensive, has a long recovery, and a significant scar.  But the results are dramatic.  Each patient has to weigh these risks versus the benefits.

What is the difference between a regular tummy tuck and a mini tuck?

Different surgeons use these terms in varying manners.  A regular tummy tuck implies a scar around the belly button, a tightening of the muscles, and a wide scar.  A mini tummy tuck implies either a shorter scar, and/or not making an incision around the belly button, and/or not tightening the muscles.  More aggressive liposuction is typically also part of a mini tummy tuck.

How will you determine what is the best tummy tuck for my body?

Dr. Teitelbuam will examine you standing, sitting, and bending over.  Some tummies look nearly perfect standing, but demonstrate significant laxity when the patient sits.  When examining before and after photos of tummy tuck, it is critical to look at the patients in all three positions: standing, bending over, and sitting down.

How will you determine if I need a tummy tuck or abdominal liposuction?

A tummy tuck is necessary if there is loose or redundant skin, if there are significant rolls of loose skin noted when sitting, or if there is a separation of your muscles.  It is very uncommon for someone who has had a baby to be a candidate for liposuction.  Liposuction of the tummy is reserve for cases in which the skin is very thick and tight and the fat itself feels firm.  Abdominal liposuction is one of the most over-performed procedures, in part due to the fact that many women do not want the scares of a tummy tuck and think that the tummy tuck may adequately satisfy their wishes.

Will I still have stretch marks after my tummy tuck?

With a full tummy tuck all of the stretch marks beneath the belly button will be removed.  Depending upon how loose the skin is, some of the stretch marks above the belly button will be removed.  Even if the upper stretch marks are not removed, they are at least shifted strongly downward.  Though a stretch mark is actually a scar, which means that it is an indelible mark in the skin, by tightening the skin with an abdominoplasty the stretch mark becomes taught and thereby is typically much less visible.

Will my belly button look normal after a tummy tuck?

With a mini tummy tuck there is no scar around the belly button. When there is a scar around the belly button, there are times in which it looks inconspicuous and there are times that it is obvious.  Honest plastic surgeons will tell all patients that the way the belly button heals is inconsistent.  While there is a planning and a technical component to the scarring around the belly button, the biggest determinant is healing characteristics that are as yet not well understood.  Many abdominoplasty patients of Dr. Teitelbaum’s have a small umbilical hernia which leads to a significant bulge within the belly button, sometimes so bad that the belly button looks like an “outie.”  He can fix this with the tummy tuck and in these cases the belly button can look even better after surgery than it did before.

Should I have a tummy tuck if I plan on getting pregnant in the future?

The short answer is that it is okay to get pregnant again after having a tummy tuck; the skin will and muscles are able to accommodate the baby.  Dr. Teitelbaum has performed many tummy tucks on women who have already had children, may have gotten divorced and would like to have more children, but have no idea when that might happen.  But it is unusual for a woman in a marriage to have a tummy tuck between children; they usually wait until they know that they are done making babies.

Are the results of a tummy tuck permanent?

Tummy tuck is one of the few operations in all of plastic surgery that almost never needs a revision.  Even women who get pregnant again tend not to loosen up as much as they did with their earlier pregnancies, however their muscles still may separate.  Patients who have lost large amounts of weight and have terrible thin skin that has lost its elasticity is more predisposed to stretch again in the future.

If I gain weight after surgery will my stomach look abnormal?

The point of the tummy tuck is not so much to remove fat – though it does – but to tighten muscle and/or remove extra skin.  So if someone gains weight after a tummy tuck, they simply look like they have gained weight; there is no specific damage to the procedure and there is no deformity.

What is Dr. Teitelbaum’s expertise in tummy tucks?

Dr. Teitelbaum has performed hundreds of tummy tucks.  Moreover, he has written two book chapters and an article about tummy tucks.  He has also lectured to other plastic surgeons about tummy tucks.

What form of anesthesia does Dr. Teitelbaum suggest for a tummy tuck?

Most plastic surgeons use general anesthesia for a tummy tuck.  Dr. Teitelbaum works with a fantastic anesthesiologist.  Together they have performed many tummy tucks which allows them to coordinate anesthesia with surgery to optimize the balance of anesthetic medicines to be sure a patient has enough anesthesia but not too much.

Where is the incision made for the tummy tuck?

The incision is in a gentle arc just within the panty line.  Dr. Teitelbaum asks patients to bring in underwear or a two-piece bathing suit bottom for him to use to plan the incision at the level the patient wants.  The width is determined by where the laxity is.  Patients pressure plastic surgeons to limit the width of the scars. But if you sit straight up and look down, it becomes apparent that skin will only be tightened for as wide as the scar is.  An incision is typically made around the belly button with a full tummy tuck, but it is usually not done with a mini-tummy tucks.

Will there be scars?

Anywhere there is an incision there will be a scar.  It amazes Dr. Teitelbaum how he can use the same techniques on two consecutive patients and one will end up with scars that are barely visible and the other will have scars that are thick and red.  Much remains to be known about scarring.  Despite the best techniques, some patients will have prominent scars.  That is why Dr. Teitelbaum puts so much effort into concealing the scars within the lines of a woman’s preferred underwear or bikini bottom style.

Can I have other procedures done at the same time as a tummy tuck?

One of the current controversies among plastic surgeons is identifying when it is prudent to perform another procedure along with a tummy tuck.  For years this was a routine practice, but studies in recent years have shown that adding significant procedures to a tummy tuck substantially increases the risk of catastrophic complications, though such complications are extremely rare.  The risk may have to do with the size of the tummy tuck, whether the muscle is being tightened, how mobile the patient will be early after surgery, etc.  Dr. Teitelbaum is extremely conservative when it comes to making these decisions.  He is on plastic surgery society task force examining these issues and has lectured about them to other plastic surgeons.  He will be able to discuss the latest data on this topic when he meets you for a consultation.

Does insurance cover tummy tucks?

Insurance does not cover tummy tucks.  But if there is a bonafide hernia then insurance should cover a portion of the hernia repair.

Do I need to go to an aftercare facility after my surgery?

An abdominoplasty is one of the few procedures for which Dr. Teitelbaum requires a stay at the recovery center.  Two nights is a minimum, and most patients will stay just two nights.  Many patients will stay for a third and a fourth night, depending upon expenses and the amount of peace and quiet they will be able to get at home.  The recovery center is great because it has hospital beds that can be bent to make you comfortable, you can get pain shots if necessary, and simply the nurses know exactly what to do to make you comfortable as well as looking out for any possible problems.  And since the recovery center is across the street form Dr. Teitelbaum’s office, he and his nurse can pop by if there is ever an issue during the day.  And since Dr. Teitelbaum lives nearby, he can always be reached to see you if you have an issue.

How painful is the recovery?

A tummy tuck is one of the more uncomfortable operations routinely performed by a plastic surgeon.  Some patients who have also had C-sections will say it is about as bad as a C-section, but some will say it is worse. But Dr. Teitelbaum will give you plenty of pain medications so patients never suffer after the procedure.  Pain builds gradually and responds promptly to medicine, so there should not be anxiety about pain going in to the surgery.  Patients who do not have their muscles tightened have a much easier recovery.

How soon can I go to work?

When you feel ready to do your job is highly individualized.  After a tummy tuck, most patients wouldn’t go to work for twelve to fourteen days.

When can I drive?

Most patients will drive about ten days after a tummy tuck.  But this is highly variable based upon your body type and what was done.

When can I resume exercise?

Exercise can begin about one month after a tummy tuck.  Sit-ups should be delayed for about three months (no one has ever complained about that!)

What will my post-operative appointment schedule be like?

The doctor will see you for the first few days after the procedure, at five days to remove the tummy tuck sutures, sometime in the next few days to remove the drains, two weeks later, and then three, six, and twelve months after surgery.

How long does the swelling last?

Swelling increases after surgery, usually peaking about 5-6 days after surgery.  After that, the swelling will subside, rapidly at first, and then gradually.  After one month, you’ll think the swelling is gone, but it will still go down more at three months, and even more at six months and even a year, though at that point changes are subtle.

Will I have a special garment to wear after surgery? How long will I have to wear it?

Most patients are given a garment to wear after surgery.  Many patients will soon switch to wearing spanx.  There is no specific time for which it has to be worn; in general, the more it is worn the less the swelling builds up and the faster the swelling resolves.

What do I have to do to care for the incision?

There will be steri-strip tapes on your abdominoplasty incision after surgery.  These will start to peel off after about a week.  You are then ready to put on scar treatment formulas. Dr. Teitelbaum will discuss options for scar treatment with you.

Do I need to take shots to prevent blood clots?

An area of controversy in plastic surgery is when to give tummy tuck patients blood thinners to prevent blood clots after surgery.  When this needs to be done, patients will commonly start these once a day shots the day after surgery.  When they leave the recovery center, they will continue at home for a week.  Dr. Teitelbaum has lectured on this subject and will discuss the latest information on this subject and suggest what he thinks is most appropriate for you to do.

When do the stitches need to be removed?

There are stitches around the belly button that are removed 5 days after surgery, but the stitches along the panty line incision are all dissolvable.  There are usually two drains to remove fluid that come out of the groin area on each side.  These are removed from five to eight days after surgery, just depending upon the quantity of fluid coming through the drains.

What should I do to prevent scarring?

Usually the liposuction scars are small and heal very well. The bottom line is that the fate of your scar is mostly determined by your own genetics and by the surgery itself.  It is not clear the extent to which putting things on scars will influence their final appearance.  However, most patients want to do something.  There has never been a direct comparison between the various products.  Patient feedback has been the most positive from three sorts of things: Scar Guard, which is a liquid containing steroid, Vitamin E, and silicone that you brush on like nail polish; Silicone gel strips (such as Neosporin scar strips); and silicone ointment (such as Scar Fade.)  You can get these from the office or the pharmacy, and you can start putting them on once the glue or the steri strip is off, following the instructions on the packaging.

What do I need to watch out for?

You will be given detailed post op instructions by Dr. Teitelbaum and his staff both before and after surgery.  There are two points that deserve emphasis.  Sudden and painful swelling can be a sign of bleeding and the doctor should be alerted right away.  Patients have drains after surgery, and one of the signs if this may be that the drains get filled with clots and stop draining.  Another important thing to look out for is any sign of a blood clot.  Calf pain, swelling of one leg, and shortness of breath are all extremely serious signs and you should be seen immediately if any of these occur.  Shortness of breath mandates an immediate call to 911.

What is the difference between a regular tummy tuck and a mini tuck?

Different surgeons use these terms in varying manners.  A regular tummy tuck implies a scar around the belly button, a tightening of the muscles, and a wide scar.  A mini tummy tuck implies either a shorter scar, and/or not making an incision around the belly button, and/or not tightening the muscles.  More aggressive liposuction is typically also part of a mini tummy tuck.n`p� ortant thing to look out for is any sign of a blood clot.  Calf pain, swelling of one leg, and shortness of breath are all extremely serious signs and you should be seen immediately if any of these occur.  Shortness of breath mandates an immediate call to 911.

Will my belly button look normal after a tummy tuck?

With a mini tummy tuck there is no scar around the belly button. When there is a scar around the belly button, there are times in which it looks inconspicuous and there are times that it is obvious.  Honest plastic surgeons will tell all patients that the way the belly button heals is inconsistent.  While there is a planning and a technical component to the scarring around the belly button, the biggest determinant is healing characteristics that are as yet not well understood.  Many abdominoplasty patients of Dr. Teitelbaum’s have a small umbilical hernia which leads to a significant bulge within the belly button, sometimes so bad that the belly button looks like an “outie.”  He can fix this with the tummy tuck and in these cases the belly button can look even better after surgery than it did before. 

Where is the incision made for the tummy tuck?

The incision is in a gentle arc just within the panty line.  Dr. Teitelbaum asks patients to bring in underwear or a two-piece bathing suit bottom for him to use to plan the incision at the level the patient wants.  The width is determined by where the laxity is.  Patients pressure plastic surgeons to limit the width of the scars. But if you sit straight up and look down, it becomes apparent that skin will only be tightened for as wide as the scar is.  An incision is typically made around the belly button with a full tummy tuck, but it is usually not done with a mini-tummy tucks.