What is a Tummy Tuck?

A tummy tuck, more formally known as abdominoplasty, is a procedure that is meant to improve the contours of the abdomen. The procedure often involves the removal of excess skin and fat, tightening of the weakened or separated abdominal muscles, and repositioning the belly button (umbilicus). Liposuctions of hips and abdomen, and other areas of the body, are incorporated into the abdominoplasty to achieve the desired result. There are many variations of the abdominoplasty procedure. It is extremely important that you see a surgeon that is skilled in all forms of the procedure to ensure that you undergo the right procedure.

Women often seek abdominoplasty after having children. When the uterus grows to accommodate the growing baby, the rectus abdominis muscles can weaken and separate. After the baby is delivered, the uterus decreases in size; however, the rectus abdominis muscles can stay weakened or separated. The formal term for this condition is rectus diastasis. Women with this condition often report that they still feel like they look pregnant when they protrude their abdomen, even when they are not.

Men and women that have sustained massive weight loss can also benefit from abdominoplasty. These patients often have a significant amount of excess abdominal skin and fat that will not go away, even with further weight loss and/or exercise. In some situations, this excess skin can cause irritation such as rashes or open wounds.

Abdominoplasty is not a substitute for maintaining a healthy weight and exercise program. Ideal candidates for this procedure are women that have completed childbearing and men and women who are at their ideal weight and are motivated to maintain their ideal weight. Significant fluctuations in weight can dramatically change the postoperative results.

About the Procedure:

The artistry of the procedure begins in the preoperative room when markings are performed, including marking areas of planned liposuction. The incision for the abdominoplasty is horizontal in orientation and located just above the pubis. The length of the incision depends on the amount of excess skin and fat that must be removed, but is generally kept as short as possible.

The procedure is most commonly performed under general anesthesia. More limited forms of the procedure can be performed under sedative anesthesia. The procedure begins with liposuction of the abdomen, hips, and other areas of excess fat deposits. This is a critical step in the procedure as it helps to achieve ideal body contours.

The abdominal skin and fat above the incision line is elevated off of the underlying muscles. The separated abdominal muscles are put back together with suture to restore the internal muscle corset, and the upper abdominal skin is moved downward. Excess lower abdominal skin and fat is then removed. Your belly button (umbilicus) is brought through a new opening in the skin, and sutured into position. The lower incision line is closed in several layers. Immediately following surgery you will be placed in a postsurgical garment to minimize swelling.

The changes to your abdomen will be visible immediately after surgery; however, final results of your tummy tuck will continue to emerge as swelling subsides. Your tummy tuck will result in a flatter, firmer abdominal contour that is more proportionate with your body type and weight. Previous abdominal surgery may limit the potential results of a tummy tuck. In women who have undergone cesarean section, the existing scars may be incorporated into the new scar. The scar may take several months to a year to fade. Although good results are expected from your procedure, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.

Following your physician’s instructions is essential to the success of your surgery. It’s important that the surgical incisions are not subjected to excessive force, swelling, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.


Tummy tuck, or abdominoplasty surgery, can be safely performed in an accredited office-based surgical facility. Dr. Hewell and Dr. Fischer’s office ambulatory surgical facility is accredited by the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF). Established in 1980, AAAASF holds outpatient and office-based facilities to hospital standards and assures the public that patient safety is the top priority in a facility. Dr. Hewell has been safely performing this surgery on an outpatient basis since 1994.

There are different types of abdominoplasty. Some of the variations of the procedure include traditional abdominoplasty, lower abdominoplasty, and superior abdominoplasty. Dr. Hewell and Dr. Fischer select the appropriate procedure for you during your consultation. It is important that you see a surgeon that understands the various techniques and selects the correct operation for you.

Yes, liposuction can safely be performed at the same time as abdominoplasty. Dr. Hewell and Dr. Fischer feel that it is important to perform these procedures together as they work synergistically to achieve ideal body contours.

It is best to finish childbearing before undergoing the procedure. During pregnancy, the growing uterus causes the rectus abdominis (six-pack) muscles to splay. These muscles are brought back together during the procedure, and excess skin and fat are removed. If pregnancy occurs following abdominoplasty, the rectus abdominis muscles will again splay apart, and you will most likely redevelop some excess skin and fat. If pregnancy occurs following abdominoplasty, a second procedure can be performed if you desire.

The procedure is most commonly performed under general anesthesia. More limited forms of the procedure can be performed under sedative anesthesia. Dr. Hewell and Dr. Fischer will recommend which anesthesia option is best for you during your consultation.

During a traditional abdominoplasty, incisions are created around the umbilicus (belly button) and above the pubic hairline. The length of the horizontal incision above the pubic hairline depends on the individual patient’s body and how much excess skin and fat needs to be removed. Patients with less excess skin may require a very short vertical incision extending upward from the center of the horizontal incision.

The rectus abdominis muscles, also known as the “six-pack” muscles, are repaired during the procedure.

During a traditional abdominoplasty, most of the stretch marks below the umbilicus (belly button) will be removed. The stretch marks that are present above the umbilicus will still be there, but will be moved to above the pubic hairline.

Dr. Hewell and Dr. Fischer see all of their abdominoplasty patients the day after surgery. The Doctors and their exceptional team will take care of all dressings at this visit.

Procedures 3



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