A tummy tuck is a body plastic surgery procedure designed to address loose skin and separated musculature in the abdomen for a smoother, tighter abdominal contour. A hanging or protruding abdomen is a common aesthetic concern for patients who have undergone pregnancy, experienced fluctuating weight, or who have loose skin in the midsection due to aging or genetics. Dr. John Ayala, our  board-certified plastic surgeon in San Antonio, can make the abdomen appear firmer and more taut by bringing together stretched muscles as well as removing redundant skin. Liposuction can also be performed in conjunction with a tummy tuck to smooth pockets of excess fat for comprehensive improvement of your body contour.

What is a Tummy Tuck?

Often known as abdominoplasty, tummy tuck surgery is designed to achieve a leaner, more sculpted appearance in the abdomen. While a flat, well-toned abdomen is a look many of us strive for through exercise and weight control, these methods are not always effective—especially if the abdominal muscles have separated. Even individuals of otherwise normal body weight and proportion can develop an abdomen that is loose and/or sagging. The most common causes of a protruding abdomen include:

  • Pregnancy
  • Aging
  • Significant fluctuations in weight
  • Genetics
  • Prior surgery

Some patients who would like to improve their abdomen may be better candidates for a mini tummy tuck, which is an abbreviated version of a complete tummy tuck that is designed for individuals with minimal excess skin and fat. The procedure typically involves a shorter incision and less recovery time than the standard tummy tuck, but mini abdominoplasty is not intended to repair the abdominal muscles.

What Can a Tummy Tuck Accomplish?

A tummy tuck can remove excess skin and restore weakened or separated abdominal muscles, often minimizing the appearance of a hanging abdomen. Depending on your goals, patients who undergo a tummy tuck commonly achieve a smoother and firmer abdominal profile. Bulges caused by isolated fatty deposits can also be treated by combining the procedure with liposuction, if desired. In cases wherein the abdomen has stretched from pregnancy and/or weight fluctuation, a tummy tuck is frequently incorporated into a Mommy Makeover treatment plan for full restoration of a patient’s pre-pregnancy figure.


Who is a Candidate for a Tummy Tuck?

Those interested in a tummy tuck should exhibit moderate to severe stretching of the skin and abdominal muscles. The procedure can be very successful for patients who have previously undergone pregnancy and/or weight loss that has led to a hanging appearance in the abdomen. In general, potential candidates for surgery should:

  • Be at a stable weight
  • Maintain realistic expectations for the outcome
  • Be healthy enough to undergo surgery and withstand the recovery process 
  • Not smoke, or be willing to quit smoking before and after the procedure 

Dr. Ayala will review your medical history and examine your concerns to determine whether a tummy tuck or another procedure, such as liposuction or a mini tummy tuck, is the best option to achieve your goals.

Tummy Tuck vs. Liposuction

If you would like to firm and tighten the abdomen, you may be considering either a tummy tuck or liposuction (or both) to make your ideal appearance a reality. These procedures can both certainly improve your abdominal contour, but learning what distinguishes a tummy tuck from liposuction may help you get a better idea of the best treatment option for your needs. 

Simply put, a tummy tuck is usually performed to target excess skin while liposuction is only capable of addressing excess fat. Therefore, determining whether your concerns involve redundant skin or fatty tissue may help you ascertain the most optimal procedure to improve your abdomen. If you have a hanging abdomen that does not improve despite healthy eating habits and regular exercise, this can also be an indication that your abdominal muscles are stretched or separated. In these cases, abdominoplasty is the only procedure that can repair loose musculature. However, if you generally have good skin tone and would simply like to smooth bulges of fat, liposuction alone can often provide the desired results. Most patients struggle with both loose skin and stubborn fat to some extent, so it’s not uncommon for patients to combine tummy tuck surgery and liposuction.

How is Tummy Tuck Surgery Performed?

A tummy tuck takes Dr. Ayala approximately two to five hours to perform. The procedure is often an outpatient surgery utilizing general anesthesia. Most patients can return home on the same day as their abdominoplasty, but some individuals may stay up to two nights in the hospital depending on their individual needs. Dr. Ayala starts by making two incisions along the hips and pelvic bone in order to expose the abdominal muscles. After he gains access to the abdominal muscles, they are pulled together and sutured. The skin is then stretched over the muscles while the excess is removed, followed by closing of the incisions. A tummy tuck is usually combined with liposuction of the love handles, upper abdomen, and/or thighs.

What is Recovery From Abdominoplasty Like?

The recovery period after a tummy tuck can range from two weeks to two months, depending on the extent of concerns addressed and your unique rate of healing. While most patients can return to work within two to three weeks, strenuous activity should be limited for at least six weeks. Plenty of rest is encouraged after surgery, but light ambulation (walking, standing, moving around, etc.) should take place as soon as possible to prevent blood clots. Bruising and swelling should resolve naturally, although it can take a few months for inflammation to fully subside. Over-the-counter pain relievers and prescribed pain medication can be taken as necessary.

How Long Do Tummy Tuck Results Last?

The results of a tummy tuck are designed to last a lifetime, although the procedure will not stop the effects of the natural aging process. A loss of firmness in the abdomen as patients grow older is natural, but the abdominal contour should always look smoother and tauter when compared to individuals who did not undergo tummy tuck surgery. There are several ways patients can help preserve their new, reshaped abdomen, including:

  • Maintaining a stable weight
  • Postponing a tummy tuck until all plans for pregnancy are complete
  • Living an active lifestyle with regular exercise

These measures should minimize stretching of the abdominal skin and help prevent a loss of skin elasticity over time so you can enjoy the outcome of your tummy tuck for years, or even decades, to come.

Will I Have Noticeable Tummy Tuck Scars?

Scarring from abdominoplasty is unavoidable, but the incision for a tummy tuck is typically situated low enough on the pubic area that resulting scars should be easily hidden with underwear or a swimsuit bottom. A mini tummy tuck often leaves a shorter scar than a traditional tummy tuck, as the incision required is usually much smaller since less skin removal is necessary. In either case, Dr. Ayala will show you exactly where your tummy tuck scars are likely to appear and give you an idea of the shape/size of your incision(s). Scarring from surgery can also lighten and fade over time, particularly when patients properly take care of their incisions according to Dr. Ayala’s instructions and/or apply medical-grade skincare products to help erase their scars. 

How Much Does a Tummy Tuck Cost?

A tummy tuck can cost between $5,000 and $13,000 depending on your location, needs, and the experience of your plastic surgeon. Fortunately, cosmetic surgery in San Antonio is often much more economical than the rates in coastal cities. Our patient care coordinator will be able to provide you with a personalized cost estimate depending on:

  • The complexity of your procedure
  • The surgical technique utilized
  • Whether complementary procedures are being performed

Although the procedure rarely qualifies for insurance coverage, Dr. Ayala accepts plastic surgery financing plans through CareCredit®. As one of the most trusted lending companies in the nation, qualified patients can often make their tummy tuck expenses more manageable by choosing the most ideal short- or long-term payment plan for their needs. Best of all, there are low- to no-interest options offered by CareCredit® that can be more budget-friendly than paying a lump sum upfront. Please call our practice if you would like to speak to a member of our office about your payment options.

Can I Get a Non-Surgical Tummy Tuck?

Unfortunately, the powerful results achieved after a tummy tuck are only possible with surgery. In order to produce a leaner and smoother abdomen, Dr. Ayala must utilize techniques that are not usually feasible with minimally invasive technologies, such as using sutures to tighten separated abdominal muscles and excising loose, overhanging skin. Although non-surgical treatments like CoolSculpting® can help attain improvement by smoothing fat bulges affecting the abdomen, tummy tuck surgery is the only effective treatment option that can address the skin and musculature. 

Dr. Ayala encourages patients to be cautious when considering products that claim to non-surgically reproduce tummy tuck results. Compression garments and girdles like the Tummy Tuck Belt® are marketed to achieve the same aesthetic effects as a tummy tuck by simply wearing the “belt” for a given length of time each day, but there is no reputable scientific evidence to support these claims. Needless to say, the only way to truly repair a hanging, protruding, or bulging abdomen caused by weakened underlying musculature is through surgical means.  

Are There Alternatives to a Tummy Tuck?

Skin laxity doesn’t exclusively affect the abdomen and many patients also develop loose, excess skin elsewhere on the body. If a tummy tuck is not the most optimal procedure to achieve your goals, Dr. Ayala can recommend alternative body lifting procedures based on where you experience skin inelasticity. 

Loose skin is also commonly found around the buttocks or arms, and can be treated with procedures including a buttock lift or arm lift, respectively. Like tummy tuck surgery, these treatment options can address the skin, fat, and underlying musculature to achieve a more taut, sculpted look. For some patients, these procedures can even help alleviate chafing, skin irritation, and other uncomfortable symptoms associated with excess skin. If you want to combine your tummy tuck with other treatments, Dr. Ayala can create a combination surgical plan to improve multiple concerns at once. This is often known as a lower body lift or a Mommy Makeover depending on what concerns you wish to address.  

Complements to Abdominoplasty

Since belly fat often accompanies loose abdominal skin, a large majority of patients add liposuction to their tummy tuck in order to further reshape their midsection. This can help slim the waistline and flanks, often resulting in a leaner and flatter abdomen. Breast procedures are also commonly performed with tummy tuck surgery to enhance contours in both the breasts and body. Depending on which procedures you’re interested in, abdominoplasty and any complementary surgeries may be performed in stages to provide the best, most long-lasting outcome. This is more common when combining more extensive procedures; however, minimally invasive treatments, such as liposuction, can often be performed at the same time as a tummy tuck. 

Choosing the Best Tummy Tuck Surgeon for Your Needs

With so many different providers in San Antonio, it can be difficult to narrow down your choice of tummy tuck surgeon. Finding the best plastic surgeon for your unique needs can be overwhelming, but there are many ways to gauge someone’s level of experience and quality of care. The following section outlines a few tips that can help you make a decision during the research process: 

  • Always select a board-certified plastic surgeon. When someone is accredited by the American Board of Plastic Surgery (ABPS), you know that he or she has completed rigorous post-graduate training specifically in aesthetic procedures. 
  • Research their experience, credentials, and professional memberships. It can be helpful to learn about a prospective surgeon’s educational background, residencies, and fellowships. In addition to a strong educational pedigree, involvement in professional organizations, as well as any recognitions or awards, can give you an idea of his or her level of experience. 
  • View before-and-after photos from the procedures you’re interested in. A patient gallery can be a good indication of the outcomes you can expect from a plastic surgeon. Therefore, it’s important to determine whether the photos showcased align with your aesthetic desires. 
  • Read online reviews before selecting your aesthetic surgeon. Reviews can be an excellent way to learn about the experiences of previous patients and often provide insight into a plastic surgeon’s bedside manner and level of care. 

Ultimately, scheduling a consultation with a prospective surgeon is the only way to determine whether he or she can achieve the types of results you desire. These initial visits are also important to establish a rapport with your plastic surgeon and ascertain how comfortable you are under their care.

Additional Tummy Tuck FAQs

  • Why do some people get seromas after tummy tuck surgery?

    A seroma, which refers to a fluid-filled lump or bump, is a common reaction to major surgeries such as  abdominoplasty, C-sections, or a hysterectomy. Seromas typically develop due to a buildup of fluid or “serum” under the skin following a procedure in which large amounts of tissue were removed or disrupted. If they develop, seromas typically appear a few weeks after surgery near the incision site(s). A seroma is typically harmless and often resolves on its own as the body reabsorbs the fluid; however, patients should seek medical attention if signs of an infection are present, such as redness, increasing pain, or fever-like symptoms.
  • Does a tummy tuck affect pregnancy?

    A tummy tuck does not affect the ability to get pregnant. However, Dr. Ayala recommends pursuing abdominoplasty only after all plans for pregnancy have been completed. From an aesthetic standpoint, pregnancy after a tummy tuck will likely re-separate the abdominal muscles that a tummy tuck originally sought to repair. Consequently, individuals who get pregnant after tummy tuck surgery may recreate the very aesthetic concerns that they wished to resolve in the first place.
  • How should I sleep after abdominoplasty?

    For the first couple of weeks after tummy tuck surgery, it’s generally recommended to sleep in a reclined position with the head and knees slightly elevated. This can be achieved by using pillows to provide support for your head and knees, thereby increasing blood circulation and limiting tension on your incisions. Sleeping in this position can not only optimize the healing process, but it may also improve the appearance of scarring after your procedure. We advise patients to avoid sleeping on their stomach until Dr. Ayala instructs otherwise.
  • What’s the difference between a tummy tuck and a panniculectomy?

    While both procedures are designed to remove loose, overhanging abdominal skin, a tummy tuck is usually performed for cosmetic reasons while a panniculectomy is performed out of medical necessity. A panniculectomy is intended to eliminate hanging skin that may be causing chafing or skin irritation after major weight loss. Unlike a tummy tuck, a panniculectomy only addresses the skin. In contrast, a tummy tuck treats both the skin and musculature to achieve aesthetic goals such as a smoother abdomen and a leaner body contour.
  • Can a tummy tuck get rid of a C-section scar?

    If you have a scar from a previous C-section, Dr. Ayala can often reuse the same incision that was made during your surgery to perform a tummy tuck. This can help you avoid the appearance of additional scarring. Dr. Ayala will assess all possible incision options after he evaluates your concerns in a consultation. In some cases, a C-section scar may need to be extended slightly in order to accommodate the nature of the tummy tuck procedure. Dr. Ayala will inform you of what you can expect before your tummy tuck.


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