Abdominoplasty · New York and New Jersey
Tummy Tuck
A tummy tuck, also called abdominoplasty, removes loose skin from the abdomen and brings separated abdominal muscles back together, for a flatter, firmer shape. Dr. Steven Ovadia is a board certified plastic surgeon who performs tummy tucks on their own and together with other surgery, with offices in New York City and New Jersey.
Overview
What a tummy tuck is
A tummy tuck removes loose skin, and the fat attached to it, from the abdomen. When the abdominal muscles have separated, they are brought back together in the same operation. The remaining skin is drawn down, so the abdomen is flatter and firmer.
Pregnancy, major weight loss, and age all stretch the skin of the abdomen. During pregnancy the two vertical muscles of the abdominal wall are also pushed apart, and in many patients they do not come all the way back together. This separation is called diastasis recti, and it can leave a bulge even at a healthy weight. Diet and exercise do not tighten skin that has stretched this far, and they do not close the separation.
A tummy tuck trades that loose skin for a scar placed low on the abdomen. How much skin needs to come off decides which type of tummy tuck fits, and how long the scar is. The types are covered below.
Candidates
Who a tummy tuck is for
A tummy tuck tends to work well when:
- You have loose skin on the abdomen that diet and exercise have not changed
- Your abdomen bulges because the muscles have separated, often after pregnancy
- Your weight is stable, including after major weight loss
- You are done having children, or plan to be before surgery
- You do not smoke or vape, or you are able to stop well before and after surgery
- You accept a scar low on the abdomen in exchange for a flatter, firmer shape
At your consultation, Dr. Ovadia examines your abdomen, including how loose the skin is, whether the muscles have separated, and how much of the fullness is fat, and tells you whether a tummy tuck, liposuction, or both is likely to give you the change you are looking for.
What a tummy tuck can do
- Remove loose, hanging skin from the abdomen, along with the fat attached to it
- Bring separated abdominal muscles back together
- Flatten and firm the abdomen and improve the waistline
- Remove stretch marks and a C-section scar that sit on the skin being removed
- Be done together with liposuction, breast surgery, or other surgery
What a tummy tuck does not do
- Be done without a scar
- Take the place of weight loss
- Remove fat that sits inside the abdomen, under the muscles
- Remove stretch marks that sit above the skin being removed
- Stop the skin from loosening again with a future pregnancy or a large change in weight
Types
Full, mini, or extended
The three types differ in how much skin is removed, and so in how long the scar is. In each one the scar is placed low, where underwear and swimwear usually cover it. Dr. Ovadia marks its position with you standing, before surgery.
Full tummy tuck
For loose skin above and below the belly button and muscles that have separated along the length of the abdomen. The scar runs low across the abdomen from hip to hip, with a small scar around the belly button.
Mini tummy tuck
For a small amount of loose skin below the belly button only. The scar is shorter, and the belly button is usually left as it is. It does not change the skin above the belly button.
Extended tummy tuck
For loose skin that continues around the sides, onto the hips and flanks, which is common after major weight loss. The scar is longer and wraps farther around the sides.
The gold line marks the scar.The shaded area is the skin that is removed.
Side by side
| Full tummy tuck | Mini tummy tuck | Extended tummy tuck | |
|---|---|---|---|
| Loose skin | Removed from above and below the belly button | Removed below the belly button only | Removed from the abdomen and the sides |
| Muscle separation | Repaired along the length of the abdomen | Can be repaired below the belly button | Repaired along the length of the abdomen |
| Belly button | Kept, and brought out through a new opening | Usually left as it is | Kept, and brought out through a new opening |
| Scar | Low, from hip to hip | Low and shorter | Low, continuing onto the hips and flanks |
After major weight loss, loose skin often runs around the whole lower trunk, onto the back. In that case the tummy tuck can be part of a larger plan that includes the back and the thighs. Dr. Ovadia goes over the options with you at your consultation.
Procedure
How a tummy tuck is done
These are the steps of a full tummy tuck. A mini tummy tuck follows the same steps on the lower abdomen only.
Marking
Before surgery, Dr. Ovadia marks the skin to be removed and the position of the scar while you are standing, so the scar sits low where underwear and swimwear usually cover it.
The skin is lifted
The incision is made low on the abdomen. The skin and fat are lifted off the abdominal wall, and the belly button is freed from the skin around it while staying attached underneath.
The muscles are repaired
When the abdominal muscles have separated, they are brought back together with stitches down the middle of the abdomen. This firms the abdominal wall and narrows the waist.
Closure
The skin is drawn down and the extra is removed. The belly button is brought out through a new opening, and the incision is closed in layers. Dressings and a compression garment go on at the end of surgery.
Every surgery has risks. For a tummy tuck these include bleeding, infection, blood clots in the legs or lungs, fluid collecting under the skin, an incision that is slow to heal or opens in places, scars that are wide or raised, numbness of the lower abdomen, an uneven contour, differences between the two sides, and the possible need for a revision. Smoking and vaping raise the risk of healing problems. Dr. Ovadia goes over the risks with you at your consultation.
Options
Tummy tuck, liposuction, or both
A fuller abdomen can come from loose skin, separated muscles, fat, or a mix of all three. A tummy tuck removes skin and repairs muscle. Liposuction removes fat. It does not tighten skin or repair muscle. Part of your consultation is working out which one, or which combination, fits.
| Tummy tuck | Tummy tuck with liposuction | Liposuction alone | |
|---|---|---|---|
| Works best when | The skin is loose or the muscles have separated | The skin is loose and there is also extra fat at the waist or flanks | There is extra fat, the skin is still firm and elastic, and the muscles are intact |
| Loose skin | Removed | Removed | Not removed. It can look looser once the fat under it is gone |
| Muscle separation | Repaired | Repaired | Not repaired |
| Fat | Removed with the skin it is attached to | Also reduced at the waist and flanks | Reduced in the treated areas |
| Scar | Low on the abdomen, and around the belly button | Low on the abdomen, around the belly button, and a few small ones | A few small ones |
A tummy tuck with other surgery
Liposuction
Liposuction of the flanks and waist is often added to a tummy tuck to shape the sides, where the tummy tuck does not reach.
Breast surgery
A tummy tuck is often paired with a breast lift, breast augmentation, or breast reduction. After pregnancy, this combination is often called a mommy makeover.
Body contouring after weight loss
After major weight loss, loose skin usually affects more than the abdomen. A tummy tuck can be planned alongside surgery of the arms, the breasts or chest, the back, and the thighs, in the same operation or in stages.
More about liposuction. There is also a page about arm lift surgery, and mommy makeover and body contouring after weight loss are on the body contouring page.
Recovery
What to expect after a tummy tuck
Walking starts right away
Short walks begin the day of surgery. Walking helps circulation and lowers the risk of blood clots. For the first several days you walk slightly bent at the waist, and you straighten up gradually as the repair relaxes.
Compression is important
You wear an abdominal binder or compression garment after surgery. The compression helps prevent and minimize swelling and supports the abdomen while it heals.
Drains are commonly used
Drains are commonly used after a tummy tuck to remove fluid under the skin. If Dr. Ovadia places them, you are shown how to care for them before you go home, and they are removed in the office.
Swelling and bruising are normal and expected
The abdomen is swollen and bruised at first, and the lower abdomen often feels numb or tight. Swelling goes down gradually over the following weeks and months, and feeling returns slowly.
Protect the muscle repair
Lifting, straining, and core exercise are limited at first so the muscle repair can heal. Activity comes back gradually, as Dr. Ovadia advises.
Scars take time
Scars are red and firm at first. They fade and soften over a year or more. Protect them from the sun while they heal.
Normal swelling comes on slowly. A rapid increase in swelling is something to watch for, and it should be brought to your physician's attention right away. The same is true of severe pain, spreading redness, a fever, or swelling or pain in one leg. For chest pain or trouble breathing, call 911.
A general timeline
This is a general guide. Everyone heals differently. During your recovery, Dr. Ovadia will review your timeline with you.
Cost
Cost and insurance
A tummy tuck done to improve the shape of the abdomen is unlikely to be covered by insurance. The cost depends on the type of tummy tuck, whether liposuction is added, and whether it is done together with other surgery. You receive a quote after your consultation.
A related operation, the panniculectomy, may be covered by some plans when it treats a medical problem.
Tummy tuck
Removes loose skin and fat, repairs separated muscles, and resets the belly button, to flatten and shape the abdomen. Done to improve the shape of the abdomen, it is unlikely to be covered by insurance.
Panniculectomy
Removes the hanging fold of skin and fat at the bottom of the abdomen, called the pannus, to treat the problems it causes. It does not repair the muscles or reshape the waist. It may be covered by some plans when medical criteria are met.
Common criteria for panniculectomy coverage
- A hanging fold of skin that causes rashes, skin infections, or sores that keep coming back
- A problem that has continued despite treatment prescribed by a physician
- A fold that gets in the way of walking, hygiene, or daily activities
- A stable weight, often for several months, after major weight loss
- Photographs and medical records that document the problem
Every plan sets its own criteria. Coverage is not guaranteed.
If you have questions about possible insurance coverage for surgery, call or email us and we will go over it with you.
Your surgeon
Board certified and double fellowship-trained
Dr. Ovadia is board certified by the American Board of Plastic Surgery. After his plastic surgery training he completed two fellowships: gender-affirming surgery at Johns Hopkins, and craniofacial and pediatric plastic surgery at UT Austin / Dell Children's Hospital.
He performs tummy tucks on their own, together with liposuction and breast surgery, and as part of body contouring after weight loss. He sees patients in New York City and in Jersey City and Millburn, New Jersey.
Questions
Common questions about tummy tuck surgery
Where is the scar after a tummy tuck?
The scar runs low across the abdomen from hip to hip, placed where underwear and swimwear usually cover it. A full tummy tuck also leaves a small scar around the belly button. A mini tummy tuck leaves a shorter scar, and an extended tummy tuck a longer one that continues onto the hips.
What is the difference between a full and a mini tummy tuck?
A full tummy tuck removes loose skin from above and below the belly button and repairs the muscles along the length of the abdomen. A mini tummy tuck removes a small amount of skin below the belly button only, with a shorter scar. Most patients with loose skin after pregnancy or weight loss are better served by a full tummy tuck. Dr. Ovadia tells you which fits at your consultation.
Will a tummy tuck fix muscle separation?
Yes. Separation of the abdominal muscles, called diastasis recti, is common after pregnancy and can leave a bulge even at a healthy weight. In a tummy tuck the muscles are brought back together with stitches. Exercise strengthens the muscles but does not close the separation.
What happens to my C-section scar?
A C-section scar usually sits on the skin of the lower abdomen that a tummy tuck removes, so it is removed along with that skin. The tummy tuck scar takes its place. It is longer, and it is placed low.
Will a tummy tuck remove my stretch marks?
Stretch marks on the skin that is removed, usually the skin below the belly button, are removed with it. Stretch marks higher on the abdomen remain, and they move lower as the skin is drawn down.
What happens to my belly button?
In a full or extended tummy tuck the belly button stays attached to the abdominal wall. The skin around it is drawn down, and the belly button is brought out through a new opening, leaving a small scar around it. In a mini tummy tuck it is usually left as it is.
Should I wait until I am done having children?
Yes, that is usually best. A later pregnancy stretches the skin and the muscles again and can undo part of the result. If you plan to have more children, it is worth waiting.
Should I finish losing weight first?
Yes. The result lasts best when your weight is stable. If you are still losing weight, more skin can loosen after surgery. After major weight loss, surgery is planned once your weight has leveled off.
When can I go back to work and exercise?
It depends on the kind of work you do and how you are healing. Lifting, straining, and core exercise are limited at first so the muscle repair can heal. Dr. Ovadia gives you a timeline at your follow-up visits.
Can a tummy tuck be combined with other surgery?
Yes. It is often done together with liposuction or breast surgery, and after major weight loss it can be planned alongside other body contouring surgery. Whether it is safe to combine procedures depends on your health and how long the operation would be.
Is a tummy tuck covered by insurance?
A tummy tuck done to improve the shape of the abdomen is unlikely to be covered. A panniculectomy, which removes a hanging fold of skin at the bottom of the abdomen, may be covered by some plans when the fold causes a documented medical problem, such as rashes or skin infections that keep coming back despite treatment. Every plan sets its own criteria, and coverage is not guaranteed.
Can I have a consultation without coming to the office?
Yes. Phone and video consultations are available, in addition to in-person visits in New York City, Jersey City, and Millburn, New Jersey.
Next step
Start with a consultation
Dr. Ovadia will examine your abdomen, go over what you are hoping to change, and explain which type of tummy tuck fits, where the scar would sit, and whether liposuction or other surgery should be part of the plan.
225 Broadway, Suite 3100, New York, NY
377 Jersey Ave, Suite 440, Jersey City, NJ
90 Millburn Ave, Suite 206, Millburn, NJ
Phone and video consultations available · info@ovadiaps.com