The Complete Guide to Tummy Tuck Surgery: What Every Patient Should Know

As a board-certified plastic surgeon in Seattle, one of the most common procedures my patients ask me about is a tummy tuck (abdominoplasty). If you’ve been considering it, chances are you’ve already been Googling and found a flood of information — some accurate, some misleading, and some that leaves you with more questions than answers. My goal with this post is to give you a clear, honest, and thorough overview of what a tummy tuck involves, the different types available, and what results you can realistically expect.

What Is a Tummy Tuck?

Let’s start with the basics here. A tummy tuck is a surgical procedure that removes excess skin and fat from the abdomen and tightens the underlying abdominal muscles (if needed). Most patients seek this procedure after pregnancy, significant weight loss, or simply changes over time that diet and exercise can’t fully address.

The goal isn’t just a flatter stomach — it’s restoring contour, improving muscle support, and creating a more balanced overall silhouette.

Who Is a Good Candidate for a Tummy Tuck?

In my practice, I tell patients that the best candidates are:

• At or near their goal weight. A tummy tuck is not a weight-loss procedure and dramatic weight changes after surgery will compromise your surgical results.

• Bothered by loose or hanging skin that won’t go away with fitness (because guys, exercise doesn’t tighten skin).

• Experiencing muscle separation (diastasis recti). This is especially common after pregnancy.

• Non-smokers in good general health with realistic expectations.

• Little Visceral Fat. Visceral fat lives on the inside of the abdomen and cannot be addressed with a tummy tuck.

If you’re planning future pregnancies, I usually recommend waiting, since the results can be undone by pregnancy changes.

Types of Tummy Tucks

Not every tummy tuck is the same — the right technique depends on your anatomy, goals, and the amount of skin laxity present. Here are the most common types:

1. Full Tummy Tuck

The “classic” approach- a full tummy tuck addresses the entire abdominal area (both above and below the belly button). It involves:

• An incision low across the hip line (usually hidden below underwear or swimwear).

• Muscle tightening (if needed).

• Removal of excess skin and fat.

• Repositioning of the belly button for a natural appearance.

This is the most common type I perform for women after pregnancy or major weight loss.

2. Mini Tummy Tuck

A smaller version for patients with skin laxity limited to the lower abdomen. It involves:

• A slightly shorter incision.

• Removal of less skin (only the skin below the belly button).

• No belly button repositioning.

It’s best for patients with good skin tone above the navel who primarily want to smooth the “pooch” below the belly button.

3. Extended Tummy Tuck

For patients with significant excess skin that extends around the sides or into the flanks, an extended tummy tuck may be appropriate. The incision runs longer, allowing me to remove more tissue and contour the waistline more dramatically.

4. Circumferential Tummy Tuck (Lower Body Lift)

This is typically performed after massive weight loss and addresses the abdomen, flanks, and lower back in one procedure. It provides the most comprehensive transformation, but also involves the longest recovery.

5. Fleur-De-Lis Tummy Tuck

This type of tummy tuck is typically used in patients who have undergone massive weight loss with significant skin laxity throughout the abdomen. It places 2 long incisions on the abdomen– one low from hip to hip and one vertical incision down the midline– creating an inverted ‘T’ shape. Muscle tightening can be performed, the belly button is repositioned in the midline incision, and conservative liposuction can be done simultaneously. 

What to Expect During Surgery

A tummy tuck is performed under general anesthesia or with IV sedation and an epidural.  It typically takes 2-3 hours, depending on the extent of the procedure. I carefully place incisions low on the abdomen so they can be hidden by clothing and swimsuits, and all sutures used are placed underneath the skin and dissolve over time. After removing excess skin and tightening the abdominal wall, the remaining skin is redraped smoothly.

Typically, 1-2 drains are used to remove excess fluid over the first few days after surgery, and patients are placed in an abdominal binder for abdominal support. 

Recovery: What Is Realistic?

Recovery from a tummy tuck is very manageable, but it does require planning and patience. Here’s what I tell my Seattle Plastic Surgery patients to expect:

• First week: You’ll be sore, swollen, and moving slowly. Most patients walk bent at the waist for several days to avoid tension on the incision. You are NOT on bedrest after surgery as movement is important for preventing blood clots from developing in your legs.

• 2–3 weeks: Energy improves, nerves start to wake up and the swelling will start to noticeably decrease. 

• 4–6 weeks: Many patients return to non-strenuous daily routines. After 4 weeks, patients may return to light exercise. 

• 3 months and beyond: Swelling gradually resolves, scars begin to fade, and results become more visible. Most patients report feeling completely back to normal by 3 months post surgery.

Final results are typically appreciated around 12 months post-surgery.

Realistic Expectations: What a Tummy Tuck Can (and Can’t) Do

A tummy tuck is a powerful procedure — but it’s important to go in with realistic expectations:

What it can do:

• Remove loose, hanging abdominal skin.

• Tighten stretched or separated abdominal muscles.

• Improve contour and waistline definition.

• Restore confidence in clothing and swimsuits.

  
  

What it can’t do:

• Replace weight loss.

• Guarantee a perfectly flat abdomen (anatomy, skin quality, and lifestyle all play roles).

• Erase every stretch mark (though many below the belly button are removed with the excess skin).

  
  

The best outcomes happen when patients view tummy tuck surgery as a complement to healthy lifestyle habits — not a substitute for them.

Final Thoughts

If you’ve been researching tummy tuck surgery, you’ve likely come across a lot of mixed messaging. My advice? Focus on facts, ask your surgeon questions, and make sure you’re choosing the right procedure for your body and goals.

Every patient’s journey is unique. If you’re in the Seattle area and considering a tummy tuck, I’d be happy to meet with you, evaluate your anatomy, and create a surgical plan tailored to you.

A tummy tuck can be truly life-changing — not just for how your body looks, but for how you feel living in it.

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Dr. Megan Dreveskracht is a Seattle-based Female Plastic Surgeon who specializes in Aesthetic Surgeries of the Breast, Body & Face. To schedule your consultation, call 206.860.5582 or fill out a contact form here.