Tummy tuck is a body contouring surgery that removes redundant skin and soft tissues of the abdomen. During the procedure, the abdominal core muscles may also be tightened to address separation that commonly occurs with pregnancies and weight gain. The following factors determine whether a patient is a candidate for tummy tuck surgery:
Body mass index
Unfortunately tummy tuck surgery is not an effective technique for weight loss. A body mass index of 30 or less, ideally closer to 25, is recommended before undergoing a tummy tuck. This lowers the risk of systemic complications and may also achieve a better aesthetic outcome. At higher BMI, more visceral fat – located within the abdomen – is present. This type of fat is linked with heart disease and other systemic conditions. If tummy tuck is performed on a patient with a large amount of visceral fat, the aesthetic outcome will be inferior as the abdomen will still demonstrate a rounded contour following surgery. The best candidate for tummy tuck presents with redundant skin of the lower abdomen and subcutaneous tissue to a lesser degree.
No further pregnancies planned
Although it may still be possible to carry a healthy full-term prengnacy following tummy tuck surgery, this would likely compromise the aesthetic outcome. Loose skin and subcutaneous tissue may recur of the abdomen and the rectus plication (stitching of the core abdominal muscles performed during a tummy tuck) would be stretched. A candidate for tummy tuck surgery should ideally have no plans for further pregnancies. If plans are uncertain, surgery should be deferred to lower the risk of requiring revision surgery.
It is recommended to achieve smoking cessation for at least one month before and after elective cosmetic surgery. This is imperative for tummy tuck given increased risk of serious healing complications, including infection and skin flap necrosis. The blood supply of the abdominal skin is compromised during the surgery, which makes smoking an absolute contraindication until well healed. If able to stop smoking for two months, many patients use this as a chance to quit smoking permanently.
Compliance with post-operative activity restrictions
Post-operative results depend on surgical technique as well as healing. In order to achieve the best aesthetic outcome, it is important to follow recommended activity modifications for 6 weeks following tummy tuck. Exercise and heavy lifting over 5 lbs should be avoided until 6 weeks post-operatively. Patients must commit to these activity modifications to lower risk of healing complications. Returning to exercise before 6 weeks post-op may increase risk of developing bleeding, seroma (fluid collection), or dehiscence (wound separation) of the incisions or muscle repair site.
Dr. Power will discuss your expectations in detail during consultation to assess whether they may be achieved through tummy tuck surgery. In some cases, it may be recommended to defer surgery until a more appropriate candidate. Surgery is not recommended, for example, for patients going through major life changes, including divorce or recent psychiatric concerns. Recent stressors may make it less likely that you are satisfied with the results of tummy tuck surgery.
If considering tummy tuck surgery in the Toronto area, please contact us to schedule a consultation with female plastic surgeon Dr. Stephanie Power. She will make specific recommendations based on your aesthetic concerns, goals, and clinical presentation.