What is a tummy tuck (abdominoplasty)? What is panniculectomy?

When diet and exercise fail to achieve the waistline you desire, surgeons have perfected the procedure to help you attain a flat, well-toned abdomen.

A tummy tuck, also known as abdominoplasty, removes excess fat, skin, and in most cases, can reestablish weakened or separated muscles – creating an abdominal profile that is smoother and firmer.

Panniculectomy which can be performed alone or in combination with a tummy tuck, removes any overhanging “apron” of skin and tissue from below the belly button. This excess skin is most typically a result of significant weight loss (100 pounds or more) through diet and exercise.

The hanging skin of the abdomen, called the pannus or “apron” can cause a variety of problems, including the inability to fit comfortably into clothing, difficulty in daily hygiene, yeast infections or cysts in the folds of skin, and lower back pain. Different from a tummy tuck, which tightens the underlying stomach muscles, a panniculectomy only removes excess skin and fat.

Many people who have achieved significant weight loss can be left with large amounts of heavy, loose folds of skin around the abdomen, which can sag and lose elasticity as a result of being stretched for a long period of time. This excess skin can lead to rashes above the pubic area and along the groin and hips. A panniculectomy can offer relief of these symptoms to enhance your health and appearance.

Tummy tuck surgery is a good option for you if:

  • You are physically healthy and at a stable weight
  • You have realistic expectations
  • You are a non-smoker
  • You are bothered by the feeling that your stomach is too large.

How is a tummy tuck (abdominoplasty) performed?

In a traditional tummy tuck, a horizontal incision is made just above the pubic hairline. The length of this lower abdominal incision is determined by the amount of excess skin. The skin is then dissected up toward the rib cage, the muscle is tightened, the belly button is repositioned and excess skin is removed. Your cosmetic surgeon may also recommend combining liposuction with your tummy tuck procedure for the best results. In those cases where loose skin extends towards the back, the incision can be lengthened into the back area performing a so-called “circumferential abdominoplasty.”

The tummy tuck procedure is generally performed under general anesthesia and can often be performed as an outpatient or with a one-night stay at Cleveland Clinic Cosmetic & Plastic Surgery Center. The procedure itself requires anywhere from two to four hours to perform. Drains are most often used and are removed several days following the procedure.

What are the different types of tummy tuck (abdominoplasty) procedures?

There are three different types of tummy tuck procedures:
Complete Abdominoplasty:
A complete abdominoplasty requires an incision above the pubic hairline, an incision around the umbilicus, or belly button, and a tightening of the rectus abdominis muscles (the pair of muscles that run vertically on each side of the stomach’s front wall). Muscle tightening, as well as skin removal, is the most important step in improving the stomach’s contour. Liposuction may also be performed at the same time of a complete tummy tuck.
Partial or Mini Abdominoplasty:
The mini abdominoplasty is performed on those patients with mild to moderate tummy contour changes, relatively little skin excess and little weakness of the abdominal wall. In the mini abdominoplasty, the navel incision is avoided. Liposuction may also be performed at the time of mini abdominoplasty surgery.
Circumferential Abdominoplasty:
Skin laxity or skin excess is a three-dimensional issue and involves not only the abdominal area, but also the back region. When there is significant excess fat in the back area as well, abdominoplasty can be performed with liposuction of the back region or circumferential abdominoplasty can be performed. The benefit of the circumferential abdominoplasty is that both skin and fat can be removed in the hip and back region, improving your body contour three dimensionally.

What results can I expect?

After a tummy tuck (abdominoplasty):
Whether you’re having a partial or complete tummy tuck at, the overall result will be a flatter, firmer abdominal contour that is more proportionate with your body type and weight. Your final results may be initially hidden by swelling and the inability to stand fully upright until internal healing is complete. Your new slimmer profile should be will begin to be apparent within a week or two following surgery. It might take several weeks or even months to appreciate the final result.