Abdominoplasty (Tummy Tuck): A Brief Overview

Medically reviewed by Jennifer Richman on March 5, 2025.

Introduction: What is an Abdominoplasty (Tummy Tuck)?

An abdominoplasty (tummy tuck) is a surgical procedure that removes excess skin and fat from the abdominal region while tightening the connective tissue around the abdominal muscles. Abdominoplasty may be performed after a patient has had a pregnancy, significant weight loss, or to relieve conditions that contribute to the separation of abdominal muscles like rectus diastasis. For transgender and non-binary patients, abdominoplasty can help alleviate feelings of gender dysphoria. This surgery can also be used in tandem with liposuction or other gender-affirming procedures to meet your specific goals.

While a tummy tuck can help reduce overhang of abdominal tissue and slim the waistline, it is not a substitute for weight loss or an appropriate diet and exercise program. The procedure can correct lower abdominal stretch marks if present in the area of skin removal, but will not correct stretch marks in the mid or upper abdominal region. Abdominoplasty outcomes can be diminished without proper aftercare or by significant fluctuations in your weight after surgery. This is why it is important to consult a professional before any procedure to make sure you qualify and to develop a thorough surgical plan that’s right for you.

Is Abdominoplasty Right for Me?

There are many factors that, after careful consideration of your medical history, lifestyle, and goals, can be meaningfully altered by an abdominoplasty. The most common reasons people consider this procedure include:

• Loose skin that they wish to eliminate or tighten
• Weakened abdominal muscles or diastasis recti
• Unwanted subcutaneous abdominal fat
• Cinching the waist to achieve an “hourglass” figure
• Rashes caused by deep skin creases near the abdomen, groin, or hips
• Back pain and posture issues from other medical conditions
• Treatment of Gender dysphoria

Abdominoplasty for Gender Affirmation

While the “tummy tuck” has been popularized as a cosmetic surgical procedure, many insurance providers cover it as a form of gender-affirming care. Please note that at the Gender Confirmation Center (GCC), we only perform abdominoplasty as gender-affirming body contouring for trans and non-binary patients.

Transmaculine, transfeminine and non-binary patients have sought out abdominoplasty for the following reasons:

• For transmasculine patients: If loose skin and abdominal muscles (e.g., rectus diastasis) from past pregnancies or weight fluctuations are a source of gender dysphoria.
• For transmasculine patients: For some folks, having more weight around the trunk, hips, buttocks and lower body than the upper body can be a source of gender dysphoria. A tummy tuck, in conjunction with other masculinizing liposuction techniques, can adjust the body’s proportions to give a more top-heavy look to the patient’s frame, drawing attention away from the width of the hips and the stomach.
• For trans feminine patients: reducing volume in the trunk (abdomen, flanks and lower back), can give the appearance of a more cinched waist. Reducing the circumference of the waist in comparison to that of the hips, especially if a simultaneous buttocks and/or hip augmentation is performed, can result in a waist-to-hip ratio that is more common for folks who have undergone a first, estrogenic puberty.

During your free surgical consultation, your surgeon will be able to tell you what you can expect as a realistic result from your surgery given your current body type.

Frequently Asked Questions About Abdominoplasty

Below is a brief overview of some frequently asked questions regarding abdominoplasty (tummy tuck) and pre/post-operation care. Please consult a board-certified surgeon for the most up-to-date and relevant information about your circumstances.

When will I be able to stand up straight, sit normally and lie down flat after an abdominoplasty?

As you recover from abdominoplasty, it will take some time before you can straighten out your posture. We recommend that patients stand partially hunched or bent at the hips for the first two weeks after surgery. While sitting and lying down for the first three weeks after surgery please have your upper body elevated in a recliner with pillows under your knees as well.

How long do the results of an abdominoplasty/tummy tuck last?

The results of an abdominoplasty are generally permanent, however, factors such as weight gain, underlying health issues, and pregnancy can affect your results so it is important to maintain a healthy lifestyle and consult a medical professional pre and post-recovery. Patients can expect at least 3-6 months to fully recover.

What is required to qualify for an abdominoplasty/tummy tuck?

To qualify for abdominoplasty, patients should be in an overall good state of health. If you have chronic medical conditions, these should be optimally managed by your care team prior to surgery. You may be asked to complete a comprehensive medical evaluation including bloodwork or other testing in order to determine fitness for surgery. Patients who smoke or vape should refrain at least 3 weeks prior to surgery.

Will insurance cover abdominoplasty?

For transgender and non-binary patients, some insurance providers will cover gender-affirming body contouring as long as you meet specific guidelines such as 12 or more months of HRT (hormone replacement therapy) treatment and a support letter from a licensed mental health professional. At the GCC, our insurance advocacy team has a 90% success rate in securing coverage free of any additional costs to our patients.

What is the difference between an abdominoplasty/tummy tuck and a mons resection and panniculectomy?

The main difference between the two procedures is that an abdominoplasty not only removes excess skin, but can also tighten the upper and lower abdominal muscles. Another key difference is that a mons resection and panniculectomy focus on the upper-groin area only and not the abdomen.

Can I undergo an abdominoplasty/tummy tuck alongside other procedures?

Your surgeon can help determine a surgical plan that makes sense for you and ensures your safety. Some procedures such as abdominoplasty, skin excision, liposuction, top surgery, or breast augmentation may be performed in tandem in some circumstances. In other circumstances, patients may have to undergo these procedures separately.

Types of Abdominoplasty Procedures and Surgical Options

Many patients decide to get abdominoplasty in conjunction with other surgical procedures such as liposuction with or without fat grafting, top surgery, breast augmentation, or other body procedures. Below we describe the three different types of abdominoplasty procedures that are most commonly performed with each type providing different benefits.

Mini Abdominoplasty: Not as Invasive and Improves Lower Abdomen

The mini-tummy tuck is mainly focused on eliminating loose skin and stretch marks below the belly button. The technique involves a single incision made just above the pubic mound, where the surgeon will then tighten loose muscles and remove excess skin to restore a flat abdominal wall below the belly button.

The resulting scar from a mini-tummy tuck is a thin, horizontal line that is typically just a few inches long. Benefits and differences from a full abdominoplasty are:

• a shorter, less invasive procedure
• quicker recovery period
• slimmer/flatter lower abdomen
• less ability to maximally tighten skin and muscle

Full Abdominoplasty: Traditional Procedure that Improves Both the Upper and Lower Abdomen

If you have a full or “classic” tummy tuck procedure your surgeon will make a horizontal, hip-to-hip incision along the lower abdomen. The length and type of incision will be based on the amount of excess skin. Your surgeon will temporarily separate the navel from the surrounding tissue area in order to lift and tighten abdominal muscles. After the skin is lifted and muscles tightened the surgeon stitches the navel back into position and closes the incisions with sutures. The resulting scar is typically longer, running from hip bone to hip bone but will also lighten over time with proper scar care.

• Best for those looking to adjust the full length of their abdominal wall.
• Can be more beneficial for re-shaping and body styling.
• An overall increase in comfort with form-fitting clothing.
• Scarring can be easily concealed by undergarments and swimsuits.

Extended Abdominoplasty: Best for Improving the Upper, Lower, and Sides of the Abdomen

An extended tummy tuck is most commonly used when a patient requires more extensive skin removal to achieve their goals. This procedure involves a wider incision, that may even be extended vertically up towards the sternum, called a fleur-de-lys abdominoplasty, to address excess tissue in the upper and lower abdomen as well as the flanks. This may increase surgery and recovery times.

Preparing for Your Abdominoplasty

Your surgery team will go over the specific ways that you should prepare for your procedure. Some general guidelines are listed below.

• Meet with your primary care provider to screen for and manage medical conditions
• Quit smoking, or at least stop smoking 3 weeks before surgery
• Fill your prescription medications at the pharmacy before surgery
• Avoid taking aspirin or any anti-inflammatory medications such as ibuprofen or NSAIDs at least 2 weeks prior to surgery as these medications can increase bleeding risks.
• Make sure you are meeting the required surgery guidelines including BMI.
• Don’t eat or drink anything starting at midnight before surgery.
• Do arrange for someone to be with you during the procedure and take you home (along with helping you with daily tasks for the next few days).
• Bring comfortable loose-fitting clothes and have light meals ready in advance for when you return home.
• Pick up any medications that were prescribed to you by your surgical team.
• Have pillows available to prop yourself up, as you will be expected to keep your back elevated after surgery.

The Abdominoplasty Procedure: What to Expect

Surgery will vary based on the type of abdominoplasty you undergo plus any additional procedures. This is what you can generally expect the day of your procedure:

• You will meet with your surgeon, anesthesiologist, nurse, and other members of your surgical care team.
• General anesthesia will be administered in the operating room before the start of the procedure.
• After an incision is made, the abdominal tissues are lifted and adjusted, with excess skin being excised and your incisions being closed with sutures. The procedure can take anywhere between 2-4 hours.
• Specialized nursing care will be provided as you wake up in the recovery room with medications for pain or nausea administered as needed.
• You may feel dizzy, sore, or nauseous and require mobility assistance.
• It is advised that you have someone with you for the next few days to assist with daily tasks, manage your drains, and distribute medications.
• You will get instructions for managing dressings, drains, and other aftercare from your care team. Supplies may be provided as needed.
• Make sure to stay hydrated, have plenty of pillows, and keep in contact with your care team post-surgery.

Recovery Process After Abdominoplasty

Recovery for an abdominoplasty/tummy tuck procedure can last from 2-4 weeks, depending on the type you undergo. You can expect to see your final results around 6 months post-op. Although scars take around 12 months to mature, an abdominoplasty incision should be easily concealed by undergarments and bathing suits. You can expect the following during recovery:

• We recommend having additional support from a friend or relative for the next 2-3 days to not strain yourself performing everyday household activities
• Avoid standing up straight for two weeks after surgery (bending or hunching at the hips is ideal)
• Prop your upper body up and place pillows under your knees while you lay and sit down for the first three weeks
• You will receive instructions for wound care and surgical drains if they are placed
• Avoid showering until drains are removed, so you will need to take sponge baths in the meantime
• You cannot submerge your incisions water for the first 3 weeks post-op
• You will be instructed to wear a compression binder over the abdomen for the first 3 weeks after surgery. This binder will be provided for you to keep.
• Avoid movements that can cause strain on the waistline like rapidly bending at the waist or lifting objects above your head
• Avoid rigorous physical activity for the first 6 weeks post-op

Potential Risks and Complications of Abdominoplasty

The best way to lower your risk of surgical complication is to:

• Ensure any chronic health conditions are being actively treated and optimally managed
• Choose a board-certified surgeon experienced in the procedure you wish to undergo
• Adhere to the post-surgery and post-recovery instructions (this includes resting, staying hydrated and following activity or mobility restrictions)

While patients most often do not require an overnight hospital stay, the operation is still considered major surgery. Pain, nausea, numbness, swelling, mild bruising, difficulty getting comfortable, and difficulty standing fully upright are common experiences after surgery. More serious risks also exist such as cardiopulmonary complications, bleeding, blood clots and infections.

Conclusion: Make an Informed Decision That’s Right for You

The GCC offers consultations free of cost, either in-person or virtually. Please note that we only perform abdominoplasty as a part of gender-affirming body contouring procedure for trans and non-binary patients. The most satisfied abdominoplasty patients tend to be those that are (1) honest with their provider about their medical history and (2) are properly informed by their surgeon about what results they can realistically expect from surgery.

While the procedure permanently removes excess skin and tightens your abdominal muscles, results can be affected by weight gain, weight loss, pregnancy and adherence to postoperative instructions. It is extremely important to consult a board-certified surgeon and research the procedure thoroughly to make sure you are adequately prepared and meet all medical qualifications.