Tummy Tuck After Major Weight Loss: Before and After, Scar and Recovery

9 hours ago

4 min read

Quick answer: A tummy tuck after weight loss (abdominoplasty) removes the hanging skin of the lower abdomen, tightens the abdominal muscles and repositions the belly button. The right time is when your weight has been stable for 6 to 12 months. The scar is placed low, under the underwear line. Liposuction of the waist and flanks is often added so the result looks even from every angle.

Key takeaways

Exercise cannot remove loose skin after major weight loss; surgery can.
Wait until your weight has been stable for at least 6 months.
The scar is placed low and runs from hip to hip, where underwear usually covers it.
The belly button is repositioned so it sits in a natural position on the new abdomen.
Most patients return to desk work after about 2 weeks.

Why does loose skin remain after weight loss?

When a person carries extra weight for years, the skin stretches and loses part of its elastic fibres. After losing 20, 30 or more kilograms, the skin cannot shrink back completely. The result is a lower abdominal fold that can cause rashes, sweating and difficulty finding clothes that fit.

Video: Tummy tuck after 30 kg weight loss, with VASER liposuction. Watch on YouTube

The video above shows a male patient who lost 30 kg. It has been viewed more than 7 million times. His operation combined a tummy tuck with VASER liposuction, and the belly button was moved to a new, symmetrical position.

What does a tummy tuck include?

Skin removal: the excess skin and fat of the lower abdomen are removed.
Muscle repair: separated abdominal muscles (diastasis recti), common after pregnancy or weight gain, are stitched back together.
Belly button: a new opening is made so the belly button sits in a natural position.
Liposuction: fat on the waist, flanks and upper abdomen is reduced so the new contour is even.
Closure: the skin is closed in layers to give the finest possible scar.

Tummy tuck before and after
Tummy tuck before and after
Liposuction before and after

Where is the scar?

The scar runs low across the abdomen, from hip to hip, and is planned so that it can usually be hidden under underwear or a bikini. Some patients with skin excess in both directions need an additional vertical scar (a fleur-de-lis tummy tuck); this is discussed openly at the consultation. Scars are red at first and fade over 12 to 18 months.

For patients with only mild skin looseness, an endoscopic tummy tightening through a few small, hidden incisions may be an alternative:

Video: Endoscopic scarless tummy tuck with skin tightening, before and after. Watch on YouTube

"After a major weight loss, the patient has already done the hardest part. My job is to remove what the body cannot fix by itself, and to place the scar where clothing can hide it." — Prof. Dr. Suleyman Tas

When is the right time?

Your weight has been stable for 6 to 12 months.
After weight loss surgery, usually 12 to 18 months after the operation.
If you plan another pregnancy, it is better to wait, because pregnancy stretches the muscles and skin again.
You do not smoke, or you can stop at least 4 weeks before and after surgery.

Recovery

First days: you walk on the day of surgery; drains may be used for a few days.
Weeks 1 to 2: you walk slightly bent forward; pain is controlled with tablets.
Weeks 2 to 6: you wear a compression garment; desk work after about 2 weeks.
Week 6 onwards: sport and lifting gradually return.

For a comparison with liposuction alone, read liposuction vs tummy tuck.

Risks and safety measures

As with any major operation, risks include fluid collection under the skin (seroma), wound healing problems at the scar, numbness of the lower abdomen and, rarely, blood clots in the legs. These risks are reduced by stopping smoking, early walking, compression garments, drains when needed and, in selected patients, blood-thinning injections. Patients with diabetes or heart conditions are prepared together with their own doctors.

Combining body contouring after weight loss

Many patients who lost a lot of weight also have loose skin on the arms, thighs, back or breasts. These areas can be treated in one or more stages. Splitting the work into stages keeps each operation shorter and safer. See our scarless arm lift guide and the body contouring page.

Men and tummy tuck

Men tend to carry more fat inside the abdominal cavity, around the organs, which surgery cannot remove. A good result for a man therefore starts with weight loss; then a tummy tuck with liposuction of the flanks gives a flatter, more masculine contour.

Frequently Asked Questions

How much weight should I lose before a tummy tuck?

Ideally you are close to your goal weight and have kept it stable for 6 to 12 months. A tummy tuck is not a weight loss operation.

Will my belly button look natural?

Yes. The belly button stays attached to its stalk and is brought out through a new opening shaped to look natural.

Can a tummy tuck be combined with other surgery?

Yes. It is often combined with liposuction, breast surgery (a mommy makeover) or arm and thigh contouring, depending on your health and the operating time.

Is a tummy tuck painful?

The first days are uncomfortable, mainly because of muscle tightening. Pain is usually controlled with tablets and improves clearly after the first week.

Can men have a tummy tuck?

Yes. Men who have lost a lot of weight often combine a tummy tuck with liposuction and chest surgery for gynecomastia.

About the Author

This article was written and medically reviewed by Prof. Dr. Suleyman Tas, a plastic, reconstructive and aesthetic surgeon in Istanbul with over 20 years of experience. He is the author of Rhinoplasty in Practice (CRC Press, 2020), has more than 40 peer-reviewed scientific publications and five patents, and teaches facelift and rhinoplasty techniques to surgeons at international courses. Read more about Prof. Dr. Suleyman Tas.

Individual results vary. Before and after photos and videos are shared with patient consent. This article is for general information and does not replace a personal medical consultation.

See More Before and After Results

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You can send your photos for an online assessment or book an appointment at the Prof. Dr. Suleyman Tas Clinic, Terrace Fulya, Şişli, Istanbul. Book an online consultation.