Your Guide to Tummy Tuck Surgery, Preparations, Procedure, and Recovery dallas, Texas

Tummy tuck surgery offers a permanent solution to saggy belly skin and lax abdominal muscles that can develop after pregnancy,  weight loss, or simply as a result of normal ageing.

With the advancements in surgical techniques and pain management, recovering from a tummy tuck is now easier than ever.  

Dr. Robert Schwartz offers his patients customized tummy tuck procedures at his plastic surgery facilities in Dallas, TX. If you have abdominal sagging and your abs aren’t as toned as they used to be, you can get an abdominoplasty - with or without liposuction - for a younger-looking body.

What is a Tummy Tuck?

A tummy tuck or abdominoplasty is a cosmetic surgical procedure that flattens the stomach and restores its younger-looking contours.

Most patients who come in for a tummy tuck consultation are women in their 30s or 40s who have had children. Others are men and women who want to tighten their midsection after losing weight.

Pregnancy and weight changes have stretched their abdominal skin and ab muscles. Once flat  tummies now bulge.

What a tummy tuck does for the abdomen is:

  • It tightens stretched, hanging skin
  • It removes stretch marks from the lower abdomen
  • It repairs the belly button, which can dilate and stretch with pregnancy or significant weight gain
  • It tightens the abdominal muscles, which stretch and loosen after weight loss or pregnancy

Most women gain a huge boost in self-confidence after getting a tummy tuck. They feel more confident wearing bathing suits and are more comfortable shopping for clothes without worrying about hiding their bodies.

What are the Benefits of a Tummy Tuck?

During a tummy tuck surgery, we can:

  • Flatten and contour the abdomen
  • Remove excess loose skin from the belly area
  • Tighten and smoothen remaining skin
  • Tighten and flatten the abdominal muscles
  • Cinch and narrow the waist
  • Repair umbilical hernias if present
  • Lift and tighten pubic sagging
  • Remove belly stretch marks
  • Remove old belly button piercings
  • Reveal muscle definition in the abs
  • Thin excess abdominal fat

What Causes Abdominal Sagging?

Abdominal sagging can result from pregnancy, changes in weight, and ageing.

The two main causes of abdominal sagging are pregnancy and significant weight loss. In both cases, the abdominal muscles and skin become stretched to make more room inside the belly for the baby or the built-up fat.

Your skin can stretch to a certain point before losing its elasticity. Beyond that point the elastic fibers break and the skin can’t snap back to how it was before. 

A tummy tuck can correct the stretched-out abdominal muscles and sagging skin.

What are the Different Types of Tummy Tucks?

The five types of tummy tuck surgeries differ in their incisions, how much correction they offer, and the type of scars they leave.

Standard Tummy Tuck

The standard or traditional tummy tuck is the most commonly performed abdominoplasty.

During a standard abdominoplasty:

  • We make a horizontal incision low on the abdomen in the upper part of the groin to separate the skin and fat layers from the deeper muscle wall. The incision typically extends from hip to hip but can be a little shorter or longer, depending on patient’s needs.
  • We also make make a circular cut around the belly button and separate it from the surrounding skin and fat. The belly button stays attached to the underlying muscle wall and maintains its original position.
  • Next, we lift the skin and fat layers off the muscle wall, all the way to the bottom of the rib cage.
  • We pull the muscles together using strong sutures to flatten and tighten the muscle wall. If there’s a hernia in the belly button, we also fix that.
  • After that, we pull down the skin and fat layers to flatten the belly and cut out the excess.
  • Finally, we make a new incision for the belly button and pull it through the incision into its new place. Then we precisely close all the incisions layer by layer using dissolving hidden stitches.

Modified Tummy Tuck

Women with loose skin limited to the lower part of their abdomen (below their belly button) may prefer a modified tummy tuck.

Unlike a standard abdominoplasty, we don’t make an incision around the belly button to separate it from the surrounding fat and skin.

Instead, we release the base of the belly button, separating it from the underlying muscle layer. That way, we can lift the entire navel along with the skin and fat layers.

As we pull down the fat and skin, the umbilicus shifts down only a little because there isn’t much loose skin in the upper abdomen. This slight shift in position isn’t noticeable when people look at your tummy.

The advantage of this abdominoplasty is that it doesn’t leave an additional scar at the belly button. But, this type of tummy tuck can only slightly tighten the upper part of the abdomen. Too much tightening would lower the belly button too far.

The modified tummy tuck is an excellent procedure for women with the right anatomy. We don’t do it as commonly as the standard tummy tuck because most women have too much upper abdominal skin laxity to qualify.

Mini Tummy Tuck

A mini tummy tuck is the least invasive type of abdominoplasty. It requires a much shorter incision, similar to a C-section scar.

We perform mini-abdominoplasty for women with only a small amount of loose skin restricted to the lower part of the abdomen.

The steps of a mini tummy tuck are similar to those of a standard abdominoplasty except we only lift the skin and fat to the belly button and not to the lower chest.

As a result, a mini tummy tuck has the following limitations:

  • We can only remove a limited amount of skin and fat (typically a few inches) from the lower abdomen
  • We can only tighten the abdominal wall so much without creating an unnatural contour in the skin
  • We can't rejuvenate the belly button through a mini tummy tuck

Although it leaves a shorter scar, mini abdominoplasty is a limited procedure that can only correct a small amount of loose skin and muscle laxity in the lower abdomen.

In our experience, not many women have the very limited laxity that benefits from this minimal tummy tuck. If you have more than subtle excess skin, a mini tummy tuck may lead to disappointing results.

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Fleur de Lys Tummy Tuck

The fleur de Lys abdominoplasty is very similar to the standard tummy tuck. except we make an additional vertical incision, either from the top of the abdomen or the belly button, all the way down to the groin.

The extra vertical incision allows us to remove more saggy skin from the abdomen’s sides, top, and bottom. This tummy tuck is sometimes needed for patients with abundant skin laxity after losing massive weight.

The upside of the fleur de lys is that it can remove more loose skin and tighten the abdomen very dramatically. The vertical scar down the middle of the abdomen can be a high price to pay though, since it will show in a bikini.

Extended Tummy Tuck

This is the most extensive tummy tuck and can also be part of what is known as a 360-degree body lift.

Similar to the standard tummy tuck, we make a horizontal incision low on the abdomen. But instead of stopping at the hips, it continues onto the lower back.

The extended abdominoplasty allows us to remove loose skin from the back and the front of the abdomen. But there are several problems with it:

  • We have to flip the patient during the tummy tuck to operate on both the back and the front. As a result, the surgery takes longer, increasing the complication rate.
  • You can’t tighten the abdomen or the back fully if you try to fix both simultaneously because it places too much tension on the incisions. The higher tension worsens the scars and can make the incision pop open.
  • Pregnancy doesn’t often loosen the lower back skin or muscles, so an extended tummy tuck isn’t usually needed.

If someone needs a tummy tuck and skin tightening in the back, we recommend separating the two procedures for better results.

What is the Best Type of Tummy Tuck for Me?

The best tummy tuck procedure is the one that makes you feel proud of your abdomen and the way it looks after the surgery.

To know what the best tummy tuck procedure is for you, you need to consider the following:

  • What are your aesthetic goals? What do you hope to get out of your abdominoplasty?
  • How much loose skin and muscle laxity do you have? Can we correct that by a mini or modified tummy tuck, or would you need a standard abdominoplasty to eliminate the sagginess?
  • Will you be comfortable with the resulting tummy tuck scars?

The standard tummy tuck offers powerful abdominal contouring with well-hidden incisions for most women.

Ninety-six percent of our tummy tucks have been standard abdominoplasties.

The remaining four percent of our abdominoplasties have been evenly divided between modified and mini tummy tucks. These are excellent procedures when used on suitable patients.

We rarely recommend or perform Fleur-de-Lys or extended tummy tucks.

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Am I a Good Candidate for Tummy Tuck?

Most tummy tucks are done to fix abdominal sagging and muscle laxity after pregnancy. You may also benefit from a tummy tuck if you’ve lost weight. This is true for both men and women.

Most tummy tuck patients are women in their thirties to fifties. But we also perform this procedure regularly on younger (in their 20s) and older patients (oldest in their 70s).

You’re an ideal candidate for a tummy tuck if:

  • You’re a woman or a man with loose skin and stretched abdominal muscles.
  • You’re done having children: You can still get pregnant after a tummy tuck. But pregnancy can undo some of the benefits of the surgery, and you might need to get it revised.
  • You’re at or close to your ideal weight: Significant weight changes after a tummy tuck can leave you with loose skin and weaken the results of your surgery.
  • You’re in good health: You don’t have any untreated medical problems that can prevent you from being under general anesthesia or recovering well from a tummy tuck.
  • You’re a non-smoker: You’re a non-smoker, or you quit smoking at least four weeks before your surgery. Smoking significantly increases the risk of wound healing problems after a tummy tuck.
  • You’re okay with post-surgical scars: You accept the trade-off of having a relatively long scar in exchange for all the benefits of the tummy tuck.

Can I Combine Tummy Tuck with Other Cosmetic Surgeries?

Yes. We often combine a tummy tuck with other cosmetic surgeries to further improve the outcome.

The most common cosmetic procedures that we pair with abdominoplasty are:

  • Liposuction: Often of the love handles, abdomen, flanks, and back. Combining liposuction with a tummy tuck enables us to contour the entire torso 360 degrees.
  • Cosmetic breast surgery: We also combine a tummy tuck with breast implants, breast reduction, or breast lift surgery as a part of a complete mommy makeover to help you get back your pre-pregnancy body with a single recovery period.

As long as you’re in good health, there should be no problem with you getting an abdominoplasty combined with liposuction or breast surgery.

Tummy Tuck vs. Liposuction

Deciding whether to get a tummy tuck, liposuction, or both depends on the issues affecting your abdomen.

The difference between a tummy tuck and liposuction is that an abdominoplasty tightens the muscles and skin of the abdomen, while liposuction does not. On the other hand, liposuction gets rid of excess tummy fat more thoroughly than a tummy tuck.

Liposuction is better if you only have excess belly fat without loose skin or stretched muscles.

You need a tummy tuck if you have loose belly skin and your abs aren’t as toned as they used to be.

You can also get liposuction at the same time as your tummy tuck surgery to get rid of saggy skin, tighten the abs, and enhance the contour of your midsection.

How is Abdominoplasty Performed in Dallas, Texas?

Here’s what you can expect if you decide to get your tummy tuck surgery at Robert Schwartz Plastic Surgery in Dallas, Texas:

  • You’ll arrive at our office usually an hour before your procedure. You’ll be checked in and visited by one of our nurses, who will confirm your medical history. We’ll start an IV and give you your preoperative medications.
  • Dr. Schwartz will review your surgery plan and mark you.
  • After that, you’ll meet with your anesthesiologist, who will give you a mild sedative before you’re taken to the operating room and put under general anesthesia.

After sterilizing the operating area, we’ll place sterile drapes to frame the abdominal area. Then we proceed with the abdominoplasty.

The steps of your tummy tuck surgery are:

  1. We’ll make the incision and lift the skin and fat off your muscles.
  2. We’ll use sutures to tighten and reshape the abdominal muscles. That allows us to tuck in the waistline and contour your abs.
  3. We pull down the skin and fat and cut off the excess.
  4. We bring your belly button into the correct position and then contour, shape, and sew it into place.
  5. We’ll inject your abdominal muscles with Exparel, a non-opioid local anesthetic that minimizes the postoperative pain from the tummy tuck.
  6. In 90% of the patients, we don’t need to place drains.
  7. Finally, we’ll close and dress your incisions, and put you in protective compression garments.

After your abdominoplasty, you’ll go into the recovery room for 1-2 hours.

Because we inject Exparel to numb the pain, you don’t need heavy painkillers while you recover from your tummy tuck procedure. So, you can usually return home the same day to recover, although you’ll need someone to help take care of you for the first 24 hours.

How to Prepare for your Tummy Tuck?

Here’s a list of the best tips that can help you get ready for your tummy tuck surgery:

  • Try to lose excess weight: Before your abdominoplasty, try to get as close to your ideal weight as possible. That helps your surgeon remove the maximum amount of extra skin and fat from your tummy to give you the best cosmetic results. It also reduces your risk of infection and other postoperative complications.
  • Quit smoking: Smoking restricts your blood flow and increases the risk of wound healing problems and other health complications after your abdominoplasty. Stop smoking, vaping, chewing tobacco, and other nicotine products at least one month before your tummy tuck to avoid complications and improve your recovery period.
  • Stop taking blood-thinning medication: Before your tummy tuck, you’ll need to stop taking Aspirin, anti-inflammatory drugs (ibuprofen), and herbal supplements. These meds can thin your blood and increase your risk of bleeding and bruising.
  • Prepare for your recovery: Arrange for someone to pick you up after your abdominoplasty and help you out around the house for a few days.

Tummy Tuck Recovery - What to Expect?

With the advancements in pain management and surgical techniques, recovery from a tummy tuck surgery is now much easier and smoother than it used to be. Here’s what you can expect during your tummy tuck recovery:

  • Most patients can return home on the same day of the surgery.
  • Within a couple of days, patients can mostly take care of themselves.
  • Within a week, most patients with office-type jobs can be back to work. You may need a little longer if your job requires manual labor.
  • Around six weeks after your tummy tuck, you can get back to working out and heavy lifting.
  • You can see almost 90% of your final results in around two months, and you’ll be ready to get back into your bathing suit.
  • Within a week, most patients with office-type jobs can be back to work. You may need a little longer if your job requires manual labor.
  • You’ll need about six months, sometimes a bit longer, to see the full results of your abdominoplasty. During that time, residual swelling will resolve, and your scars will fade into a lighter colour.

One of the modern pain management strategies at Robert Schwartz Plastic Surgery is Exparel injections. Exparel is a long-acting non-opioid anesthetic that offers pain relief for 2-3 days after surgery.

In addition to Exparel, we use atraumatic surgical techniques and drain-less wound closure. All of these have made recovery from abdominoplasty dramatically easier.   

Blog Articles ON Tummy Tuck

Diastasis Recti (Is a tummy tuck the solution?)

Dr. Robert Schwartz

9/26/2022

Diastasis recti is the separation of the rectus abdominis muscles - usually during or after pregnancy. Diastasis recti can happen when the linea alba is overstretched and cannot return together.

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Can I Get A Mini Tummy Tuck?

Dr. Robert Schwartz

12/17/2019

Dallas plastic surgeon, Dr. Robert Schwartz discusses candidacy for a mini tummy tuck procedure.

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What Kind of Scars Will I Have After my Tummy Tuck?

Dr. Robert Schwartz

11/22/2022

Scars are, in a sense, the price you pay for a tummy tuck. A tummy tuck surgery can tighten your abdominal muscles, remove loose skin, decrease stretch marks, and rejuvenate your belly button.

Read article

Dr. Robert Schwartz, M.D.

Dr. Robert Schwartz is the founder and director of Robert Schwartz Plastic Surgery in Dallas, TX. He is certified by the American board of Plastic Surgery and member of the American Society of Plastic Surgeons. He graduated from the David Geffen School of Medicine at UCLA in Los Angeles, CA and has been in practice for over 20 years. Dr. Schwartz is gifted with a keen eye and the unique skill to visualize you at your best, and he will execute that vision throughout every phase of your treatment to consistmently deliver stunning results. This is what makes him a world-class plastic surgeon.

Tummy Tuck FAQ

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Where will my tummy tuck be performed?

We perform our tummy tucks at a JCAHO-certified ambulatory surgery center.

What is a tummy tuck?

The tummy tuck, or abdominoplasty, is a surgical procedure to tighten lax abdominal wall muscles and remove excess skin and fat.

How soon can I exercise after a tummy tuck?

Most types of exercise can be restarted eight weeks after a tummy tuck. Performing physically strenuous activities earlier than this can impair healing.

When can I drive after a tummy tuck?

Most patients can resume driving 10 days after a tummy tuck.

Where are the scars from a tummy tuck?

All surgical procedures result in scars. The main tummy tuck scar extends across the lower abdomen starting just above the pubic hair. The length of the scar varies from patient to patient but, in most cases, is from hip to hip. We use advanced multilayer incision-closure techniques and custom design each incision to accommodate the clothing styles you prefer. Nonetheless, tummy tuck scars will typically remain visible when you are undressed.

Most tummy tucks also require a small circular scar around the umbilicus (belly-button). We have developed techniques that will often hide this scar inside the belly button and produce a more natural looking “innie.”

Will insurance pay for a tummy tuck?

Some insurers may cover a tummy tuck following massive weight loss. The vast majority of tummy tucks are cosmetic and therefore, not covered.

When can I return to work after a tummy tuck?

Most patients with desk jobs can return to work in 10-14 days. Patients with more physically demanding jobs will require a longer recuperation.

What type of anesthesia will be used for my tummy tuck?

Your tummy tuck will be performed under general anesthesia (i.e. you will be asleep). We use only board-certified physician anesthesiologists.

Who is a candidate for a tummy tuck?

After pregnancy, many women find that their tummies never return to their previous flat contour. The abdomen often bulges forward and is covered by loose, hanging skin covered with stretch marks. These women are excellent tummy tuck candidates as are men and women who experience similar problems after significant weight loss.

How painful is a tummy tuck?

We provide all of our tummy tuck patients with the On-Q pain pump system. The pump bathes the tightened muscles with local anesthetic for several days. This dramatically reduces post-operative pain and lessens the need for narcotic pain medicine. Our tummy tuck patients are usually able to return home several hours after surgery.

Is it ok to laugh after abdominoplasty?

In the first few weeks after a tummy tuck, it's best to avoid anything that causes a forceful contraction of the abdominal muscles. This obviously applies to heavy lifting but also includes sneezing, coughing, straining because of constipation, and vigorous laughter. Any activity that creates a sensation of pulling or tearing should be immediately ceased.

Why doesn't tightening the skin during a tummy tuck cause new stretch marks?

Stretch marks occur when the skin is stretched beyond the limits of its elasticity. A tummy tuck removes excess skin that has already been stretched. The remaining skin is tightened but not excessively. Overtightening would not only cause stretch marks but would also produce an unnatural contour.


How do I know if I need liposuction or a tummy tuck?

Liposuction and tummy tucks (abdominoplasty) are both excellent contouring procedures for the abdomen. But they serve different and complementary purposes:

  • Liposuction primarily removes fat. (The Vaser ultrasonic system I use also tightens the skin but this is a relatively mild effect.)
  • Tummy tucks tighten loose skin and also repair abdominal muscles that have been stretched out (usually from pregnancy.)

So if your abdomen is relatively lean but protrudes outward, you probably need a tummy tuck. Likewise, if you have loose, hanging abdominal skin, a tummy tuck is probably right.

On the other hand, if your skin is relatively smooth and elastic but there is a fat layer you can't get rid of, liposuction is probably the procedure for you.

Of course, sometimes the problem is fat, skin and/or muscle. In that case, both liposuction and a tummy tuck may be needed.

During your consultation, we examine your abdomen carefully and assess you goals to determine which procedure better meets your needs.

Is it normal to have a sore throat after surgery?

Sore throat can happen after surgery. It is usually caused by the endotracheal tube the anesthesiologist uses to help you breath. It is somewhat more common in women than in men. The soreness is usually mild and goes away within a few days. A severe sore throat or one that lasts for more than a few days should be reported to Dr. Schwartz.

Can I donate blood before surgery?

Donating blood causes a temporary anemia. This usually corrects within 1-2 weeks. Nonetheless, we recommend that patients do not donate blood for at least one month before cosmetic surgery.

Some patients have expressed interest in donating blood for their own use, if needed. Since most cosmetic procedures are designed to produce minimal to moderate blood loss, transfusion is almost never needed. While you are, of course, free to self-donate blood, this would almost always be unnecessary.

*Individual results are not guaranteed and may vary from person to person.

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