All Procedures
Extended Abdominoplasty: Extended Tummy Tuck
Useful information for patients on Extended Abdominoplasty (Extended Tummy Tuck) procedures
What Is an Extended Abdominoplasty?
An extended abdominoplasty, or extended tummy tuck, is a commonly performed body-contouring procedure designed for patients whose excess skin and tissue extend beyond the front of the abdomen into the flanks and lateral waist.
Like a standard tummy tuck, the procedure removes excess abdominal skin and fat and may include repair of abdominal wall laxity or rectus diastasis. The primary difference is that the incision and skin excision extend farther around the sides of the body, allowing more extensive treatment of loose skin along the flanks and improving the transition between the abdomen, waist, and hips.
This procedure is particularly useful for patients who have experienced significant weight loss, pregnancy-related changes, or substantial fluctuations in weight and have more extensive skin laxity than can be adequately treated with a standard tummy tuck.
Liposuction is frequently combined with an extended abdominoplasty when appropriate to further contour the abdomen, waist, and flanks.
The belly button typically remains attached to its underlying stalk and is brought through a new opening in the redraped abdominal skin. When abdominal wall laxity or rectus diastasis is present, tightening of the abdominal fascia may also be performed.
An extended abdominoplasty should not be confused with a lower body lift. An extended tummy tuck treats the abdomen and extends laterally into the flanks, while a lower body lift involves a circumferential incision and addresses excess tissue around the entire lower torso, including the posterior trunk, buttocks, and lateral thighs.
Who Is It For?
Extended abdominoplasty may be appropriate for patients who:
- Have significant excess or loose abdominal skin
- Have skin laxity that extends from the abdomen into the flanks or lateral waist
- Have experienced significant weight loss, including after bariatric surgery or medical weight-loss treatment
- Have abdominal wall laxity or rectus diastasis
- Have residual skin and tissue excess that would not be adequately corrected with a standard tummy tuck
- Are at or near a stable, healthy weight
- Are in good overall health
- Do not smoke or use nicotine, or are able to discontinue nicotine as directed before and after surgery
- Have realistic expectations regarding the longer scar required for more extensive contour correction
The principal trade-off of an extended tummy tuck is a longer incision and scar in exchange for the ability to remove more extensive skin laxity and achieve a smoother contour of the abdomen and flanks.
An extended abdominoplasty is a body-contouring procedure and is not a substitute for weight loss.
Extended Tummy Tuck vs. Standard Tummy Tuck vs. Lower Body Lift
- A standard tummy tuck primarily addresses excess skin and abdominal wall laxity of the front of the abdomen.
- An extended tummy tuck carries the incision farther around the sides of the body to treat more significant skin laxity extending into the flanks and lateral waist.
- A lower body lift or belt lipectomy extends circumferentially around the torso and is intended for patients with significant skin laxity involving not only the abdomen and flanks but also the lower back, buttocks, and lateral thighs.
The appropriate procedure depends on the distribution of loose skin, previous weight loss, body shape, scar tolerance, and the patient’s individual goals.
Preparation
Preparation typically includes:
- A detailed medical history and physical examination
- Preoperative laboratory testing as indicated
- Additional medical or cardiac evaluation when appropriate based on age and medical history
- Maintaining a stable weight before surgery
- Discontinuing nicotine before and after surgery according to your surgeon’s instructions
- Reviewing prescription medications, over-the-counter medications, vitamins, supplements, and weight-loss medications with your surgical team
- Temporarily discontinuing medications or supplements that may increase surgical risk when medically appropriate
Patients who have experienced significant weight loss may also require assessment of nutritional status before extensive body-contouring surgery, as adequate nutrition is important for wound healing.
Specific fasting and medication instructions will be provided by the surgical and anesthesia team.
Useful Information
Ensure you consider all aspects of a procedure. You can speak to your surgeon about these areas of the surgery in more detail during a consultation.
Length
How Long Is the Procedure?
Operative time varies depending on the extent of skin removal, abdominal wall repair, liposuction, previous surgery, and whether additional procedures are performed. May range around 5-6 hours.
Anesthesia
Do I Need Anesthesia?
Extended abdominoplasty is typically performed under general anesthesia.
Inpatient/Outpatient
Is The Procedure Inpatient or Outpatient?
The procedure may be performed on an outpatient basis in appropriately selected patients. An overnight stay may be recommended depending on the extent of surgery, combined procedures, medical history, and individual circumstances.
Temporary surgical drains may be used depending on the surgical technique and extent of the procedure.
Additional Information
Temporary effects may include:
- Swelling and bruising
- Tightness or a pulling sensation
- Temporary numbness or altered skin sensation
- Discomfort or soreness
- Fluid accumulation
- Fatigue during early recovery
Because an extended tummy tuck involves a longer incision and more extensive tissue removal than a standard tummy tuck, swelling and recovery may also be more extensive.
Potential risks include:
- Bleeding or hematoma
- Infection
- Seroma or fluid accumulation
- Delayed wound healing or wound separation
- Skin or fat necrosis
- Unfavorable, widened, or asymmetric scarring
- Temporary or persistent changes in skin sensation
- Contour irregularities or asymmetry
- Umbilical healing problems
- Deep vein thrombosis (DVT)
- Pulmonary embolism
- Anesthesia-related complications
- Need for revision surgery
The longer incision associated with an extended tummy tuck creates a longer permanent scar. Every effort is made to position the scar as favorably as possible, but scar position and quality vary according to anatomy, the amount of tissue removed, skin quality, healing characteristics, and postoperative care.
Surgical risks cannot be eliminated, but they can be reduced through appropriate patient selection, nicotine avoidance, optimization of medical conditions, careful surgical planning, early postoperative mobility, and adherence to postoperative instructions.
Recovery varies according to the extent of surgery and whether liposuction, abdominal wall repair, or other procedures are performed at the same time.
Patients are encouraged to begin gentle walking soon after surgery to promote circulation and reduce the risk of blood clots. Because of tightness in the abdomen, patients may initially walk slightly flexed and gradually return to a fully upright posture as healing progresses.
Many patients require approximately two weeks before returning to desk-based work, although recovery time varies. Jobs involving significant physical activity or lifting generally require a longer period away from work.
Strenuous exercise, heavy lifting, and activities that place excessive tension on the incision or abdominal wall should be avoided during early healing and gradually resumed according to your surgeon’s instructions.
A compression garment may be recommended for several weeks to provide support and help control swelling.
Pain is generally managed with a postoperative pain-control regimen tailored to the individual patient. Early gentle walking is encouraged, while strenuous activity should be avoided until cleared by the surgical team.
During early recovery, patients may be advised to sleep on their back with the upper body and knees slightly flexed to reduce tension on the abdominal incision. Specific positioning instructions may vary depending on the procedure and should follow the recommendations of the surgical team.
An extended abdominoplasty can provide:
- A flatter and firmer abdominal contour
- Removal of more extensive loose or hanging abdominal skin
- Improved contour of the flanks and lateral waist
- Better transition between the abdomen, waist, and hips
- Improved abdominal wall contour when rectus diastasis or abdominal wall laxity is repaired
An improvement in body contour is visible after surgery, but swelling initially obscures the final result. The contour becomes progressively more defined over several months as swelling resolves and the tissues settle.
Scars are permanent but typically fade and mature over time. Scar maturation may continue for 12 months or longer.
Results can be long-lasting when a stable weight and healthy lifestyle are maintained. Significant weight fluctuations or future pregnancy may stretch the tissues and alter the surgical result.
Please note: Individual results vary based on anatomy, amount and distribution of skin laxity, skin quality, previous surgery, weight stability, and overall health. Consultation with a board-certified plastic surgeon is necessary to determine whether a standard tummy tuck, extended tummy tuck, or lower body lift is the most appropriate procedure.