You have probably heard of a tummy tuck, but did you know there are various types of tummy tucks?
Also known as abdominoplasty, a tummy tuck removes excess skin and fat from the abdomen and tightens the underlying muscles. The intended results are a firmer, flatter belly and a slimmer waistline.
The location and amount of redundant skin are especially crucial in determining which tummy tuck procedure is the right choice for you. However, other aspects of your anatomy like skin quality, existing scars, and natural body type are also significant.
If you have undergone massive weight loss, your plastic surgeon will likely recommend an extended tummy tuck.
What Is an Extended Tummy Tuck?
An extended tummy tuck is essentially a standard tummy tuck that’s more extensive. With this technique, the hip-to-hip incision made during a full tummy tuck extends around the hips, allowing the surgeon to remove more excess tissue.
Extended abdominoplasty targets your tummy and flanks i.e., the area on the sides and back of your midsection between your ribs and hips.
In some cases, a vertical incision that runs up the middle of the stomach is also required (Fleur-de-lis tummy tuck) for even more skin removal.
Extended Tummy Tuck Cost
The latest statistics from the American Society of Plastic Surgeons (ASPS) report that the average cost of a tummy tuck is $6,154.
And according to the Institute of Aesthetic Surgery, an extended tummy tuck can cost up to $20,000. That’s because it covers more areas than a mini tummy tuck and full tummy tuck.
Your final cost will depend on factors such as:
- Your surgeon’s expertise and experience: choose a plastic surgeon that’s board-certified by the American Board of Plastic Surgeons (ABPS) to ensure your safety and desired results.
- Where your surgery is performed: tummy tuck costs vary across the country. These costs include hospital and surgical facility costs, surgeon’s fees, anesthesia fees, laboratory charges, medications costs, and costs for post-surgical garments.
- The number of treatments performed: for more comprehensive body contouring, plastic surgeons can combine extended abdominoplasty with other procedures, including liposuction and thigh lift.
- Who administers your anesthesia: during an extended tummy tuck, you’ll be under general anesthesia. Anesthesiologists and nurse anesthetists (CRNAs) are both qualified to administer anesthesia. But the former, who some surgeons prefer to work with, charge higher fees.
An extended tummy tuck is a cosmetic procedure, so your health insurance will typically not cover it. However, if combined with hernia repair, your insurance may help pay for some of the costs, including anesthesia and surgical facility fees.
Find out if your plastic surgeon offers any financing options and which payment plans (e.g., CareCredit) are accepted.
How Does an Extended Tummy Tuck Work?
When someone loses a significant amount of weight, significant amounts of saggy skin will likely result. The excess skin usually hangs from their stomach and extends to the hip and back areas. It also affects the lateral thighs.
In this case, a standard tummy tuck is not the best option since it only contours the front half of your upper body. An extended abdominoplasty, on the other hand, will address the excess skin on your abdomens as well as your sides and back.
The procedure also tightens abdominal muscles and repositions the belly button. Your plastic surgeon will achieve all this through a horizontal incision that’s longer than a standard tummy tuck incision and an incision around the navel.
An extended tummy tuck targets your:
- Upper abdomen
- Lower abdomen
- Lateral thigh
Are There Any Risks or Side Effects?
As with any other surgical procedure, an extended tummy tuck poses various risks. But if performed by a board-certified plastic surgeon, the surgery is generally safe.
Common side effects most patients experience include swelling, bruising, pain, temporary numbness, and fatigue.
According to one study, abdominoplasty has a higher rate of major complications than other cosmetic plastic surgery procedures. The study, published in the November 2015 issue of the ASPS journal Plastic and Reconstructive Surgery®, analyzed 25,478 tummy tucks performed between 2008 and 2013.
The researcher found that major complications occurred in 4% of patients who underwent abdominoplasty compared to 1.4% who had other cosmetic surgery procedures.
These complications included hematoma, infection, and blood clots (venous thromboembolism). Your plastic surgeon will discuss these and other potential complications of an extended tummy tuck before you consent to have one.
The study also showed that combining abdominoplasty with other procedures increases the risk of complications. Other risk factors identified included obesity, male sex, and being older than 55.
Preparing for Extended Abdominoplasty
You’ll initially have a consultation with a plastic surgeon to discuss various aspects of extended abdominoplasty, including its benefits and potential risks.
The surgeon will also examine your midsection to determine if it’s the appropriate treatment for you and take photos for your medical record.
Expect to answer questions about your health, expectations of surgical outcomes, and lifestyle. The consultation is also the time to ask your plastic surgeon questions to ensure that you fully understand the procedure and any risks.
Your plastic surgeon will also tell you how to prepare for an extended tummy tuck. For instance, your doctor may ask you to:
- Quit smoking for a certain period
- Eat a healthy, balanced diet to promote healing
- Stop taking some medications (e.g., aspirin) and dietary supplements that thin your blood
- Take certain medications to help prevent complications, such as blood clots
During an extended tummy tuck, you will receive general anesthesia, which will make you completely unconscious during the surgery. Your surgeon will then:
- Make a horizontal incision along your abdomen at about the same level as your pubic hairline. The incision will extend to the back of your hip bones. How far it extends depends on the amount of extra skin.
- Lift the abdominal skin to reveal and tighten the abdominal muscles by bringing them together in the midline using sutures. The belly button remains attached to the abdominal wall at all times.
- Pull and smooth the skin down, then create a new opening for the belly button in the midline and suture it in its original position.
- Trim the excess skin and close the incision using dissolvable sutures.
The procedure will take place in an office-based surgical facility, ambulatory surgical center, or hospital.
Remember to make plans for someone to drive you home and stay with you at least the first night after the surgery.
After your extended tummy tuck, you will have bandages over your incisions. Your surgeon may also ask you to wear a compression garment or abdominal binder for about six weeks to reduce swelling and offer support during recovery.
Small surgical drains may be placed under your skin near the surgical site to prevent fluid accumulation. The drains are usually removed a few days after surgery.
There are board-certified plastic surgeons like Mark D. Epstein that use a suturing technique that restricts fluid accumulation, eliminating the need for surgical drains.
You will be given specific instructions before going home, which will include:
- How to care for your wound, dressings, and drains
- How long you should wear the compression garment
- What medication to take or apply and when
- The best way to sit or lie down
- Do’s and Don’ts during tummy tuck healing.
- How to bathe
- When you can resume normal activities and exercise
- When to return for a follow-up appointment
It’s normal to experience pain after surgery, so your doctor will prescribe pain medication as needed. Swelling and bruising are also to be expected but will usually go away in about six weeks.
You initially won’t be able to stand fully upright due to significant tension at your waist. It may take a week or two until you’re able to stand up straight with minimal effort. But until then, don’t force it.
You will require at least two weeks of downtime before you can return to light activity. And should stay clear of strenuous activity for up to six weeks or as long as your surgeon sees fit.
Walking is, however, encouraged immediately to increase blood circulation and reduce the likelihood of blood clots forming. Your surgeon may also prescribe blood thinners for a short period for the same reason.
Because extended abdominoplasty removes significant excess skin and fat, you will immediately see a massive improvement despite the swelling. As the swelling subsides, your results will become more noticeable.
You will see your final results six months or more after the procedure. Ideally, your extended tummy tuck will result in a smoother and more toned abdomen.
According to another study, all 25 patients who underwent an extended abdominoplasty reported being extremely satisfied with their results.
The results should be long-lasting as long as you maintain a stable weight, which will require maintaining a healthy lifestyle.
An extended tummy tuck results in a horizontal scar that extends to the back of your hip bones. So if someone views your body posteriorly, they will see the scar’s tail ends.
The scar is permanent but will eventually fade, becoming barely noticeable. Most underwear and swimsuits should easily conceal it.
Your surgeon will give you detailed scar management instructions to prevent abnormal scar formation. For instance, you should not subject your surgical incisions to excessive force during recovery.
Unlike a traditional tummy tuck, which only targets excess skin and fat on the abdomen, an extended tummy tuck also addresses the flanks, resulting in more skin removal.
Extended abdominoplasty, therefore, costs more and requires a longer recovery period.
- Mark D. Epstein (n.d). Extended Abdominoplasty. epsteinplasticsurgery.com/procedures/body-procedures/abdominoplasty/guide-abdominoplasty/extended-abdominoplasty
- Cleveland Clinic (Dec 30, 2020). ominoplasty (Tummy Tuck). my.clevelandclinic.org/health/treatments/11017-abdominoplasty-tummy-tuck
- American Board of Cosmetic Surgery (n.d). Tummy Tuck Guide. americanboardcosmeticsurgery.org/procedure-learning-center/body/tummy-tuck-guide/
- American Society of Plastic Surgeons (n.d). Tummy Tuck (Abdominoplasty). plasticsurgery.org/cosmetic-procedures/tummy-tuck
- Realself (September 1, 2020). Tummy Tucks: Everything You Need to Know. realself.com/surgical/tummy-tuck