Author: Dr. Carfagna Rocco

Date: 10/06/2020

Abdominoplasty or a "tummy tuck" consists in the removal of a strip of adipose and cutaneous tissue located in the abdominal region in order not to reduce weight but to surgically firm the abdominal muscle wall.

This procedure gives the abdomen a firmer, flatter and more harmonious appearance. Diet and exercise alone cannot produce this result because this situation is often accompanied by diastasis of the right abdominal muscles with the associated weakening of the abdominal wall. Stretch marks, when applicable, and if present, are removed with the excess skin. Stretch marks present on the remaining skin of the abdomen will be improved by stretching the upper umbilical region but will not be eliminated.

A permanent scar will always remain after surgery, which, depending on the type of procedure, may also extend from one iliac spine (hip bone) to the other.
The best candidate for abdominoplasty is a healthy man or woman,who has a large accumulation of fat and/or excess abdominal skin (pendulous abdomen), which cannot be improved with diet and exercise. Sometimes, instead of a formal abdominoplasty, a less complex procedure may be indicated, called "mini-abdominoplasty", possibly combined with liposuction, or a single liposuction where there is not a clear "pendulous abdomen" but an excess of adipose tissue.
In any case, the situation should therefore be carefully examined by an experienced surgeon. Surgery is particularly indicated for patients who, after several pregnancies, have excessively "stretched" the skin and abdominal muscles in an irreversible way.

This type of surgery is performed under spinal, or general  anaesthesia (i.e. completely asleep), performed by an anaesthetist in the operating theatre. A certain amount of fluid will be administered intravenously during the operation and sometimes even the next day. Afterwards it will be possible to return to a regular diet. The operation takes about 3–4 hours. The pain is generally moderate and well-controlled with the usual painkillers available, both in hospital and at home.

After surgery, patients should rest for 24–48 hours and then get up to walk (small walks). For a few days, the feeling of tension in the abdomen will force you to "bend forward", and coughing, sneezing and all other activities involving tension in the abdominal muscles may cause discomfort and slight pain. It is recommended not to lie on your abdomen for two weeks (sleeping in a prone position).

A recent case of mine is that of Serena, a 30-year-old woman who, after two pregnancies, had very loose and stretchy skin on her abdomen even though she went to the gym and had a healthy diet.

During her first pregnancy, about 10 years ago, Serena was very careful to take care of her skin because her mother, years before, had been forced to have an abdominoplasty following her last child.
Serena had immediately applied specific creams to firm up her skin and went to the pool on the advice of friends who said it would be good for her.
Despite taking precautions, she still developed a lot of stretch marks and after the birth the skin on her abdomen was very stretchy and sagging.

After her second pregnancy, the situation was worse and although Serena had a balanced lifestyle of healthy eating and regular physical activity, her abdomen did not improve. After a few years she then began to consider making an appointment with a plastic surgeon.
She came to my office thanks to a friend of mine, a patient: Serena had been pleasantly impressed by the breast augmentation surgery I had given her friend and accompanied her to a check-up to meet me in person.

Serena had considered her options very carefully because she told me that she had also seen the unconvincing results of other cosmetic surgeries on friends who had gone to clinics offering special promotions. For this reason, she had preferred to wait and choose carefully which doctor to go to.

After the first meeting during her friend's check-up, Serena decided to make an appointment and the following month she came to my office for a visit. We talked at length about her problem, her expectations and her reasons for seeing a specialist.

After a thorough examination of her abdomen, which showed evident tissue ptosis and severely bruised skin, I decided that the best choice for Serena's situation was abdominoplasty.

Even though she agreed that surgery was necessary, she still had some fears related to the fact that the abdominoplasty her mother had undergone a few years earlier in a public facility had not produced good results at all.
I explained to her in detail the procedure and the costs of the surgery, informing her of the invasiveness of the operation and the scar that would be left. I clarified all her doubts and reassured her about the expertise that my team and I would be using in the phases before, during and after the surgery.

Serena trusted me, accepted my advice and we decided together to wait a few months to carry out the abdominoplasty so that she could reach her target weight and lose a few extra kilos through diet and exercise.

The operation took place under spinal anaesthesia with sedation and lasted two and a half hours. The next day Serena left the clinic and went home. After 4 days we removed the drainage, the only element which caused her a slight discomfort.

Serena told me in amazement that she didn't feel any pain and, even though only a few weeks have passed since the surgery, she is already happy with the results. She knows that it will improve in the coming months, that she will have to have further check-ups and that she will have to follow some advice such as applying a specific cream to improve the scar, but she is definitely satisfied with her choice to undergo the surgery.

Carfagna Rocco


Dr. Carfagna Rocco

Medical Surgeon
Salerno (Italy)

Profile Contact

Ask a free consultation to the author

Dr. Carfagna Rocco

Related articles


Mini-abdominoplasty is a variation of abdominoplasty (tummy tuck), the surgery that reshapes the abdomen. The mini-abdominoplasty gets rid of...


Men with persistent "too much flab" or excess skin on the abdomen that does not go away with diet and exercise may require abdominoplasty surgery...

(maximum 1000 characters)

Comment on the article