What is Abdominoplasty (Tummy Tuck)

A tummy tuck is more than just a cosmetic fix. For many people, it’s the final step in reclaiming comfort, mobility, and confidence after pregnancy, significant weight loss, or the natural effects of aging.

The goal isn’t to create a “perfect” stomach — it’s to bring your body back into better balance, so clothes fit better, movement feels freer, and your core is supported.

Why People Choose a Tummy Tuck

Even with a healthy lifestyle, some people struggle with loose skin and separated muscles that no amount of diet or exercise can fix. This is especially common after pregnancy or weight loss, where the skin’s elasticity has been stretched beyond recovery.

Others experience skin folds that rub, cause rashes, or make clothes difficult to wear comfortably. That’s where a tummy tuck can help.

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A tummy tuck can:

• Remove excess, sagging skin
• Tighten separated or weakened abdominal muscles (diastasis recti)
• Improve posture and core support
• Reduce lower back pain
• Prevent irritation in skin folds
• Enhance confidence and body image
• Minimize some stretch marks below the belly button
• In some cases, improve mild urinary incontinence by reinforcing pelvic support

Pros and Cons at a Glance

Pros

• Creates a flatter, firmer abdominal contour
• Removes loose skin and some stretch marks
• May improve posture, core strength, and mild urinary incontinence
• Can be combined with liposuction or other procedures
• Results are long-lasting if your weight stays stable

Cons

• Major surgery with several weeks of downtime
• Permanent scar (usually low, hip-to-hip; a vertical scar may be needed in some cases)
• Higher complication rate than many cosmetic procedures
• Not a weight-loss procedure — it doesn’t remove internal (visceral) fat
• Can be costly, and often not reimbursed unless medically indicated

Who Is a Good Candidate?

You may be a good candidate for abdominoplasty if:

• You have loose or sagging abdominal skin that won’t improve with diet or exercise
• You have excess fat deposits with poor skin elasticity
• You have muscle separation (diastasis recti) from pregnancy or weight fluctuations
• You’re in good general health and can avoid smoking before and after surgery
• Your BMI is ideally under 30–34 (higher BMIs increase risk and may require a staged plan)
• You’re not planning a future pregnancy, which could reverse your results
• You have realistic expectations and understand where scars will be placed

A tummy tuck does not remove visceral fat — the deep fat around internal organs — so if that’s a major contributor to your abdominal shape, some roundness may remain.

If you’re wondering whether you qualify for a tummy tuck, speaking directly with an experienced surgeon can help you understand your options and set realistic expectations. Browse trusted providers →

Preparing for Surgery

Getting ready for surgery properly can help improve your comfort and recovery.

Before surgery:

• Stop smoking at least 4–6 weeks before and after surgery — nicotine reduces blood flow and impairs healing.
• Keep your weight stable for a few months beforehand.
• Set up your home: prepare a recovery area where you can lie slightly bent at the waist, stock up on meals, and keep essentials close by.
• Arrange help for childcare, pets, and chores during the first week.
• Buy recovery items in advance: compression socks, loose clothing, extra pillows, and (if possible) a spare post-op garment.

In Belgium, if your surgery is medically indicated — for example, due to skin irritation or hygiene problems from excess skin — your mutualité/mutualiteit may reimburse part of the cost.

How the Procedure Works

A full tummy tuck typically takes 2–4 hours and is done under general anaesthesia.

Step-by-step:

1. Incision — A low horizontal incision is made just above the pubic area, where it can be hidden by underwear. In cases of extreme skin excess, a vertical incision may be added.
2. Skin and fat separation — The skin and fat are lifted from the abdominal wall.
3. Muscle repair — If the abdominal muscles have separated, they are stitched together for better core support.
4. Skin removal — Excess skin is trimmed, and the remaining skin is pulled down.
5. Belly button repositioning — The belly button is preserved, but a new skin opening is created for a natural appearance.
6. Liposuction (optional) — Some surgeons add liposuction to contour the waist.
7. Closure — Incisions are closed, and a compression garment is applied. Drains may be placed for several days.

Techniques vary between surgeons, so it’s helpful to review before-and-after photos before choosing your provider.

Techniques differ from one specialist to another, so it’s worth seeing examples of their work before deciding.
See experienced abdominoplasty providers →

Variations and Techniques

Your surgeon may recommend one of several approaches:

• Mini abdominoplasty – For loose skin limited to below the navel.
• Full abdominoplasty – Tightens both upper and lower abdomen, with belly button repositioning.
• Fleur-de-Lis abdominoplasty – Removes skin both vertically and horizontally; often used after major weight loss.
• Panniculectomy – Removes a large “apron” of skin and fat, mainly for functional or hygiene reasons.
• Mons pubis lift – Tightens and reshapes the area above the pubic bone.
• Hourglass abdominoplasty – Combines muscle repair, skin removal, liposuction, and fat grafting to hips/buttocks.
• Mommy makeover – Combines tummy tuck with other post-pregnancy procedures (e.g., breast lift, liposuction).
• Drainless tummy tuck – Uses specialised stitching to avoid drains; recovery comfort may improve, but procedure time is longer.

Abdominoplasty vs. Liposuction vs. Mini Abdominoplasty

While all three can improve abdominal contour, they target different issues:

• Liposuction – Removes fat but does not tighten skin or repair muscles. Best for firm skin and strong abdominal muscles.
• Mini abdominoplasty – Focuses on the lower abdomen only. Removes excess skin below the belly button, may tighten lower abdominal muscles, and typically involves a shorter scar and faster recovery than a full tummy tuck.
• Full abdominoplasty – Removes excess skin and repairs muscle separation across the entire abdomen, often with belly button repositioning. Best when skin is loose or muscles are weak in both upper and lower abdomen.

Many patients benefit from a combined approach — for example, liposuction with a mini or full abdominoplasty — to address fat, skin, and muscle in one operation.

Non-surgical methods such as tightening creams, wraps, or abdominal binders can improve skin tone slightly but cannot remove excess skin or repair separated abdominal muscles. For significant changes, surgery is the only reliable option.

Not sure if you need a mini or full tummy tuck?
‍Learn more about the mini tummy tuck and see if it’s the better fit for your needs.
Read about the mini tummy tuck →

Possible Complications of Abdominoplasty

Abdominoplasty is a major operation. While most patients recover well, complications can occur even with the best surgical technique. Being informed helps you recognise issues early and understand what can be done.

Common or moderate complications:

• Seroma – fluid build-up under the skin; may require aspiration or temporary drains.
• Hematoma – a collection of blood under the incision; may require drainage.
• Infection – usually managed with antibiotics; severe cases may need surgical cleaning.
• Delayed wound healing – more likely in smokers, diabetics, or patients with poor circulation.
• Poor scar quality – widened, thickened, or pigmented scars; scar revision may be needed.
• Temporary numbness or tingling – typically in the lower abdomen; often improves over months.
• Contour irregularities – uneven skin or fat distribution, especially if combined with liposuction.
• Asymmetry – slight differences in scar position, contour, or muscle repair between sides.

Less common but serious complications:

• Umbilical necrosis – loss of blood supply to the belly button, leading to partial or complete tissue loss; reconstructive surgery may be required.
• Skin necrosis – death of skin along the incision, usually in smokers or after excessive tension; may require wound care or revision.
• Deep vein thrombosis (DVT) – blood clots in the legs.
• Pulmonary embolism (PE) – a clot that travels to the lungs; can be life-threatening.
• Persistent pain or tightness – rare, but may require physical therapy or nerve treatment.
• Anaesthesia-related complications – including allergic reactions or breathing issues.

Revisional surgery:
Some patients may require a secondary procedure to improve contour, correct asymmetry, or revise scars. This is more common after massive weight loss or when healing is complicated.

How to reduce your risks

• Stop smoking at least 4–6 weeks before and after surgery.‍
• ‍Choose a board-certified plastic surgeon with extensive tummy tuck experience.
• Follow your surgeon’s pre- and post-operative instructions exactly.
• Maintain a stable weight and good nutrition before surgery.
• Use compression garments and start gentle walking early to improve circulation.

Your choice of surgeon matters more than any technique or tool. Compare credentials, results, and patient feedback before committing.
Explore our vetted plastic surgeons →

Recovery and Aftercare

Recovery is a gradual process:

Week 1:

• Expect swelling, tightness, and need for assistance with daily tasks.
• Walk slightly bent at the waist; wear your compression garment 24/7.
• Pain and tightness are usually most noticeable in the first 48–72 hours and gradually improve over the next two weeks. Muscle repair often causes a feeling of stiffness or pulling when standing upright, which eases as tissues heal.
• Short walks help circulation and reduce clot risk.

Weeks 2–4:

• You may stand straighter and move more comfortably.
• Light daily activities resume; avoid lifting anything heavy (including children).
• Driving is usually possible after you stop prescription pain medication.

Weeks 4–6:

• Most return to work (non-physical jobs).
• Gradual return to low-impact exercise.

After 6 weeks:

• Heavier exercise and core workouts may resume if cleared by your surgeon.
• Scars begin to fade; continue your scar care routine.

Long-term:

• Swelling can take 6–18 months to fully resolve.
• Emotional ups and downs are normal — arrange support in advance. Having entertainment, books, or light activities ready can help pass the time during the early recovery days. Stay connected with friends or family for conversation, even remotely, to avoid feeling isolated. Knowing that these mood changes are temporary can make them easier to handle.

Recovery support and guidance are part of a good surgical journey — the right provider will guide you from day one.

Recovery support and guidance are part of a good surgical journey — the right provider will guide you from day one.
Connect with Belgian tummy tuck specialists →

Results and Longevity

A tummy tuck can restore abdominal shape and improve comfort.

• Scars: Usually placed low and hidden by underwear/swimwear; may extend further if large amounts of skin are removed. A vertical scar is sometimes necessary. Some surgeons use a simple “pinch test” during consultation — pinching the loose skin to show exactly where the scar will sit and how long it might be — so you can visualise the result in advance.
• Duration: Results can last 10–20 years with stable weight and healthy lifestyle.
• Special considerations: Pregnancy after tummy tuck is safe but may reverse results; male patients often seek tummy tuck after massive weight loss; hernia repair can be performed at the same time.

Scarring After Abdominoplasty

A tummy tuck always leaves a scar because the procedure requires surgical incisions. The main scar usually runs low across the lower abdomen, from hip to hip, placed so it can be hidden under underwear or swimwear. In cases of significant skin removal (e.g., after massive weight loss), a vertical scar may also be necessary.

How Scars Evolve Over Time

• Early phase (0–6 weeks): The incision is closed with fine sutures, and the scar looks red or pink, slightly raised, and firm. This is part of normal wound healing.
• Maturation phase (6 weeks – 12 months): The scar slowly softens, flattens, and fades in colour. Some patients develop thicker, more prominent scars (hypertrophic or keloid), particularly if they have a genetic tendency.
• Long-term: Most scars fade considerably within 12–18 months but rarely disappear entirely.

What Studies Show About Scar Position and Appearance
A large clinical review of 310 abdominoplasties found that most scars were positioned about 5–6 cm above the vulvar crease — low enough to be hidden by most underwear or swimwear. Patients preferred these lower scars, and surgeons can plan their position carefully during preoperative markings, usually with the patient standing.
Symmetry matters too: uneven scar height from one side to the other was a common source of dissatisfaction. Checking alignment during closure helps ensure both sides are level.
The study also found that scars placed under less tension and shaped to follow the body’s curves tended to heal finer. High-tension closures, on the other hand, were more likely to widen over time. About 6% of patients eventually had scar revision, typically for widening or malposition, usually after the scar had matured for at least one year.

Factors Influencing Scar Quality

• Genetics (family history of raised scars or keloids)
• Skin type and colour (darker skin may have higher risk of hyperpigmentation or keloids)
• Tension on the incision during healing
• Infections, wound separation, or poor blood supply
• Smoking, diabetes, or poor nutrition, which can slow healing

Scar Prevention and Care

• Follow your surgeon’s wound care plan closely.
• Keep the incision clean and dry during early healing.
• Wear your compression garment as instructed to limit swelling and support flat scar formation.
• Avoid stretching or straining the incision for at least 6 weeks.
• Protect scars from sun exposure for 6–12 months to avoid darkening.
• Apply silicone gel sheets or topical silicone early, once the incision has fully closed, to help flatten and soften scars.
• Gentle scar massage, when approved by your surgeon, can improve flexibility and texture.

When to Seek Medical Advice
If you notice persistent redness, swelling, itching, pain, or thickening of the scar, consult your surgeon. Early intervention can prevent a minor scar problem from becoming permanent.

Treatment Options for Prominent Scars

• Steroid injections – help flatten thick or raised scars.
• Laser therapy – fractional CO₂ or Er:YAG lasers improve texture and flexibility; pulsed dye lasers reduce redness.
• Microneedling – mechanical collagen stimulation, sometimes combined with PRP, to soften and smooth scars.
• Laser resurfacing – fractional CO₂ or Er:YAG treatment to remodel scar tissue and blend it with surrounding skin.
• Scar revision surgery – removes and re-closes the scar for a finer result, usually after one year.

While scars are a permanent part of abdominoplasty, careful prevention, precise surgical technique, and, if necessary, professional treatments can make them far less noticeable over time.

The way your scar heals depends not only on aftercare but also on your surgeon’s technique and attention to detail during closure.
Find Belgian tummy tuck surgeons known for excellent scar placement →

Cost of Tummy Tuck in Belgium

Typical price ranges:

• Mini tummy tuck: €2,400–€2,900
• Full tummy tuck: €4,000–€5,500
• Fleur-de-Lis: €6,000+

Prices often include the surgeon’s fee, clinic costs, anaesthesia, post-op garment, and initial follow-ups.

If your procedure is medically indicated (e.g., severe skin overhang causing hygiene problems), your mutualité/mutualiteit may reimburse part of the cost.

Fees vary widely, so it’s smart to review several offers and understand exactly what’s included. Compare trusted clinics near you →

FAQ about Tummy Tuck (Abdominoplasty)