Body
What is it Like to Have a Tummy Tuck?
A tummy tuck, or abdominoplasty, is surgery that can address excess abdominal skin and abdominal-wall laxity, sometimes with liposuction for fat. It involves scars and a staged recovery. Early movement, returning to work and resuming exercise are separate milestones.
In this episode.
Episode summary
A tummy tuck, or abdominoplasty, is surgery that can address excess abdominal skin and abdominal-wall laxity, sometimes with liposuction for fat. It involves scars and a staged recovery. Early movement, returning to work and resuming exercise are separate milestones.
In this July 2, 2020 episode of Plastic Surgery: Before and After, board-certified New York City plastic surgeon Darren M. Smith, MD describes how tummy tuck surgery and follow-up were organized in his practice. He repeatedly notes that arrangements and recovery decisions vary by patient and practice.
Key takeaways
🩹 Understand the scar tradeoff.
Dr. Smith describes a low horizontal scar and a scar around the belly button for the operation discussed. Scars remain even as their appearance changes.
🎯 Plan the early support.
The episode covers anesthesia, the recovery room and postoperative nursing arrangements used in his practice at that time.
🔎 Drains have a purpose.
He explains that drains remove fluid during healing and discusses monitoring before removal.
🩹 Recovery happens in stages.
The conversation separates gentle walking, the initial recovery period, desk work and exercise.
🔎 Appearance continues to evolve.
Swelling and the tissues' adaptation to the new contour take longer than the initial time away from work.
Questions this episode answers
Does a tummy tuck leave permanent scars?
Yes. The episode emphasizes that scars are part of the decision to have surgery. Their location and visibility should be discussed before choosing the operation.
When does Dr. Smith describe returning to work and exercise?
In this 2020 recording, he gives examples of about two weeks before desk work and four to six weeks before regular exercise, while emphasizing individual clearance. These historical examples are not instructions for your own recovery.
When is the final contour apparent?
Dr. Smith explains why the early appearance is not the final result. He describes changes over six months to a year as swelling settles and tissue adapts, rather than promising that everyone follows the same schedule.
Preparation note: Obtain current written fasting, medication, drain-care and activity instructions from your surgical and anesthesia teams. The recording describes an older practice protocol, not instructions to follow independently.
🔗 Related information
Explore tummy tuck information, preparing for plastic surgery, or request a consultation with Dr. Smith in New York City.
Originally released July 2, 2020. Show notes updated September 30, 2026. This is general education. Current recommendations, suitability, risks and expected results require an individual assessment.
Original show notes
Dr. Darren Smith, a board certified plastic surgeon in New York City, taps his tummy tuck experience to give you a sense of what the process is like.
Read the conversation.
[00:08] I'm Board Certified New York City Plastic Surgeon Dr. Darren Smith, and this is Plastic Surgery Before and After. Your source for the real deal about plastic surgery procedures, news about trends in aesthetic medicine, and candid sessions with industry insiders. We hope you enjoy today's episode. What is it like to have a tummy tuck? Well, a tummy tuck or abdominoplasty is one of the most powerful transformative operations that we perform in our practice. And the goal of a tummy tuck or abdominoplasty is to improve the contour or shape of the abdomen. And while this procedure is very popular for women of many different ages and life stages and similarly for men, it is most popular we found by looking at our patient population in women that have finished having children. And that makes sense because Childbearing and pregnancy stretches out the abdominal wall in terms of the abdominal muscles and it can create a rectus diastasis, which is a separation between the two rectus abdominis muscles, which are the vertical paired muscles that form the six-pack. It stretches out the abdominal skin and it can lead to changes in distribution of fat in the abdomen and around the waist. So an abdominoplasty often combined with some liposuction addresses all of these things. Now the abdominoplasty procedure is real surgery.
[01:49] by which I mean it is an invasive procedure and Significant incisions are required and they leave a significant scar specifically There is a scar that generally goes almost from hip to hip and there's also a small scar that goes around the belly button now those scars do fade over time, but there always will be some Scar present so when someone elects to have an abdominoplasty They are essentially saying that it's worth it to them to have These scars in order to have a really awesome abdominal shape and that's a very reasonable decision to make especially because that long Horizontal scar that goes across the waist can almost always be hidden below the underwear line or below the bikini line So that being said an abdominoplasty is generally done under general anesthesia. That means that you're completely asleep. So the process really begins about 12 hours before surgery. At that point, you can no longer eat or drink anything. And then when you arrive for surgery on the day of your procedure, you'll meet with an anesthesiologist. In our practice, we only work with board certified anesthesiologists.
[03:09] And they'll start an IV to give you some medication that will get you relaxed. Then we'll move you into the operating room and you will drift off to sleep. The procedure itself takes approximately two and a half to three and a half hours depending on the size of the procedure and the complexity of the individual case. When you wake up you may feel a little sore but you really won't have much pain at this point as we give you a lot of very powerful numbing medication in the operating room and in fact we can even give you a medication that will make you almost completely numb for 48 to 72 hours. And that's an option that we discuss with our patients before they have the procedure. So when you do wake up, you'll initially feel tight in your abdomen, but not really having that much discomfort. You'll notice that you have two drains. We place them coming out of the horizontal low incision. And you'll really wake up and become less drowsy over the next couple hours.
[04:15] And at that point, you'll be evaluated by our medical staff. And again, this scenario that we're describing here really only applies to how we do things in our practice. And this will vary significantly from practice to practice. But in the case of how we perform our abdominoplasty or tummy tucks, you'll be evaluated and closely monitored in our recovery room. And usually by about two hours or so, you're cleared to leave. If you live in the Manhattan area, you are allowed to go right home. We do require you to spend the evening with one of our nurses and he or she is there to keep you comfortable and to get you used to having had a major surgery and essentially to be my eyes and ears and I'm in communication with him or her throughout the night to make sure that everything is going fine.
[05:08] If you do not live in Manhattan, I do require my patients to spend at least one night in Manhattan after the procedure. And if you live nearby, you can then go home the following morning. However, if you're coming in from out of town, I do like my patients to stay in the New York City area for seven to 10 days after the procedure. But these are recommendations and guidelines that we really determine on a case-by-case basis. In any event, when you do go home or to the hotel that you're staying in, you will find that you are up and walking right away. We do not like people to just lie in bed. And the reason for this is we find that it's important to do these things to prevent several kinds of complications. Most importantly, a venous thromboembolism, which is a blood clot that can form in the legs and go to the lungs and be fairly dangerous. And it also helps your lungs recover so you can get back to breathing normally as rapidly as possible. It has several other health benefits as well. So you will be up and walking around, but you will be walking bent at the waist for the first week or so because things will be quite tight and we don't want to put unnecessary tension on the abdominal repair. So you will be up and walking around and during that first week you really won't be doing much other than gently walking and resting. It's someone else's turn to do tasks around the home so you can kind of enjoy that aspect of things.
[06:49] And it is really during the second week where you start to more or less return to your baseline a little bit more. You start to stand up and walk straight and feel a bit more comfortable. The soreness really probably peaks for most folks at around three days after the procedure. That's when their swelling is peaking and it's when their pain medication is wearing off. But the discomfort is fairly manageable, especially with the medications that we're using. And this is something we have a lot of experience with. So we're able to make it quite comfortable for people. So the first two weeks are basically your initial recovery. And after usually the first week, the first drain can come out and it usually takes an additional week for the second drain to come out.
[07:35] And those drains are there to drain any fluid that your body produces after the procedure. And we don't want that fluid to collect in the abdomen after the surgery because it can theoretically get infected or cause what's called a seroma, which is a fluid collection which, if left untreated, can change the shape of the abdominal contour. So after those first two weeks in general, your drains are out, you're walking straight up. but you're still not up to any major physical activity. Most of our patients, though, that have desk jobs are fairly comfortable to go back to work at the two-week mark. It's really not until four to six weeks after the procedure that we start to clear people to get back to their full regular exercise schedule. And again, this is something that we determine on a case-by-case basis. Now, you will notice a dramatic change in your appearance really right after the surgery.
[08:31] But it takes a good six months to a year to see the final result. And that's because we have to wait for two things to happen. One, your swelling has to go down. And two, your body has to adjust to its new shape. So while we've removed skin and we've suctioned fat and we've sewn the muscles together to repair any rectus diastasis that was present, your connective tissue will then actually contract and conform to your body's new shape. So that process takes several months. So while you'll see a really nice result right away It just keeps getting better for the first six months to a year So while an abdominoplasty or tummy tuck is a significant surgical procedure, it's one that we work with our patients to prepare them for and get them set up to really do excellently and have a very smooth recovery. And we remain in very close contact with them during the recovery process to make sure any and all of their needs are met and they are kept healthy and safe.
[09:32] Thanks for listening, and don't forget to subscribe, share the show, and head over to DarrenSmithMD.com for more real-world plastic surgery talk.
Sources and context.
Original Captivate episode. Original release date: 2020-07-02. The recording is the source for the transcript and episode discussion. Later context in the written summary is identified separately.
Behind the conversation.
Darren M. Smith, MD, FACS