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Abdominoplasty - Tummy Tuck Risks and Complications



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Possible risks of Abdominoplasty include:

Bleeding (Hematoma) -
pooling of blood from the surgical site
fluid accumulation
Poor wound healing

Sutures or "Spitting a Stitch"
Skin loss
Blood clots -
Deep vein thrombosis, cardiac and pulmonary complications
or other changes in skin sensation
Anesthesia risks
Fat Necrosis -
Fatty tissue that has died off
Looseness of skin
can occur if you are not at your ideal weight

Rectus Diastasis - separation of the muscles at the midline of the belly
Umbilicus (Navel) - malposition, scarring, or loss of the umbilicus might occur


Pubic distortion - distortion of the labia or pubic area might occur

"Dog Ears" or Skin Contour Irregularities
in the lower extremities

Allergic reaction
Possibility of having a revision surgery
Substandard aesthetic result



  • Blood Clots (Deep Venous Thrombosis, Cardiac & Pulmonary Complications)

Blood clots are a risk that is associated with abdominoplasty surgery. Any surgery that involves the use of general anesthesia for longer than 30 minutes carries a high elevated risk of causing internal blood clots. Blood clotting is nature’s way of controlling bleeding after an injury or an incision is made, however; blood clots can become dangerous. When a clot forms inside a blood vessel, it can interfere with your circulation or become lodged in an artery inside the heart, causing a heart attack. Clots can also travel to the brain and can become the cause of having a stroke, as well as the lung in which it would end up being a pulmonary embolism.

At the initial consultation you will be asked to give your medical history along with any and all medication you are taking on a regular basis. It is this information that the surgeon will be able to ascertain whether or not you are at an increased risk of forming blood clots following surgery.

Patients who are at risk of forming blood clots:

  • Women who take birth control pills
  • Women who take Hormone Replacement Therapy
  • Women who are over the age of 40 years
  • Patients who are taking cancer treatments
  • Patients with heart problems
  • Patients who recently have been pregnant

The timeline for developing blood clots after abdominoplasty surgery can vary, however the greatest risk is the first few days following surgery.


Decreasing the risks of blood clots forming in the legs:

  • Take short walks inside your room as soon as you are able after surgery
  • Take short walks outside your home within a week after surgery
  • Avoid all heavy lifting for 4-6 weeks after surgery
  • No vigorous activities (jogging or running) for 4-6 weeks after surgery




Unfortunately sometimes infection happen no matter how careful a surgeon is with keeping their surgical room clean and sterile. Most infections following abdominoplasty procedure is from the patient with failing to care for their incisions properly. As stated so many times before, it is very important to follow your surgeon’s instructions of when and where to change the bandages. More than likely you will have drains which will help with the bleeding and leakage right after surgery. It is the drain incisions sometimes that are culprit with introducing bacteria to this area, so being proactive with any changes to the surgical area is paramount.

Signs to call your surgeon immediately:

  • Fever – temperature of 101 degrees or higher

  • Chills

  • Sweating

  • Excessive pain or redness from the incision site

  • General malaise

  • Drainage from the incision has a greenish tint

  • Bad odor coming from the incision site

  • Draining too steadily

All the above symptoms are signs of an early infection, and if caught early enough, then sometimes all the patient might need is an increase in antibiotics. Infections can cause a delay in wound healing as well as prolong the recovery time for abdominoplasty surgery. Because of the risks that are associated with an infection with this surgery, you need to be in the best of health at the time or the procedure to give you the very best odds.





Skin necrosis results from the loss of skin from a poor blood supply. It is more common in larger operations and smokers. The skin changes coloration from a light red to a darker color over the course of a few days. This skin might blister and peel, and also turn black over a period of a week. Patients who are still smoking and also ex-smokers who newly quit will be at a higher risk for this severe complication. Large scale skin necrosis in abdominoplasty surgery occurs normally lower on the abdomen area and can include the pubic area as well. In smaller skin necrosis cases, areas of the incision will scab over and take a very long time to heal. This complication is very rare in non-smokers.





Fat necrosis occurs when fat cells lose blood flow.  Fat cells are living cells and if there is no blood flow, they may die and cause "fat necrosis".  The liquefied fat cells can harden overtime underneath the skin, causing firmness or contour irregularities.  Surgical intervention might be needed to help alleviate some of the symptoms caused by fat necrosis.





All patients are going to be different with their healing times from any surgical procedure. There are some risks that are considered much higher in abdominoplasty surgery who tend to heal at a slower rate. Age and physical condition of the patient is always going to dictate how someone is going to heal. Of course those patients who exercise are physically fit, and are younger will always bounce back a little bit easier than those patients that were not.

Normal healing time with abdominoplasty is approximately between four to six weeks. Patients that are experiencing pain and severe discomfort beyond that time are considered to be slow healers. Skin necrosis or tissue death is one complication that can occur with patients who do heal slowly. If this does happen, then a skin graft is sometimes needed, which is not a simple procedure. The scarring can also tend to be more pronounced on patients who were slow healing, developing into hypertrophic scars or keloids.

Presence of an infection of course will delay healing time as well, as it depletes the body’s immune resources from closing the wound. So the quicker you have an infection under control, the better off the patient will be.






In rare cases, local allergies to tape, suture material, or topical preparations have been reported.  Systemic reactions which are more serious may occur to drugs used during tummy tuck surgery and prescription medicines. 





Most surgical techniques use deep sutures, which might spontaneously poke through the skin, become visible, or produce irritation that might require removal.  Spitting a stitch can lead to infection if not taken care of.  Make sure you call your surgeon if this happens, so they can remove it with sterile instruments.  Read more about sutures or spitting a stitch here.





Skin laxity might occur after abdominoplasty if the patient is not at their ideal weight before the procedure.  Age does decrease the skin's natural elasticity over time and also the strain of excess body fat can also contribute to your abdominal skin stretching out.  Having an active lifestyle can help your abdominoplasty benefits to last longer.

Another factor to consider is pregnancy.  If a patient ends up having more children after their tummy tuck, more than likely a revision will be needed.  Pregnancy stretches out the skin of the abdomen and also the abdominal muscles will lose their firmness.





Pregnancy or gaining weight can all begin to contribute to the separation of the midline of the abdominal area.  The laxity of these muscles can reduce muscle strength and can cause abdominal sagging.  This condition is known as "rectus diastasis".  Most of the time, if rectus diastasis is caught early, exercise can help alleviate this problem.  However, if the damage is severe, this can only be corrected with surgery.  Endoscopic tummy tuck surgery tightens just the abdominal muscles without removing excess skin.  The benefit of endoscopic tummy tuck surgery is that there are much less visible scars.





Malposition of the navel is a risk that rarely occurs.  The new navel could be placed too high or too low or not in the middle of the torso.  Surgery may be required to move the umbilicus to a more favorable position.

Loss of the umbilicus can happen if the blood supply is compromised or is inadequate after the implantation.  If this should occur, further surgery will be recommended.





The mons-pubis appearing enlarged after abdominoplasty surgery can be due to several factors.  Swelling at the mons pubis area may take longer than the rest of the abdomen to resolve, as this is the most dependent or lowest point of the surgical area.  The swelling of the Mons Pubis can also be from when the surgeon tightens the muscle layers above this area.  This ends up pulling the fatty tissue of the mons together - causing them to "bulge". 

Swelling or bruising in the pubic mound may appear even though no surgery had been performed in this area. This swelling is medically referred to as edema, which is an excess accumulation of fluid. With much swelling post-operatively in the abdominal area, the swelling will generally tend to gravitate downward. Bruising will also move in this direction. With time, this will also subside.

If this enlargement or distortion of this area is not resolved after 3 to 4 months, then  persistent excess fat should be considered.  Reduction of the mons pubis can be achieved through liposuction.  If there is excess skin at the mons pubis then reduction by direct excision is could be recommended.





As with most patients, there might be some differences between the right and left side of their body before any surgery is performed.  Having surgery might not be able to correct this difference.  Having a abdominoplasty or a tummy tuck might not yield perfect symmetry in the body after the procedure. 

There are many factors that are taken into consideration regarding asymmetry:

  • skin tone

  • fatty deposits

  • skeletal make-up

  • muscle tone




Contour and shape irregularities and depressions may occur after a tummy tuck, body lift, or thigh lift. Residual skin irregularities at the ends of the incision or "dog ears" are always possible as is skin pleating when there is excessive redundant skin. "Dog ears" need to be reduced by excision or liposuction or a combination of the two techniques. Depending on the size of the dog ears, treatment can be performed as a minor procedure under local anesthesia.





It is perfectly normal for the skin of the abdomen, navel, genitalia, buttocks and thighs to become inflamed and swollen.  Bruising is also very common, and you could have residual swelling for up to several weeks or months post op.  Minimizing swelling and bruising is important - wearing a compression garment after your abdominoplasty will help tremendously.  Most plastic surgeons want you to wear the compression garment 24 hours a day for several weeks. 

Massaging the areas a few times a day will help reduce some of the swelling.  The skin can become overly dry and itchy after surgery.  Massaging with lotion or a skin moisturizer will help, but it is essential that you keep this lotion out of the area of the surgical incision





There may be some numbness in the lower area of the abdomen area and thighs after a tummy tuck procedure.  In the majority of patients, this numbness will disappear and sensation will gradually return to near normal.  The process of regaining the feeling back may take many months, or even years to complete. 





Fortunately most "bad reactions" to anesthesia are not life-threatening.  However, all forms of anesthesia including the different forms of local, can carry a risk of an allergic reaction.  Anesthesia exposes the body to controlled levels of toxic chemicals in order to make sure there is no pain felt during a surgical procedure.  The main goal of anesthesia is to either stop pain temporarily or to induce a semi-conscious or unconscious state.  Even though anesthesia carries a risk, the benefits outweigh any potential disadvantage.

The most important factor is making sure that whoever administers the anesthesia are board certified in anesthesiology.  By doing this, you reduce the risks of any complication that might arise during surgery.  All body functions and chemistry are monitored during your surgery to ensure a safe procedure.

The most common reaction or danger of having anesthesia is an allergic reaction to one of the medications used.  This is addressed immediately by the attending anesthesiologist by monitoring your vital signs.  If an allergic reaction occurs, your anesthesiologist is equipped to handle this immediately.  Severe allergic reactions during anesthesia are fortunately rare.

It is very important to tell your anesthesiologist every medication you take on a regular basis, so that he can prevent any potential problem during surgery. 

Read more about anesthesia risks and complications





After abdominoplasty there will be some degree of pain and discomfort which can be controlled by narcotic pain medication.  Because of the pain associated with this procedure, it is not uncommon for the surgeon to recommend bed rest for the first few days after surgery.  Keeping the patient's legs slightly bent at the hips will help reduce the amount of strain placed on the abdominal muscles. 

Most surgeons will provide the patient with a compression binder, which will help support the newly tightened areas.  Walking will be instructed to help reduce the chance of blood clots forming.

Some plastic surgeons might recommend the pain pump immediately following surgery, which will help tremendously with the patient managing the pain. 

Read more about the pain pump





The number one reason for slow healing is from patients who smoke or are exposed to second hand cigarette smoke. Because smoking decreases the size of the blood vessels in your skin, less oxygen will get to the surgical area to help promote healing. Larger blood vessels are needed for circulation to carry oxygen to your skin cells. Oxygen speeds up the recovery process, and cigarette smoking depletes these oxygen levels making it more difficult for patients to have a rapid recovery. 

Read more about smoking and cosmetic surgery

Risks of Smoking with Abdominoplasty Surgery:

  • Smoking starves your heart of oxygen
  • Forms blood clots in your veins
  • Difficulty breathing during and after surgery
  • Increase your risk of infection
  • Impair the healing of skin and wounds
  • Change the breakdown of certain drugs in your bloodstream


When you have surgery, the anesthesia that is used puts your body under stress. It has a tendency to lower your resistance to infection, and if you are unconscious, you’re breathing and heart needs to be monitored to prevent problems. If you smoke the body is less able to cope with the stress.

The nicotine that is found in cigarettes increases your heart rate and or course will increase your blood pressure every time you smoke. The heart will therefore work harder because it needs more oxygen. The carbon monoxide in cigarette smoke competes literally for the oxygen in your blood. Nicotine reduces the supply of oxygen to the tissue by up to 15%. Smokers have up to ten times more carbon monoxide in their blood than non-smokers. This makes it harder for oxygen to be carried in your blood stream from your heart to your surgical area; and oxygen is needed in order for the wounds to heal.

It is so important to always make sure you are on the same page with communication with your surgeon during the pre operative and post operative periods. Early intervention on any post op complication is always the best. Experiencing complications on abdominoplasty are rare, as most patients normally sail through this procedure with no problems at all. But because this is major surgery, it is best you know of all the possible things that could possibly go wrong so if you find something happening to you, you will know how to act on it. Good patient – doctor relationships and communication makes for a positive outcome with an easy recovery process.





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