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Earlier this month I had the opportunity to discuss abdominoplasty, more commonly know as the tummy tuck, live in San Francisco on KRON4’s Body Beautiful. The show is half an hour long, so I will break it up into smaller themed segments. Look for it here in the near future.

Tummy tuck before and after pictures. All three layers (skin, fat and muscle) of the abdomen are improved. Click on picture for more examples.

Many common tummy tuck questions came up during the show and even more questions were raised afterwards from the audience and in the emails that followed. The most common question asked was, “Who needs a tummy tuck?” I would like to share some of the reasons people have tummy tucks here.

First the disclaimer, when I answer general questions the answers are generally true; however, sometimes specific situations arise with an individual that leads to a different answer. While what you read on the San Francisco Plastic Surgery Blog, or on my personal web site ( is carefully designed to provide you with the information needed to learn about plastic surgery, it is important to actually see a Board Certified Plastic Surgeon before any specific course of action can be recommended. Every patient is different, and consequently every operation is different. A vital ingredient for a beautiful plastic surgery result is individualizing the plan to suit your specific needs.

Who needs a Tummy Tuck?

A tummy tuck tightens the abdominal wall. It improves three layers: the skin, the fat, and the muscle. The ideal candidate for a tummy tuck is in good shape and not too far from their goal weight. In order to be a candidate, you should need help in at least one of the following three areas that the surgery improves.

Loose Skin

Loose skin can be caused by pregnancy and weight loss. Both stretch the abdominal skin. If the skin is stretched too much, it cannot recoil. After pregnancy or weight loss, the skin may remain stretched and begin to hang. Unfortunately, in this situation, more weight loss does not help. Instead it leads to more loose skin.

A tummy tuck removes this loose skin from the lower abdomen, and tightens the skin that remains. This results in a smoother contour and better fitting clothes.

Excess Fat and Stretch Marks

Whenever I am removing excess lower abdominal skin, I can remove two other problems: excess fat and stretch marks. Excess fat that is below the belly button, is removed along with the excess skin. Women tend to put most the excess fat between the muscle and the skin, making it easy to remove. Men more often put excess fat behind the muscle, where it is not accessible. This internal fat must be lost with diet and exercise, and cannot be surgically removed.

Any stretch marks that are in this skin, are also removed. If the stretch marks are confined to the central abdomen below the belly button, the majority, if not all of them, can be removed with a tummy tuck.

Muscle Laxity

Babies and internal fat are behind the muscle layer of the abdominal wall. Because of this, pregnancy and weight gain also stretch the muscle layer. The muscle, and its case, can become overstretched to the point that the abdomen cannot be sucked in, not matter how strong the muscle layer. Tummy tucks allow me to tighten the case of the muscle and provide a smooth flattened foundation that can support the gut and keep it contents from pushing forwards.

If someone is significantly overweight, it is the internal fat that prevents me from being able to optimally tighten the abdominal wall. If the abdominal wall cannot be maximally tightened, abdominal fullness will remain. In this situation, additional weight loss will improve the results.

The three segments of the Tummy Tuck Video are now posted on the San Francisco Plastic Surgery Blog. Here is the link to Tummy Tuck (Abdominoplasty) San Francisco Video – Part 1 of 3; here is the link to Tummy Tuck (Abdominoplasty) San Francisco Video – Part 2 of 3; and here is the link to Tummy Tuck (Abdominoplasty) San Francisco Video – Part 3 of 3. Happy viewing.

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