Abdominoplasty (tummy tuck): an OR 101 guide
Reviewed by Rodnie Oro, cath lab charge nurse · Last reviewed: October 2026 · Education only, not medical advice
Abdominoplasty in one minute
What it is: surgery to remove excess skin and fat from the lower abdomen and often tighten the muscles.
Who it is for: people with loose skin after major weight loss or pregnancy, when criteria are met.
Main risks: bleeding, fluid collection (seroma), infection, wound healing problems, blood clots, scarring.
Usually: under general anaesthetic, 2–4 hours, 1–3 nights in hospital.
On this page: What is an abdominoplasty? · Who is it for? · When is it done? · Step by step · Recovery · Risks · Kit list · First time in theatre? · FAQ
What is an abdominoplasty?
An abdominoplasty (tummy tuck) removes loose skin and fat from the lower abdomen.
The surgeon:
- marks the abdomen before surgery
- makes a low cut from hip to hip, and frees the skin up to the ribs
- often stitches the stretched muscles together
- pulls the skin down, removes the excess and makes a new opening for the belly button
It is often cosmetic; on the NHS it is available only when local criteria are met.
New to the acronyms? See the Cath Lab Abbreviations A–Z.
Who is it for?
It may be considered for people with:
- loose skin after major weight loss, when criteria are met
- loose skin and muscle separation after pregnancy
The decision is made by your plastic surgery team, who will talk through the reasons, the alternatives and the risks with you.
When is it done?
Most operations are planned; some are urgent. Before it, you usually have:
- an examination and photographs (with consent)
- a stable weight for some months
- advice to stop smoking
- a review of medicines, as per centre protocol
- a chance to ask questions and give consent
Step by step
1. Getting ready
Team brief and WHO checklist first, including the pre-op markings. The anaesthetic team and ODP give the anaesthetic (general, as per centre protocol); antibiotics and blood-clot prevention are given as per centre protocol. The circulating practitioner checks positioning, pressure areas, the diathermy plate and warming. The scrub practitioner sets up the instrument trolley and does the first count. The patient is positioned so the table can be flexed at the hips for closure.
2. Access
A low cut across the lower abdomen from hip to hip, and a cut around the belly button.
3. Removing skin and tightening
- A. Loose skin. Loose skin and fat are marked.
- B. Markings. The low cut is made and the skin freed upwards.
- C. Muscle repair. The muscles are tightened down the middle.
- D. Closed. Excess skin is removed and the wound closed.
The table is flexed for closure; the team checks pressure areas when the position changes.
4. Finishing
Drains may be placed, per surgeon, the wound closed in layers and the belly button brought out. Final counts are confirmed and the patient goes to recovery with a full handover and blood-clot prevention plan.
Recovery and aftercare
- First days: walking slightly bent; pain relief; blood-clot prevention.
- Going home: often 1–3 days.
- Support garment: as advised.
- Activity: avoid heavy lifting for about 6 weeks.
- Scar: low, usually hidden under underwear; fades over months.
- Follow-up: wound checks.
Call 999 if you have chest pain or sudden breathlessness. Contact your team if a wound becomes red, hot, swollen or leaky, a flap or graft changes colour, or you have a fever.
Risks and complications
Your team will explain the risks that apply to you. Possible problems include:
- bleeding or haematoma
- seroma (fluid collection)
- infection
- wound healing problems
- blood clots in the legs or lungs
- numbness of the lower abdomen
- scarring and asymmetry
Theatre kit list (printable)
Example kit list
Every theatre has its own protocol, and sizes and doses vary.
- plastic surgery instrument set
- marking pen
- diathermy and lit retractor, per surgeon
- strong sutures for muscle repair
- drains, per surgeon
- closure sutures
- dressings and support garment
Procedural steps
- Team brief, WHO sign in; markings checked; anaesthesia
- Positioning; clot prevention; prep; count
- Low cut; skin freed upwards
- Muscle repair
- Table flexed; excess skin removed; belly button repositioned
- Drains; closure; counts; sign out and handover
First time in theatre?
đź’ˇ First-time tip
- Know your role. Scrub, circulating, anaesthetic and ODP each have their own checks; ask at the team brief.
- Counts matter. Swabs, needles and instruments are counted before, during and at closure; speak up if one is missing.
- Markings. Pre-op markings guide the whole operation; take care not to wipe them off during prep.
- Table flex. Know how to flex the table and recheck pressure areas after.
- Warmth. Large areas of skin are exposed; keep warming running.
FAQ
Will I lose weight?
It is not a weight-loss operation.
Where is the scar?
Low across the abdomen, usually under underwear.
Is it available on the NHS?
Only when local criteria are met.
Related guides
Sources
All checked on 14 October 2026. Each page's own date is shown where it gives one.
- NHS. Tummy tuck (abdominoplasty). nhs.uk/conditions/cosmetic-procedures/tummy-tuck
- StatPearls (NCBI Bookshelf), search: abdominoplasty. ncbi.nlm.nih.gov/books
- British Association of Plastic, Reconstructive and Aesthetic Surgeons. www.bapras.org.uk
- World Health Organization. Surgical Safety Checklist. who.int
Disclaimer
Education only. This page is for general education for healthcare students, theatre staff and curious readers. It isn't medical advice and doesn't replace advice from your own doctor, surgical team or local unit protocols. Equipment and medicines are described generically. No product or manufacturer is recommended. If you think someone is having a medical emergency, call 999.
Disclosure: I work in the medical device industry. This page is independent education and isn't sponsored or reviewed by any company.
All diagrams on this page are original illustrations created for rodnieoro.com.
