Abdominoplasty is often performed with general anesthesia. It can also be done using a local anesthetic with a sedative. There may be some discomfort with local anesthesia. The tummy tuck surgery takes about two to five hours.
A tummy tuck usually begins with a relatively long incision across the abdomen, from hip bone to hip bone. The shape of the incision is like a smile, with a flat bottom. The flat part of the smile occurs at the bottom point of the abdomen immediately above the pubic area. The sides of the smile form a gentle curve along the pelvis up to the top of the hip bone. A second incision is made around the belly button to free it from the abdominal tissue.
The skin is separated from the abdominal wall, up to the ribs, exposing the vertical abdominal muscles (rectus muscles). These muscles have usually been stretched apart by previous pregnancies. The rectus muscles are then stitched into a new position, tightening the muscles and reducing the waistline. After the muscles have been repositioned and tightened, the excess skin is stretched and removed.