Dr. Dirk Lazarus

Plastic, Reconstructive & Cosmetic Surgeon

MBChB (UCT), FCS (SA) Plast & Recon Surg

Tummy Tuck (Abdominoplasty)

If your tummy (abdomen) has excess skin, too much fat or lax muscles then you may be suitable for some form of abdominoplasty. An abdominoplasty can improve your shape and contour and allow you to fit into clothes better. Excess fat with good skin quality, provided you are of normal weight for height, can often be treated with liposuction alone. When the skin quality is poor, if there are stretch marks, if the muscles are split apart (divarification) – often as a result of prior pregnancies or if you have a Caesarian section scar, the usually some form of abdominoplasty or tummy tuck will be recommended. You still need to be of normal weight for height (a body mass index of under 30). Tummy tuck is frequently combined with liposuction so as to optimise shape.

There are a number of different tummy tuck procedures (and there may be variations of these too):

  1. Classic (traditional or full) tummy tuck, usually, but not always with some liposuction
  2. Mini tummy tuck with liposuction
  3. Fleur d’lis (FDL) tummy tuck or variations


The classic (full) abdominoplasty operation involves removing the skin and fat below the belly button. The tissue is then dissected up to the rib cage to allow the tummy muscles to be tightened and the skin flap from above to be pulled down. This leaves a scar which runs in the bikini line from hip to hip. The belly button is brought out through a new hole created in the correct and normal location in that flap. This operation is suitable for women who have completed their families. A classic abdominoplasty is frequently combined with liposuction of the love handles and perhaps also of the upper tummy.

Mini tummy tuck: Younger women who have excess tummy and love handle fat will benefit more from liposuction. Other areas can be liposuctioned at the same time, such as the thighs.

Before, 9 months after and 18 months after mini tummy tuck

Before, 9 months after and 18 months after mini tummy tuck

The surgery is done as day case surgery (in and out the same day) in my own, private facility. The anaesthetist will administer your sedation and regional spinal anaesthetic (similar to an epidural). This will be supplemented with local anaesthesia. You will be asleep, pain-free and unaware at the time of surgery and you will have a quick recovery. Tummy tuck surgery takes about 3 hours.

At the end of surgery, the wounds are closed with dissolving sutures, tape is placed over the cuts and a dressing is applied. I usually use drains for classic tummy tucks. Depending on the drainage, these are removed 5-7 days after surgery. An abdominal binder will be given to you to wear for 3 weeks after surgery.

Painkillers will be prescribed for post-operative pain. Bruising and swelling will last about 2-3 weeks and you can resume your normal activities after 4-6 weeks. It takes a few months for the shape to settle and about a year for the scar to mature, but the improvement in shape and contour is rapid and the effect of abdominoplasty long lasting.

Please see patient instructions for peri-operative care.

Last updated: 1 December 2017

Before and after classic (full) tummy tuck

Hi Dr Lazarus,

You probably won’t remember me, but I will NEVER forget you. You performed a tummy tuck and breast augmentation on me last year April. It has been exactly one year since the operation and I cannot tell you how happy I am with the results. I have had endless compliments and my self esteem has improved tremendously, thanks to you. I promised you before I left your offices at my last appointment that I will either come and see you again to show you the results or send you a pic. I cannot show you in person as my sis who lived in Cape Town at the time has moved to London and so the next best thing to do is to send you a pic. I am really happy with the results, especially the “boobies” :). Here are a couple of pics, the quality is not that great because I took it with a webcam, but I really want you to see the results.

Kind Regards and thanks again.