Abdominoplasty removes loose abdominal skin and fat and repairs separated rectus muscles to refine the abdominal contour.
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Overview
After pregnancy and childbirth or large changes in weight, abdominal skin often stays stretched and the connective tissue between the rectus muscles remains separated. In this state, even if you reduce fat through exercise and diet, the skin folds and the area around the navel stays rounded. Abdominoplasty removes the excess skin and fat and repairs the separated rectus muscles to refine the abdominal contour.
The result of abdominoplasty is decided not by how much is removed but by the design — deciding in advance where and how much to remove. Excessive removal puts tension on the closure, which can cause the wound to open or the skin to die; too little leaves sagging behind. Atelier Plastic Surgery published in a peer-reviewed journal the Reverse Lip Design, which draws the skin excision line in advance as an inverted lip shape to predict the amount removed, closure tension and scar position, and applies this design in surgery.
Abdominoplasty is major surgery performed under general anesthesia. Atelier Plastic Surgery performs only one general anesthesia surgery per day, with an anesthesiologist. Dr. Go personally handles the consultation, the surgery and postoperative follow-up.
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Recommended for
Loose abdominal skin with widespread stretch marks after childbirth
Diastasis recti, where the area above and below the navel bulges even when you tense your abdomen
Abdominal skin that folds after major weight loss
Loose skin that liposuction alone is judged unable to resolve
A distorted navel or an accompanying umbilical hernia
Skin that hangs over a cesarean section scar
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Surgery & treatment methods
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Full abdominoplasty (with rectus muscle repair)
Through a horizontal incision in the lower abdomen, the skin and subcutaneous fat are lifted up to above the navel, and the separated rectus muscles are sutured together at the midline to firm the abdominal wall. The excess skin is then removed along the pre-designed excision line, and the navel is reset in its new position. The incision is planned to sit within the underwear or swimsuit line.
Suited for · Loose skin both above and below the navel with separated rectus muscles
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Mini abdominoplasty
When only the skin below the navel is loose, the skin and fat are removed through a short lower-abdominal incision without touching the navel. The incision length and recovery period are shorter than for a full abdominoplasty. Details are on the mini abdominoplasty page.
Suited for · Sagging limited to below the navel with no or mild diastasis recti
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Combined liposuction
When fat is also present on the flanks, upper abdomen and waistline, liposuction is performed in the same session as the abdominoplasty. It refines the side profile that skin removal alone cannot address, so the front and side contours connect. The extent of liposuction is limited to protect the blood supply to the skin in the excision area.
Suited for · Abdominal sagging with remaining fat on the flanks and waist
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Navel reshaping
In abdominoplasty the navel is not created anew; the original navel, still attached to the abdominal wall, is brought out through a new opening in the repositioned skin and fixed in place. The position, size and depth of the navel and the shape of the new opening must be designed together with the excision line to avoid a navel that spreads sideways or is ringed by scar. Atelier Plastic Surgery applies the Reverse Lip Design to distribute skin tension evenly around the navel and sutures it to form a slightly vertical, concave navel. If an umbilical hernia is present, the fascia is repaired at the same time. For reshaping the navel on its own, please see the umbilicoplasty page.
Suited for · When you want the position and shape of the navel refined together with abdominoplasty
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Illustrations & photos
Incision comparison: conventional vs reverse-lip abdominoplastyBefore · Surgical design · Right after surgeryPresentation on reverse-lip design abdominoplasty
Surgical designs and results are drawings based on photos; results vary by individual.
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Key facts
Surgery time
About 3–4 hours (longer with combined liposuction)
These may vary depending on your condition; we will give you precise details at your consultation.
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Atelier Plastic Surgery's approach
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The extent of excision is decided before surgery
The result of abdominoplasty is decided by the design of where and how much to remove. Atelier Plastic Surgery draws the skin excision line before surgery as an inverted lip shape to predict the amount removed, closure tension and scar position. This helps reduce wound separation and upward migration of the scar, and the design has been published as a journal paper and conference presentations.
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Rectus muscle repair is decided by examination
Diastasis recti must be assessed separately from the visible sagging. During consultation we palpate the abdomen while you lie down and measure the gap between the rectus muscles with ultrasound to decide the extent of repair. When the separation is pronounced, repairing the abdominal wall accounts for half of the result.
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The navel decides the result
After abdominoplasty, the navel is the first thing the eye is drawn to. We design its position, size and the shape of the opening together with the excision line, so the scar hides inside the navel and the navel settles into a vertical, concave shape.
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One case a day, performed by Dr. Go
Abdominoplasty is a long surgery in which managing blood clots and bleeding matters. We schedule only one general anesthesia surgery per day so that, together with an anesthesiologist, we can focus on one patient from preoperative testing through recovery. We operate CCTV in the operating room and a private recovery room, and check for seroma with ultrasound after surgery.
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After surgery
Day of surgery
You wake from anesthesia in a private recovery room and keep your waist slightly bent to reduce tension on the abdomen. You wear compression stockings to prevent blood clots and begin short walks the same day.
Days 1–3
We monitor drain output and remove the drains once it decreases, then discharge you. You wear a compression garment and walk without fully straightening your waist. Pain is controlled with prescribed medication.
Week 1
At the first visit we check the wound and look for seroma. Showering is permitted depending on the wound. Light housework is possible, but no lifting heavy objects.
Week 2
Stitches are removed. You begin straightening your waist gradually and can return to seated desk work. Some swelling and bruising is normal at this stage.
Weeks 4–6
You finish wearing the compression garment and start light aerobic exercise. Abdominal exercises and heavy lifting are postponed until about 6–8 weeks, once the rectus repair has stabilized.
Months 3–6
Swelling subsides and the contour settles. Scar redness fades during this period, and scar care with treatments such as pico laser continues as needed. The final shape takes about 6 months to 1 year, varying by individual.
Recovery care and the aftercare schedule are described in the Safety Care System. Safety Care System
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Side effects · Precautions
Abdominoplasty is a general anesthesia surgery with a wide area of excision, and the following complications may occur: bleeding and hematoma; seroma, a collection of fluid in the dissected space (which can occur even after drain removal and may require repeated needle aspiration); infection; wound dehiscence, where the closure separates; skin necrosis at the center of the incision or around the navel (the risk is higher in smokers and people with diabetes); navel distortion and navel necrosis; reduced sensation and numbness in the lower abdomen (usually recovering over several months, though it may persist in some cases); thickened or discolored scars; skin bunching at the ends of the incision (dog ears) and asymmetry; and pain at the rectus repair or recurrence of the separation. Because the surgery is long, there is a risk of deep vein thrombosis and pulmonary embolism, which we prevent with compression stockings, early walking and anticoagulant therapy when needed. Results vary by individual and additional correction may be needed. Smokers must stop smoking for at least 4 weeks before and after surgery, and because a future pregnancy can change the result, the timing of surgery is decided during consultation. All of the above is explained fully at consultation.
The content on this page is general medical information provided in accordance with the Medical Service Act. The results of surgery and treatments and the recovery period may vary by individual. All surgeries and treatments carry a risk of side effects, so please decide after a thorough consultation with a specialist.
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Related research
PaperFirst author
The Reverse Lip Design: A Design for Safe and Effective Abdominoplasty
A study proposing a design that pre-plans the skin excision line in abdominoplasty as an inverted lip shape, so that the extent of excision and closure tension can be predicted and the navel shape planned at the same time
ConferenceSpeaker
Strategies for Safe and Effective Abdominoplasty
Korean Society of Plastic and Reconstructive Surgeons, 79th Congress (PRS Korea) · 2021.11 · Online
Korean title: Safe and Effective Abdominoplasty
ConferencePoster
A New Design for Safe and Effective Abdominoplasty: The Reverse Lip Design
Korean Society of Plastic and Reconstructive Surgeons, 76th Congress (PRS Korea) · 2018.11 · Seoul
Korean title: A New Design for Safe and Effective Abdominoplasty — Reverse Lip Design
Each treatment page lists the items relevant to it; the full list is on the Academic Activities page.View all academic activities
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FAQ
Q1How do I know whether abdominoplasty or liposuction is right for me?
We pinch the skin while you lie down and stand up. If the skin does not spring back when released and stays slack, skin removal is needed. If only fat can be pinched and the skin is firm, liposuction may bring improvement. If diastasis recti is present, liposuction alone leaves the abdomen rounded, so we measure the rectus gap with ultrasound to decide.
Q2Where is the scar, and how long is it?
It runs horizontally across the lower abdomen above the pubic bone, and its length varies with the amount of skin removed, from between the hip bones to near the flanks. It is designed at a height concealed by underwear and swimwear. A circular scar also remains around the navel, but it is sutured to hide inside the navel. Scars fade over about 6 months to 1 year; depending on your skin, hypertrophic scars can form, in which case laser care is added as needed.
Q3Is rectus muscle repair always necessary?
If diastasis recti is absent or mild, skin removal alone may be enough. When the separation is pronounced, removing skin alone leaves the abdomen looking rounded again, so the repair determines the result. Whether and how far to repair is decided by palpation and ultrasound findings, and after repair, exercises that strain the abdominal muscles are restricted for about 6–8 weeks.
Q4I plan to have children. Can I still have surgery?
Pregnancy after surgery is not impossible, but it stretches the abdominal wall and skin again and can change the result. We recommend surgery after your family plans are complete; the usual guideline is at least about 6 months after your last delivery and the end of breastfeeding, once your weight has stabilized.
Q5Is it possible with a cesarean section scar?
Yes. The existing cesarean scar is usually included in the incision line and removed with it, so the scars are consolidated into one. If earlier surgery has left adhesions beneath the skin, we assess the dissection and blood supply more carefully.
Q6When can I exercise after surgery?
Walking is encouraged from the day of surgery. Light aerobic exercise is typically possible after about 4–6 weeks, and abdominal exercises and heavy lifting after about 6–8 weeks once the rectus repair has stabilized, adjusted to your individual recovery.
Q7What happens to the navel?
The original navel stays attached to the abdominal wall while the surrounding skin is removed and drawn down, so its position does not change much; it is brought out through a new opening and fixed in place. The shape and size of that opening and the closure tension determine the shape of the navel, so they are designed in advance together with the excision line. Details are in the navel reshaping section above.
