A full tummy tuck is a surgical procedure that removes excess skin and fat from the entire abdominal area, from the rib cage down to the pubic bone, while also tightening the underlying abdominal muscles. It was the third most popular cosmetic surgery in the United States in 2024, with over 171,000 procedures performed. Unlike smaller variations that target only the lower belly, a full tummy tuck reshapes both the upper and lower abdomen and includes repositioning the belly button.
What Happens During the Procedure
The surgery begins with a horizontal incision just above the pubic area, running from hip to hip. This incision is typically placed in a V or U shape so the resulting scar sits low enough to be hidden by underwear or a bikini. There’s also a small incision around the belly button to free it from the surrounding skin.
Once the incisions are made, the surgeon lifts the entire abdominal skin flap upward to the level of the ribcage and breastbone, exposing the abdominal muscles beneath. This is where the structural work happens. The two vertical bands of muscle that run down the center of your abdomen are stitched back together along the midline, a technique called plication. These muscles commonly separate during pregnancy or from significant weight changes, leaving a gap that no amount of exercise can close. The surgeon sutures the gap in two layers, from the breastbone down to the pubic bone, pulling the abdominal wall tight like a natural corset. In some cases, additional rows of stitching are placed along the sides to further narrow the waistline.
After the muscle repair, the skin flap is pulled down, the excess is trimmed away, and everything is closed with sutures. The upper edge of the removed skin is usually at or above the level of the original belly button, which gives a sense of how much tissue is actually excised.
How the Belly Button Is Repositioned
One detail that surprises many people: your belly button doesn’t move during a full tummy tuck. It stays attached to the deep abdominal wall exactly where it’s always been. What changes is the skin around it. When the abdominal flap is pulled downward and the excess is removed, the surgeon cuts a small new opening in the repositioned skin and brings the belly button through it, then sutures it in place. This leaves a small circular scar around the belly button in addition to the longer hip-to-hip scar below.
Full Tummy Tuck vs. Mini Tummy Tuck
The key differences come down to how much territory the surgery covers. A mini tummy tuck uses a shorter incision, only addresses the area below the belly button, and doesn’t require the belly button to be repositioned at all. It tightens a smaller section of muscle and removes less skin. A full tummy tuck addresses both the upper and lower abdomen, repairs separated muscles along their entire length, and involves significantly more tissue removal.
A mini tummy tuck works well for someone with a small amount of loose skin concentrated below the navel. If you have excess skin, fat, or muscle separation that extends above the belly button, a full procedure is typically needed to get meaningful results.
Who Is a Good Candidate
Most plastic surgeons consider the procedure safest for patients with a BMI below 35. Ideally, you should be within 10 to 15 pounds of your goal weight before surgery, because significant weight loss afterward can compromise your results and leave you with loose skin again. Weight stability matters more than hitting a specific number on the scale.
The most common candidates are women after pregnancy (especially multiple pregnancies) and people who have lost a large amount of weight through diet, exercise, or bariatric surgery. In both cases, the abdominal skin has been stretched beyond its ability to snap back, and the muscles may have permanently separated. A full tummy tuck addresses both problems in a single operation.
What Recovery Looks Like
The first week is the hardest. You’ll walk slightly hunched over because the tight abdominal closure makes it uncomfortable to stand fully upright. Light walking is encouraged from day one to keep your circulation moving, but the priority is rest. Most surgeons place one or two small drainage tubes near the incision to prevent fluid buildup. These typically stay in for seven to ten days, and you may be asked to measure and record the fluid output at home so your surgeon can decide when it’s safe to remove them.
You’ll wear a compression garment continuously for the first two weeks, then as much as possible for another month. This supports the repair, controls swelling, and helps the skin conform to your new contour. By week two, many people feel well enough to return to work and handle light daily tasks. Most normal activities resume around week four. Strenuous exercise, including anything that engages the core, is generally off limits until about six weeks post-op.
Scars and How They Heal
The hip-to-hip scar is permanent, but it fades significantly over time. Its final appearance depends on your skin type, genetics, how well you care for the incision, and whether you smoke (smoking impairs healing and leads to wider, more visible scars). Surgeons place the incision in the lowest natural crease of the abdomen so it can be concealed by most clothing. The small scar around the belly button also softens and becomes less noticeable over the first year or two.
Risks and Complications
The most common complication is seroma, a pocket of fluid that collects under the skin after the drains are removed. Reported rates vary widely depending on technique, from under 1% to as high as 15% in some surgical series. When a seroma develops, it usually needs to be drained with a needle in the office, sometimes more than once.
Infection occurs in roughly 1% to 4% of cases and is typically managed with antibiotics. Other possible complications include blood clots under the skin (hematoma), delayed wound healing along parts of the incision, and temporary or permanent changes in skin sensation below the belly button. The risk of serious complications increases with higher BMI, smoking, and procedures that combine abdominoplasty with other surgeries.
Cost
Surgeon fees for a tummy tuck range from $8,000 to $13,500 according to 2024 data from the American Society of Plastic Surgeons. That figure covers only the surgeon’s fee. Total cost including anesthesia, the operating facility, compression garments, and follow-up visits is often higher. Health insurance rarely covers abdominoplasty unless it’s performed for medical reasons such as chronic skin infections or hernias associated with the muscle separation.