“Sleeve it and Tuck it” -Tummy Tuck after Sleeve Gastrectomy.

A tummy tuck is a cosmetic rejuvenation procedure that involves the removal of excess skin and fat and muscle-tightening techniques in the abdomen. Patients can restore the look of a flatter, more athletic midsection, which can be transformative for those who have lost weight after a sleeve gastrectomy. Still, surgeons must ensure that these patients adequately heal from their sleeve gastrectomy before considering the tummy tuck as the next step.

To discuss post-weight loss surgery body contouring, call Texas Surgical Arts in Houston to schedule an appointment with Dr. Ricardo Bonnor M.D., F.A.C.S.

Get started today by calling his Houston practice at (281) 579-5638, or fill out a contact form, and a member of his team will get back to you as soon as possible. 

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Redundant Skin After Sleeve Surgery

Although achieving weight loss can be an incredible accomplishment, many are left dissatisfied with their appearance. Up to 96% of patients who undergo bariatric surgery develop lax skin after losing a significant amount of weight. (1) Not only will fat deposits atrophy and reveal a slimmer frame, but the skin that once stretched over a larger body can sag with every bit of weight lost. This is not merely a cosmetic defect. It can greatly impact one’s psychosocial health, detract from everyday activities, and lead to feelings of embarrassment. Additionally, the development of redundant skin can lead to physical problems such as: 

  • Hygiene issues and increased sweating
  • Yeast infections and rashes due to chafing
  • Decreased mobility, inhibiting patients from practicing healthy habits like exercise and sports that will help maintain their weight
  • Limited clothing options
  • Poor posture due to the weight of the sagging tissues
  • Skin hyperpigmentation and textural issues
  • Stretch marks

Why Does Skin Sag After Massive Weight Loss?

Surgeons typically perform bariatric surgeries on patients with a BMI over 30, so the resulting weight loss can be dramatic. Studies have shown that those who have lost a massive amount of weight have decreased collagen in their skin- the protein that provides it with a more rigid, taut structure. Under close evaluation, the remaining collagen fibers exhibit a disorganized arrangement and are too thin. (2)

Tummy tucks designed for post-bariatric patients can tighten the skin, revealing slimmer contours that highlight the results of patients’ hard-earned weight loss.

Do I Need a Tummy Tuck After Massive Weight Loss?

Individuals considering a tummy tuck after bariatric surgery may: 

  • Experience rashes, infections, and excess sweating under the abdominal skin.
  • Have diastasis recti, a condition in which the abdominal muscles separate from each other.
  • Have a hernia that has developed in the abdominal area.

Benefits of the Tummy Tuck 

  • The skin-tightening aspect of the procedure can effectively remove scars, stretch marks and restore taut, healthy-looking skin.
  • Abdominal muscle restoration techniques can improve your posture. The core muscles work as stabilizers for your back and body as a whole, and the permanent sutures to tighten them together after stretching can facilitate better strength and balance.
  • If you are a woman, the procedure may help resolve symptoms of stress urinary incontinence compounded by diastasis recti. (3) Diastasis recti caused by obesity and/or pregnancy can affect the functioning of the pelvic floor muscles, leading to bladder leakage. The tummy tuck can help restore better functioning in this area.
  • Surgical techniques can resolve hernias that may still be present from before your sleeve gastrectomy. Hernias most often develop due to intra-abdominal pressure from pregnancy or the strain of carrying excess weight.
  • The resulting scar is low and thin that you will be able to cover the post-surgical scar with underwear or a swimsuit.

What is the Timeline for a Tummy Tuck after a Sleeve Gastrectomy? 

  • You have achieved the recommended weight loss. This usually occurs about 1 year after the initial surgery. (1) Your BMI should also be below 32.
  • You have met your nutritional needs and are deemed to be in good overall health. Research finds that the most common deficiencies after sleeve gastrectomy are vitamin B12, iron, thiamine, calcium, and folic acid. (4)
  • You are willing to stop smoking for some time to improve your circulatory system.

Procedure Techniques

Tummy Tuck with Lipo 360

In addition to the standard tummy tuck techniques, Dr. Bonnor will also utilize liposuction to provide contouring effects throughout the entirety of the midsection, not just the front side. For the liposuction portion of the procedure, Dr. Bonnor will only have to make an incision of less than an inch to remove fat via suction through an instrument called a cannula. If you have young skin that can retract well, a tummy tuck with lipo 360 can be an excellent option to enhance your cosmetic results. Generally, those with a BMI over 30 will benefit from a tummy tuck in combination with tummy tuck skin excision techniques. (5)

Extended Tummy Tuck

An extended tummy tuck involves implementing techniques that address excess skin and fat along the flanks, improving the contours of the waist. For this technique, Dr. Bonnor will extend the lower pubic incision to above the most prominent part of the hips, creating a more even slimming effect beyond just the front of the abdomen.

Fleur de Lis Tummy Tuck

A fleur de lis tummy tuck is a procedure specifically designed for post-bariatric patients. For this procedure, Dr. Bonnor will use a combination of vertical and horizontal incisions to resect the excess tissue to restore the abdominal contours. This technique can work for those with a pannus, displaced navel, and those with multiple scars.

Cost of a Tummy Tuck in Houston

Every patient receives personalized information regarding the cost of their tummy tuck at their consultation. Consider applying for our available financing options with CareCredit- a trusted medical financing institution. To schedule a date and time to speak with Dr. Bonnor, call (281) 579-5638 or submit your inquiry with our online contact form.

Commonly Asked Questions (FAQ)

How long do I have to wait to get a tummy tuck after weight-loss surgery?

Timing plays a significant role in determining the appropriateness of a tummy tuck after bariatric surgery. Most surgeons recommend waiting until you have achieved a stable weight before considering any body contouring procedures.

How long will the tummy tuck take to complete?

Depending on the amount of excess skin and fat you have, the procedure can take up to 4 or 5 hours. For post-bariatric patients, tummy tucks are more comprehensive and will take longer than the average tummy tuck.

Are the results of a tummy tuck permanent?

The results of a tummy tuck are not permanent, but they are long-lasting. If you work to maintain your weight, the results will be noticeable for many years. As you age, your skin may naturally wrinkle and lax skin may accumulate.

How can I treat my tummy tuck scarring?

Incorporating silicone taping, and scar creams into your recovery routine can help reduce the prominence of your scar. Always consult your surgeon before implementing any of these techniques. Within 1 year, your tummy tuck scar will have faded significantly.


  1. Sadeghi P, Duarte-Bateman D, Ma W, et al. Post-Bariatric Plastic Surgery: Abdominoplasty, the State of the Art in Body Contouring. Journal of Clinical Medicine. 2022;11(15):4315. doi:https://doi.org/10.3390/jcm11154315 
  2. Rocha RI, Junior WC, Modolin MLA, Takahashi GG, Caldini ETEG, Gemperli R. Skin Changes Due to Massive Weight Loss: Histological Changes and the Causes of the Limited Results of Contouring Surgeries. Obesity Surgery. 2021;31(4):1505-1513. doi:https://doi.org/10.1007/s11695-020-05100-3 
  3. Brito, M. J. A. D., Nahas, F. X., Bussolaro, R. A., Shinmyo, L. M., Barbosa, M. V. J., & Ferreira, L. M. (2012). Effects of Abdominoplasty on Female Sexuality: A Pilot Study. The Journal of Sexual Medicine, 9(3), 918–926. doi: 10.1111/j.1743-6109.2011.02583.x  
  4. Mulita F, Lampropoulos C, Kehagias D, et al. Long-term nutritional deficiencies following sleeve gastrectomy: a 6-year single-centre retrospective study. Menopausal Review. 2021;20(4):170-176. doi:https://doi.org/10.5114/pm.2021.110954 
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