Quick Summary
- Who it is for. Patients with separation of the abdominal muscles or loose lower abdominal skin after pregnancy, who have completed their family
- BMI. Below 29, with a stable weight for at least six months. Dr Turner does not offer abdominoplasty at a BMI of 29 or above
- The procedure. Abdominoplasty with rectus diastasis repair and 360 liposuction
- Surgery time. 3.5 to 4 hours
- Hospital stay. 3 to 4 days
- Recovery. Desk-based work at 2 to 4 weeks; strenuous activity and core exercise restricted for 6 weeks
- Medicare. Item 30175 may apply after pregnancy when all of its criteria are met, including a diastasis of at least 3 cm on imaging
- Consultation requirements. Referral, minimum two consultations, psychological screening, and a seven-day cooling-off period before surgery can be booked
Abdominoplasty After Pregnancy
Pregnancy stretches the abdominal wall. For many women the muscles and skin recover over the following year. For others, the two vertical rectus muscles remain separated (rectus diastasis) and the lower abdominal skin stays loose, despite a stable weight and regular exercise.
Abdominoplasty repairs the muscle separation, removes loose lower abdominal skin and fat, and repositions the belly button.
Dr Turner considers abdominoplasty for patients who:
- have rectus diastasis or loose lower abdominal skin after pregnancy
- have a BMI below 29 and a stable weight for at least six months
- have completed their family, as a later pregnancy can stretch the repair
- have allowed the abdominal wall time to recover after their last pregnancy and after breastfeeding
- do not smoke or use nicotine products, including vapes, which impair wound healing
Abdominoplasty is not a weight-loss procedure. Weight gained after surgery, or a later pregnancy, can stretch the repair.
BMI and Weight: Below 29
Dr Turner offers abdominoplasty only to patients with a body mass index (BMI) below 29. At a BMI of 29 or above, he will not offer surgery. The reason is safety: the risk of wound healing problems, fluid collections (seroma) and blood clots rises as BMI rises.
Your weight also needs to have been stable for at least six months before surgery. If your BMI is 29 or above, the time to arrange a consultation is once you have reached, and held, a BMI below 29 for six months. Your GP is the right starting point for managing weight.
BMI is your weight in kilograms divided by the square of your height in metres. As a guide, a BMI below 29 means a weight below:
| Height | Weight for a BMI below 29 |
|---|---|
| 155 cm | under 69.6 kg |
| 160 cm | under 74.2 kg |
| 165 cm | under 78.9 kg |
| 170 cm | under 83.8 kg |
| 175 cm | under 88.8 kg |
| 180 cm | under 93.9 kg |
BMI is a screening measure and does not account for muscle mass or body shape. Your BMI is measured at consultation.
The Procedure
Dr Turner performs abdominoplasty with rectus diastasis repair and 360 liposuction. The separated rectus muscles are brought back together and secured with sutures to repair the midline, loose skin and fat are removed across the lower abdomen, and the belly button is repositioned. Circumferential (360) liposuction of the flanks and lower back is performed in the same operation.
Operating time is about 3.5 to 4 hours, with a hospital stay of 3 to 4 days.
The incision is placed low, in the pubic region, where underwear or swimwear usually covers it. It runs from hip to hip, and its length depends on how much skin is being removed. A second, smaller scar sits around the belly button.
Surgery is performed under general anaesthesia at an accredited Sydney private hospital, with a specialist anaesthetist providing care throughout. Drains are used and are generally removed before discharge or at the first post-operative review.
Indicative Pricing
Abdominoplasty with rectus diastasis repair and 360 liposuction ranges from $22,000 to $35,000, all-inclusive. That figure covers the surgeon’s fee, the anaesthetist, hospital and theatre time, the hospital stay and scheduled post-operative reviews.
Where Medicare item 30175 applies, the total sits towards the lower end of that range, because a partial rebate is paid against the schedule fee for the eligible part of the surgery and hospital cover that includes the relevant category may cover hospital costs. Without a Medicare item, the procedure is paid privately and sits towards the upper end.
Within the range, what you pay depends on the extent of skin removal, the operating time your case needs, and the extent of the liposuction component. A consultation fee of $450 applies. A personalised written quote is provided after your consultation, once the surgical plan is set.
Medicare Item 30175
Medicare item 30175 covers abdominoplasty with repair of rectus diastasis after pregnancy. It applies only when every one of its criteria is met:
- the abdominal wall defect is a consequence of pregnancy
- the diastasis is at least 3 cm, measured by diagnostic imaging from a radiology provider before surgery
- there is at least moderately severe pain or discomfort at the diastasis during everyday use, or low back pain or urinary symptoms likely due to the diastasis, documented in your records
- symptoms have not responded to non-surgical treatment, which must have included physiotherapy
- you have not been pregnant in the last 12 months
The item can be claimed once in a lifetime, and Medicare benefits are not available for surgery performed for cosmetic purposes.
[A5, confirmation needed] Where item 30175 applies, Medicare pays a partial rebate against the schedule fee for the eligible part of the surgery, and hospital cover that includes the relevant category may cover hospital costs. Cosmetic components, such as 360 liposuction, are charged privately.
Eligibility is assessed at consultation, and your imaging and physiotherapy records are part of that assessment. Different Medicare items apply to loose skin after significant weight loss; this page covers abdominoplasty after pregnancy.
What Abdominoplasty Can and Cannot Change
Abdominoplasty changes the structure of the abdominal wall. It brings the separated rectus muscles back together, removes loose lower abdominal skin and fat, and repositions the belly button. Where diastasis contributes to back discomfort or core weakness, some patients report less discomfort once recovered, but this varies and cannot be promised. Removing an overhanging skin fold can relieve irritation of the skin beneath it.
It does not reduce weight. It does not remove stretch marks above the area of skin that is removed, and it does not prevent changes from later weight gain or pregnancy. It leaves a permanent scar across the lower abdomen. Outcomes vary between individuals.
Recovery
Recovery follows a general pattern, although every patient heals differently.
The hospital stay is 3 to 4 days. The first week is the most uncomfortable, with tightness across the abdomen, and patients walk bent slightly forward at first. Pain is managed with prescribed analgesia. A compression garment is worn continuously.
Most patients return to desk-based work within 2 to 4 weeks, depending on how physical the role is. Driving resumes once you can brake sharply without hesitation, usually around 2 to 3 weeks.
Strenuous activity and any core exercise are restricted for 6 weeks, to protect the muscle repair. From 6 weeks there is a gradual return to higher-intensity exercise, generally complete by 3 months.
Swelling settles progressively, and both swelling and scars continue to change over 12 months. Detail is in the recovery after tummy tuck guide.
Risks and Complications
Abdominoplasty is a major operation and carries real risk. These are discussed in detail at consultation.
- Seroma, a collection of fluid under the skin flap, which is the most common complication and may need drainage
- Wound healing problems, particularly at the centre of the incision, with risk higher in people who smoke or use nicotine products, including vapes, and as BMI rises
- Deep vein thrombosis and pulmonary embolism, with preventive measures used to reduce the risk
- Bleeding or haematoma, occasionally requiring return to theatre
- Infection
- Changes in sensation across the lower abdomen, which are common early and may be permanent in patches
- Healing problems at the belly button, which sits on a narrow blood supply after repositioning
- Separation of the muscle repair over time, particularly with later weight gain or pregnancy
- Contour irregularities after liposuction
- Scarring, which is permanent, fades over 12 to 24 months, and varies between individuals
- Need for revision surgery
Consultation Requirements
The Medical Board of Australia’s cosmetic surgery guidelines, in force since 1 July 2023, set these requirements. Dr Turner applies them to every abdominoplasty patient, including those eligible for item 30175.
- A referral is required, preferably from your usual GP, or from another GP or specialist medical practitioner.
- You will have a minimum of two consultations with Dr Turner before surgery; the first can be by video, and the second is in person.
- Every patient is screened for psychological factors, including body dysmorphic disorder, with referral for independent evaluation where indicated.
- After the second consultation and signed consent, a cooling-off period of at least seven days applies before surgery can be booked or a deposit paid.
- Patients under 18 have a cooling-off period of at least three months and a mandatory independent psychological evaluation.
Frequently Asked Questions
What is the difference between abdominoplasty and liposuction?
Liposuction removes fat. It does not remove loose skin or repair separated muscles, so it does not treat what pregnancy typically leaves behind. Abdominoplasty repairs the muscle separation and removes loose skin, and liposuction of the flanks and lower back is performed in the same operation to shape the surrounding contour. Liposuction alone in a patient with rectus diastasis and loose skin generally makes the loose skin more obvious.
Does Medicare cover abdominoplasty?
Medicare item 30175 may apply after pregnancy when all of its criteria are met. These include a diastasis of at least 3 cm measured by diagnostic imaging, documented symptoms, failed non-surgical treatment including physiotherapy, and no pregnancy in the last 12 months. The item can be claimed once in a lifetime, and abdominoplasty for cosmetic reasons is not covered. Eligibility is assessed at consultation.
What is rectus diastasis and how is it assessed?
Rectus diastasis is separation of the two vertical rectus abdominis muscles, most commonly after pregnancy. At consultation the gap is assessed clinically. For Medicare item 30175 it must be measured by diagnostic imaging from a radiology provider and be at least 3 cm.
What BMI is required for abdominoplasty?
A BMI below 29. Dr Turner does not offer abdominoplasty to patients with a BMI of 29 or above, because the risk of wound healing problems, seroma and blood clots rises with BMI. Your weight should also have been stable for at least six months before surgery. If your BMI is 29 or above, your GP is the right starting point, and a consultation can be arranged once you have held a BMI below 29 for six months.
How long after pregnancy can I have a tummy tuck?
The abdominal wall needs time to recover after the last pregnancy and after breastfeeding, and your weight needs to be stable. Medicare item 30175 requires that you have not been pregnant in the last 12 months. Abdominoplasty is generally considered once your family is complete, as a later pregnancy can stretch the repair.
Can I have a tummy tuck after a caesarean section?
Yes. A caesarean scar sits in the same lower abdominal area and is usually removed or incorporated within the abdominoplasty incision. Any overhang of skin above the caesarean scar is part of the assessment at consultation.
How long is recovery from abdominoplasty?
The hospital stay is 3 to 4 days. Most patients return to desk-based work within 2 to 4 weeks. Strenuous activity and core exercise are restricted for 6 weeks, with a gradual return to higher-intensity exercise between 6 weeks and 3 months. Swelling and scars continue to settle over 12 months, and every patient heals differently.
