You’ve seen the headlines on popular magazines about celebrities who get back their ‘pre-baby body’ within about a month or so of giving birth. Maybe some of them may just be blessed with exceptionally elastic skin; or they have time to do 500 abdominal crunches per day, as well as the ability to say no to every source of refined sugar—even at 2 a.m. when that doughnut looks awfully good while the little one is nursing.

For those of us—let’s refer to ourselves as ‘the 99 percent’—who don’t have those genetic, lifestyle or behavioral abilities, it can be all but impossible to get rid of that little postpartum tummy bulge. People who lose large amounts of weight may find themselves in similar straits, dealing with excess skin and stretched muscles that might be what we politely refer to as ‘exercise-resistant.’

If you don’t need to lose a lot of weight but just need a little help to make everything in the mid-section more taut, a tummy tuck might be the answer. (And it’s likely that more than a few of those magazine-cover celebrities have had some ‘surgical correction.’) Known clinically as abdominoplasty, a traditional tummy tuck is a significant surgery requiring hospitalization and recovery, but the results can be remarkable.

“If there is still a great deal of internal (intra-abdominal) weight, then the results of a tummy tuck would be sub-optimal,” notes plastic surgeon Dr. Michele Koo. “The pressure and fullness from the intra-abdominal fat (round fullness) would prevent a flat tummy and stretch the muscle repair, which is part of the tummy tuck.” In other words, abdominoplasty is not a weight-loss procedure or a good choice for those who are not already at or near their ideal weight.

“Smokers must be smoke-free for at least two to four weeks before and after the surgery,” Koo adds. “And if one is still significantly overweight (with a BMI greater than 30) without having started a healthier lifestyle, then again the results would be sub-optimal. I personally start my patients on a minimum activity level and a change of eating habits regimen prior to considering surgery if they are obese. I don’t want my patients to invest significant time, emotional and monetary resources for a tummy tuck if they won’t have a long-lasting, significant change that they will love.”

Other procedures may be better choices for people who need to lose weight or reduce fat. Liposuction or a noninvasive contouring technique like CoolSculpting can help reduce fat, while a tummy tuck primarily removes excess skin and repairs or repositions abdominal muscles, explains Dr. Terence Myckatyn, a plastic and reconstructive surgeon with Washington University Physicians.

“An abdominoplasty is a countering procedure that is the ‘reward’ after weight loss—it is not a procedure designed to achieve weight loss,” Myckatyn stresses. “There are rarer reasons why a patient should not consider an abdominoplasty or needs to make certain provisions to reduce the risk of a complication, as well. As always, candidates need to be thoroughly evaluated by a board-certified plastic surgeon to assess their suitability, as well as possible alternatives.”

Myckatyn adds that patients must be committed to a healthy lifestyle in order to preserve the results. “Diet and exercise programs should be sustainable and maintain an adequate level of nutrition since recovery from surgery depends on normal nutrition to help heal post-surgical wounds,” he says. “They also need to be sustainable since the long-term benefits of a cosmetic abdominoplasty will only last as long as the weight loss. Cosmetic surgery will not prevent you from gaining back the weight.”

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