What can be done about that stubborn tummy ‘pooch’ that plagues so many women after childbirth or significant weight loss? When you’ve exercised and dieted for months—or even years—but still have a protruding tummy, is it time for surgery?

    That depends. Abdomino plasty, commonly known as a tummy tuck, can be the perfect solution for some people, but it may not be right for others.  “Tummy tucks address excess skin, stretch marks and hanging tissue,” explains Dr. Judith Gurley, a plastic surgeon who practices in Chesterfield. “Tummy tucks are also great for reconstructing the abdominal wall by bringing the belly muscles together along the abdominal midline to strengthen and flatten the abdomen.”

    However, Gurley says that many patients who assume a tummy tuck is needed to regain their shape can benefit from liposuction alone. “Liposuction is much quicker and involves a speedier, more comfortable recovery,” she says. “If a patient doesn’t have hanging, stretched skin, then liposuction alone can get rid of a tummy ‘pooch.’”

    Repairing a diastasis recti, which is a separation between the left and right side of the rectus abdominis muscle that covers the front surface of the belly area, is another tummy tuck benefit. Gurley notes that most women who have this condition following pregnancy are unable to return the abdominal muscles to their proper position through exercise alone. Besides creating a stronger abdominal area, Gurley says the return of core muscular integrity can be beneficial for supporting the back.

        If a tummy tuck is appropriate, then considerations turn to a patient’s readiness for major surgery. “As with any surgery, general health needs to be evaluated prior to the procedure,” says Dr. David Caplin, a plastic surgeon with Parkcrest Plastic Surgery. “Abdominoplasty is performed under general anesthesia as an outpatient or with an overnight stay. Patients with any significant health issues should always make their surgeon aware of these prior to surgery.”

    Because it is a cosmetic procedure, tummy tuck costs are not covered by insurance and may range from $6,000 to $15,000, Caplin says. Cost depends on the complexity and length of time required to perform the surgery, which can range from 90 minutes to several hours. In many cases, liposuction is combined with abdominoplasty, which can be more cost-effective than undergoing the procedures separately. The combined sugery removes excess skin, corrects the abdominal muscles, and removes fat from the abdomen, hips and back.

    “I suggest taking at least two weeks off from an office occupation or at least three to four weeks from a strenuous occupation” following abdominoplasty, advises Dr. Michele Koo, a plastic surgeon with Aesthetic Surgery Institute. Post-surgical drains are required and remain in place for one to two weeks. Once the drains are removed and the patient is off prescription pain medication, she can resume driving and desk work. A compressive garment is worn for the first two weeks, around the clock, and then for another two weeks during the day only, Koo adds. Core exercises and cardiovascular workouts can resume after several weeks.

    “There is relatively little pain associated with the surgery, but the patient is not able to stand up straight for about seven to 10 days,” Koo says. “Patients are, however, fairly worn out after the surgery, as if they had the flu, for approximately seven to 10 days, primarily from fluid fluctuations associated with liposuction, which I usually perform with the tummy tuck.”

    Koo adds that “this is the ‘kick in the rear’ that most of my patients need to keep them on track and take them to the next level of maintaining a healthier lifestyle. When they can actually see the results of all their hard work with an incredible new body shape, they are much more willing and able to maintain this new lifestyle permanently.” She urges patients to eat a healthy diet and exercise regularly after recovery.

    “While their bodies will be remarkably changed for the short term after a body reshaping and contouring, if they are not willing to alter their long-term eating habits and activity level, the change will be short-lived, perhaps only one to two years,” Koo warns.