If your New Year’s resolution involves a flat tummy, you may think you can easily check it off the list with one little surgery. But abdominoplasty, popularly known as a ‘tummy tuck,’ is not a little surgery—and it’s not for everyone.

A tummy tuck can solve the problems of excess abdominal skin and muscle laxity for a select group of candidates, particularly women who find they can’t rid themselves of a post-pregnancy belly bulge. However, abdominoplasty is a serious surgery that requires serious recovery time, and its long-term success largely is dependent on the patient.

Not everyone who wants a flatter abdomen is an ideal tummy tuck candidate. “Heart or lung disease is a major contraindication. Smokers must be smoke-free for at least two to four weeks before and after the surgery. And if one is still significantly overweight—in the obese category of BMI (body mass index) greater than 30—without having started a healthier lifestyle, then again the results would be sub-optimal,” says Dr. Michele Koo, a St. Louis plastic surgeon.

Dr. Marissa Tenenbaum, a plastic surgeon with West County Plastic Surgeons of Washington University, agrees. “Occasionally I do turn people away,” she says. “I want my patients to have a great result without the added risks that obesity can cause. Ideally, the patient is at or near an ideal weight and has maintained that weight for several months. They need to understand that a tummy tuck is not a weight-loss procedure—people are often surprised that they only lose a couple pounds after having a tummy tuck.”

Shaping up before the procedure is common advice. “An abdominoplasty is a very safe procedure, but as with any surgical procedure, there are some things you can do to improve the odds that everything goes well,” says Dr. William Huffaker, a plastic surgeon with St. Louis Cosmetic Surgery.

“Any surgical procedure goes easier for patients who routinely exercise before surgery,” Huffaker notes. “Even walking 2 miles three times a week is adequate. There also will be some blood loss, so why not prepare yourself? Before surgery, take an iron tablet and a separate multi-vitamin each day. You'll need to continue this for a while after surgery, as well. And your body needs extra protein to heal well. Thirty grams a day before surgery and 60 grams a day after is a good start.”

Post-surgical success also relies on a patient’s ability to adhere to a healthy lifestyle that will result in weight maintenance. “The tummy tuck has at least a two-week recovery, and one has to change their lifestyle or the flattest stomach after the surgery will only be short-lived,” Koo says. “Again, everyone in relatively good health is a candidate if they have excess skin, but how long the results will last is completely dependent on the person's willingness to sustain a change of eating and activity level to maintain a stable weight.”

So resolve to eat right and exercise in order to achieve a healthy weight. Then talk to a board-certified plastic surgeon to determine if a tummy tuck is right for you.

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