There is more than one way to flatten your tummy. Diet and exercise works for those who need to reduce fat in general. Liposuction removes fat cells from targeted areas. Noninvasive procedures freeze fat and cause it to disappear over time. But the only thing that addresses the abdominal muscles, fat and excess skin is abdominoplasty—a tummy tuck.

Tummy tucks are surgical procedures that usually require an overnight stay in the hospital and several weeks of recovery. Yet for women who have lost massive amounts of weight or who are left with muscle and skin laxity due to pregnancy, tummy tucks can create a tighter, more taut abdominal area.

“There really are no good alternatives to tummy tucks,” says Dr. David Caplin, a plastic surgeon with Parkcrest Plastic Surgery. “There are some external ultrasound devices that claim to be able to shrink skin and reduce fat to some degree without making any incisions but these are, as yet, nowhere near as effective as traditional surgery. Liposuction may be an alternative in patients whose primary problem is excess fat and who have a very limited amount of loose skin. SmartLipo (laser-assisted liposuction) is one of the techniques that I have found very effective in these cases.”

Although minor tweaks to the procedure, such as new types of stitches and local anesthetics to help reduce post-surgical pain, are available, abdominoplasty has changed little over the past several years, explains Dr. Terry Myckatyn, a plastic and reconstructive surgeon with West County Plastic Surgeons of Washington University.

Despite the advent of nonsurgical procedures and technologies designed to flatten the tummy, ‘no other procedure can do what the tummy tuck can do,’ Myckatyn says. “It’s not a weight-loss procedure at all,” he emphasizes. Instead, Myckatyn views abdominoplasty as a corrective procedure.

When the abdominal muscles have been stretched, as in pregnancy, a gap can occur down the middle of the abdomen where the muscles used to come together. This separation is known as diastasis recti, and exercise alone will not correct it. Surgeons can bring the muscles back together while removing excess skin, tightening the entire abdominal region and cosmetically repairing the belly button.

“This is a significant surgical procedure and it requires commitment on the part of the patients if they want to maximize safety and outcome,” Caplin says. “They have to be willing to limit activity postoperatively, and their weight should be as close to ideal as possible at the time of surgery.”

He also recommends consulting a qualified, board-certified plastic surgeon who has experience in all types of body-contouring procedures, “in case there is a good alternative to a tummy tuck that might involve less surgery.” Potential patients also need to make sure the facility in which the surgery is performed is appropriately accredited and equipped to handle any problems that might arise both during and after surgery, Caplin notes.

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