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Are sit-ups just not giving you the taut tummy you desire? If you've got a little too much flab or excess skin in your abdomen that won't diminish with diet or exercise, you may want to consider an abdominoplasty, popularly referred to as a "tummy tuck".

This procedure flattens your abdomen by removing extra fat and skin, and tightening muscles in your abdominal wall.

But be cautioned: This is a major surgery, so if you're considering it, take the time to educate yourself, thoroughly analyze your own situation and do not rush to make the final decision.

A tummy tuck should be the last resort for people who have exhausted all other measures, and the procedure should not be used as an alternative to weight loss.

Who Are the Best Candidates For a Tummy Tuck?

A tummy tuck is suitable for both men and women who are in good general health overall.
It should not be confused with a liposuction (the cosmetic surgery used to remove fat deposits), although your surgeon may elect to perform liposuction as part of a tummy tuck.

Women who have muscles and skin stretched by multiple pregnancies may find the procedure useful to tighten those muscles and reduce that skin. A tummy tuck is also an alternative for men or women who were obese at one point in their lives and still have excessive fat deposits or loose skin in the abdominal area (see more on Body contouring after major weight loss).

Who Should Not Consider a Tummy Tuck?

If you're a woman who is still planning to have children, then you may want to postpone a tummy tuck until you're through bearing children. Here's why: During surgery, your vertical muscles are tightened. Future pregnancies can separate these muscles.

Are you still planning to lose a lot of weight? Then you do not want to consider a tummy tuck.
It's important to note that a tummy tuck can cause prominent, permanent scarring. If this is something you don't want, you may want to reconsider. Your doctor will discuss all these options with you when you go for the consultation.

How a Tummy Tuck is Done ?

Depending on your desired results, this surgery can take anywhere from one to five hours. The complexity of your particular situation also will determine whether you have it completed as an in-patient or outpatient procedure.

You will receive general anesthesia, which will put you to sleep during the operation. It's important to have someone with you who can drive you home. If you live alone, you also will need someone to stay with you at least the first night after the surgery.

There are two options for a tummy tuck. You and your surgeon will discuss your desired results, and he or she will determine the appropriate procedure during your consultation.

I. Complete abdominoplasty
Your abdomen will be cut from hipbone to hipbone in this procedure, the option for those patients who require the most correction. The incision will be made low, at about the same level as your pubic hair.

Your surgeon will then manipulate and contour the skin, tissue and muscle as needed. Your belly button will have a new opening if you undergo this procedure, because it's necessary to free your navel from surrounding tissue. Drainage tubes may be placed under your skin and these will be removed in a few days as your surgeon sees fit.

II. Partial or mini abdominoplasty
Mini-abdominoplasties are often performed on patients whose fat deposits are located below the navel and require shorter incisions.

During this procedure, your belly button most likely will not be moved. Your skin will be separated between the line of incision and your belly button. This type of surgery may also be performed with an endoscope (small camera on the end of a tube). The procedure may only take up to two hours, again, depending on your own personal situation and the complexity of your needs.

How to Prepare For Tummy Tuck Surgery?

If you smoke, you will have to stop for a certain period as determined by your doctor. It is not enough to just cut down on smoking. You must stop completely for at least two weeks prior to surgery and for two weeks after. Smoking can increase the risk of complications and delay healing.

Make sure you eat well-balanced, complete meals and do not try to diet excessively before the surgery. Proper nutrition plays a key role in healing properly.

If you take certain medications, your surgeon may instruct you to stop taking these for a certain period before and after the surgery. Your surgeon will determine this as part of your pre-operative consultation.

Before undergoing the surgery, you'll need to get your home ready for your post-operative care. Your home recovery area should include:

Plenty of ice packs
Supply of loose, comfortable clothing that can be taken on and off very easily
Petroleum jelly for incision sites
Telephone within reaching distance
Hand-held shower head and bathroom chair

You know yourself best, so make sure you set up the safest, most comfortable recovery area before you undergo the surgery to meet your personal needs.

What Are the Complications and Side Effects of Tummy Tuck Surgery?

As expected, you will have pain and swelling in the days following surgery. Your doctor can prescribe a painkiller if needed and will instruct you on how to best handle the pain. Soreness may last for several weeks or months.

You may also experience numbness, bruising and overall tiredness for that same time period.
As with any surgery, there are risks. Remember, this surgery affects a very crucial part of your body. Though they're rare, complications can include infection, bleeding under the skin flap or blood clots. You may carry an increased risk of complications if you have poor circulation, diabetes or heart, lung or liver disease.

You may experience insufficient healing, which can cause more significant scarring or loss of skin. If you do heal poorly, you may require a second surgery.

As we mentioned before, the scars from a tummy tuck are fairly prominent and though they may fade slightly, they will never completely disappear. Your surgeon may recommend certain creams or ointments to use after you've completely healed to help with the scars.

Taking Care of Yourself After Surgery
Whether you're having a partial or complete tummy tuck, your incision site will be stitched and bandaged. It's very important that you follow all your surgeon's instructions on how to care for the bandage in the days following surgery. The bandage used will be a firm, elastic band that promotes proper healing. Your surgeon will also instruct you on how to best position yourself while sitting or lying down to help ease pain.

If you are an exceptionally physically active person, beware: You will have to severely limit strenuous exercise for at least six weeks. Your doctor will advise you on this as you go through the process. You may need to take up to one month off of work after the surgery to ensure proper recovery. Again, your doctor will help you determine this based on your personal situation.
Return to Living
Generally, most people love the new look after they've undergone this procedure. However, you may not feel like your normal self for months after the surgery. You've gone through a tremendous amount to make this happen, both emotionally and physically, and it's very important that you follow proper diet and exercise to maintain your new look.

Does Insurance Cover a Tummy Tuck?

Be warned: Insurance carriers generally do not cover elective, cosmetic surgery. But, your carrier may cover a certain percentage if you have a hernia that will be corrected through the procedure, or your anterior muscles are abnormally spread.

It's extremely important that you begin communicating with your insurance company early on, and that you discuss your insurance concerns with your surgeon. In most cases, your surgeon will write a letter to your insurance carrier, making the case for medical necessity, if it applies to you.

It's also very important to realize that insurance may only cover certain portions of the surgery, so make sure you get details. With any cosmetic surgery, this may affect future insurance coverage for you and your premiums may increase.

Reviewed by the doctors at The Cleveland Clinic, Department of Plastic Surgery.

See related before after images on Tummy Tuck Photos and Abdominoplasty Before and After. See this post on Tummy Tuck Gone Wrong