Women who want to reshape their belly and tighten their stomach muscles after pregnancy. People who have lost a significant amount of weight and want to trim excess flabby skin on their midline. 

These are the two most common patient groups that come to plastic surgeon Reza Momeni, MD, at Summit Health to explore tummy tuck surgery. A tummy tuck, which is also called an abdominoplasty, is a cosmetic surgery that is used to enhance the appearance and shape of someone’s midsection. 

“The goal of tummy tuck surgery is to look better on the outside and feel good on the inside,” says Dr. Momeni. “Tummy tucks are a very manageable procedure — they are generally fairly straightforward for patients to go through and recover from.”

Nearly 140,000 tummy tucks are performed each year in the U.S., making the procedure the sixth-most common cosmetic surgery. Here are 10 things Dr. Momeni says everyone who is considering having this enhancement should understand.

1. A tummy tuck improves your shape and appearance. It is not weight loss surgery. The procedure is designed to help contour a patient’s abdomen by removing excess skin and small amounts of fat. During a tummy tuck, the overstretched abdominal muscles are tightened with internal stitches to make the abdomen flat again. The remaining skin is then rejoined together, creating a smooth and more toned appearance. 

Only about three to four pounds of fat are lost during a typical tummy tuck. Patients who are looking to lose a significant amount of weight should focus on nutrition, calories, and lifestyle changes, rather than liposuction and tummy tuck.

2. There are different types of tummy tucks. Your plastic surgeon can help you decide which option is right for you. 

• Standard tummy tuck or full tummy tuck — includes repair and tightening of muscle laxity (also known as rectus diastasis), removal of excess lower abdomen skin, and often some liposuction for the front of love handles
• Mini tummy tuck — involves removal of lower abdomen skin only, without lifting the upper abdomen skin or fixing the muscle diastasis separation
• Extended tummy tuck — is similar to a standard tummy tuck, but the incisions are extended farther to the side of the waistline for patients who have excess or stretched skin there as well

3. The abdominal wall stretches after pregnancy. Many of the patients who come to Dr. Momeni have returned to their pre-pregnancy weight and work out regularly. But their stomachs look different than they did before having children. As the baby grows, the muscles in the abdominal wall stretch. 

“These patients find that they have different anatomy than before,” explains Dr. Momeni. “The abdomen is supposed to stretch so the baby grows, but it does not always return to the way it was before.  Even if women are the same weight, there will usually be some tissue hanging over their belt or bikini line and stretching of the muscle that makes some patients feel like they are a few months pregnant. To make the stomach look flat again, we have to go in and fix those muscles.”

4. Do not consider surgery until your weight is stable. There is no ideal weight for a tummy tuck procedure, as long as the candidate is healthy. But it is important for patients to be at a point where they do not plan to lose or gain more than 10% of their body weight. People with a BMI over 35 should consider plastic surgery very cautiously, because the risk of complications increases. 

“If you weigh 160 pounds but you really want to be 120 pounds, then it is not the right time for a tummy tuck surgery,” describes Dr. Momeni. “If you are happy with your body weight but want to shake that extra skin and loose muscle off, a tummy tuck can help you achieve your goal.”

5. Do not crash diet before the procedure. Some people think they should starve themselves prior to a tummy tuck to shed a few extra pounds. This results in a worse outcome, explains Dr. Momeni. “A lot of times patients lose weight right before the procedure, thinking they are going to get a better result,” he says. “The surgery actually can turn out worse after crash diets, because their body is deficient in proteins and essential nutrients.”

6. Tummy tucks can be combined with other procedures. Many individuals seeking plastic surgery are looking to have multiple body areas improved. A tummy tuck can be done at the same time as other cosmetic enhancements. For example, patients who have a tummy tuck after extensive weight loss often want to have excess skin removed from other areas of their body like the arms or neck. In women who have been pregnant, the surgery is commonly combined with a breast lift, reduction, or augmentation.   

“As long as the patient is healthy and the length of the operation is not unsafe, we can combine a tummy tuck with one or two other operations,” explains Dr. Momeni. “Generally, we like to keep the total operation time for each patient under six hours.”

7. Recovery is not as extensive as it used to be. Tummy tucks have evolved tremendously over the past 20 years. Patients used to stay overnight in the hospital for several days. Today, the procedure can be performed in two to three hours at an outpatient ambulatory surgical center. 

“Every patient is different,” says Dr. Momeni. “But generally, you’ll need about two weeks off from work. It will take about a week before you can stand up straight and approximately three weeks before you start to get through an entire day without feeling any discomfort.”

8. Several advancements have been made in tummy tuck procedures. There are many reasons why an overnight stay is no longer necessary with a tummy tuck procedure. Such advancements include: 

• The type of anesthetic that is used in the outpatient setting is very minimal when compared with the hospital setting years ago. 
• Improvements in the types of nerve blocks that are available help minimize postoperative pain, often helping patient to avoid opioid medicines altogether. 
• Drains, which used to be placed at the surgical site to get rid of excess fluid, are not always needed today. In drainless procedures, the patient is typically walking around and showering the next day. 

9. Scars can be hidden and well-managed.  A tummy tuck procedure uses a horizontal incision that can be covered up along the waistline, under the waistband of bathing suits. In most cases, Dr. Momeni says they can use a C-section incision if one is present, so patients only end up with one scar. “In addition to hiding our incisions, we carefully manage the scar healing process, so patients have the best possible result,” he adds. 

10. You can have children after a tummy tuck. But it is best to wait until you have completed your family. Dr. Momeni advises that you postpone your tummy tuck until you are finished with childbearing. Getting pregnant after this procedure will not harm you or the baby, but it will negate the benefits of the surgery.