Who doesn't want a trim, flat stomach? Millions strive for tighter tummies, usually starting by improving their diet and exercise routines. However, these changes often aren't enough to achieve desired results. While body fat can be reduced through a healthy diet and workout plan, the loose muscles and skin that frequently result from extreme weight loss, pregnancy, and even aging and heredity aren't as easily eliminated.

For this reason, abdominoplasty is the surgical procedure of choice for an increasing number of Americans. According to the American Society for Aesthetic Plastic Surgery (ASAPS), more than 185,000 Americans opted for abdominoplasty in 2007, making it one of the nation's most popular elective surgeries.

Also known as a tummy tuck, this procedure tightens the muscles in the abdominal wall and removes excess skin and fat, resulting in a flatter, smoother midsection. Ideal candidates are women whose stomach muscles and skin have been stretched by multiple pregnancies, individuals whose skin is sagging from having lost a large amount of weight, and those who are simply genetically predisposed to having a bulkier midsection and are unable to lose the weight through diet and exercise.

Understanding the Procedure

The complexity and amount of time necessary to complete abdominoplasty can vary considerably. The procedure can last anywhere from one to five hours and is done as an inpatient or outpatient procedure, depending on the patient's needs. Abdominoplasty is most often performed under general anesthesia but may also be done under local anesthesia with mild sedation, which typically causes more discomfort.

The procedure begins with the surgeon making a long incision right above the pubic mound and across the abdomen from hip bone to hip bone. A second incision is then made to separate navel from abdominal tissue. Although the skin around the navel is moved, the navel itself actually remains in place. The skin is then separated from the abdominal wall, all the way up to the ribcage, so that the vertical abdominal (rectus) muscles are exposed. These muscles are then tightened and repositioned through stitching, shrinking your waistline.

Once this portion of the surgery is complete, the surgeon will then remove excess fat, either by hand, via liposuction, or through both.  Finally, the excess and loose skin is stretched and removed. The remaining skin is then redraped over your abdominal area and stitched back into place and the belly button is repositioned through the newly draped skin. 

Recovery After Abdominoplasty

Because abdominoplasty is considered a major surgical procedure, the recovery time is substantial. The abdominal area will likely be swollen and sore for the first several days following the operation, and bed rest for this time is often necessary. Medication can be prescribed to help control pain and discomfort. 

Some people are able to return to work and a regular routine after a week or two; others require up to four weeks for recovery. Most patients need several weeks to feel back to normal and to see the full results of the surgery. Recovery time is likely to be shorter for those who are in good physical condition.

Compression garments are often provided to wear around the abdomen for several weeks following the surgery, and sometimes special elasticized stockings are required to decrease the risk of blood clots forming in your legs while you are healing.

Many physicians agree that starting a light exercise routine, such as walking, about a week after the operation can improve the recovery. However, it's critical to avoid any type of strenuous activity for at least six weeks. During recovery, pay attention to your body's limitations to avoid reopening the wounds, which could set back healing and possibly cause dangerous infections.

Tummy Tuck Costs

The cost abdominoplasty is high—ranging from $3,000 to $8,500, depending on the complexity of the surgery and the desired results. It is considered an elective procedure, and most insurance companies will not cover the cost unless it has been deemed necessary for medical reasons or is being done for reconstructive purposes after an accident. However, companies, such as Capital One, offer financing options to help offset the costs.