context: Are sit-ups not giving you the taut tummy you want? If you've got too much flab or excess skin in your abdomen that doesn't respond to diet or exercise, you may be considering a "tummy tuck," which doctors call "abdominoplasty." This surgery flattens the abdomen by removing extra fat and skin, and tightening muscles in your abdominal wall. It's not the same as liposuction, although you may choose to get liposuction along with a tummy tuck. This is a major surgery, so if you're considering it, you should know the facts before you decide whether to go forward. A tummy tuck is suitable for men and women who are in good health. Women who have had several pregnancies may find the procedure useful for tightening their abdominal muscles and reducing skin. A tummy tuck is also an option for men or women who were once obese and still have excess fat deposits or loose skin around the belly. If you're a woman who plans to get pregnant, then you may want to postpone a tummy tuck until you're done having children. During surgery, your vertical muscles are tightened, and future pregnancies can separate those muscles. Are you planning to lose a lot of weight? Then a tummy tuck also is not for you. A tummy tuck should be a last resort after you've tried everything else. It should not be used as an alternative to weight loss. You should also consider the appearance of scars after a tummy tuck. You can talk about scar placement and length with the doctor before the surgery. The first step is to choose a surgeon and see him or her for a consultation. At that meeting, you'll talk about your goals and the following options: Complete abdominoplasty. The surgeon will cut your abdomen from hipbone to hipbone and then contour the skin, tissue, and muscle as needed. The surgery will involve moving your belly button, and you may need drainage tubes under your skin for a few days. Partial or mini abdominoplasty. Mini-abdominoplasties are often done on people whose fat deposits are located below the navel. During this procedure, the surgeon most likely will not move your belly button, and the procedure may only take up to two hours, depending on your case. If you smoke, your doctor will ask that you quit smoking from at least two weeks before the surgery until two weeks after the surgery. It is not enough to just cut down on smoking. You must stop completely since smoking makes complications more likely and slows healing. Don't try a drastic diet before the surgery. Eat well-balanced, complete meals. A healthy diet may help you heal better. Tell your doctor about everything you take, including prescription drugs, herbal medicines, and other supplements. Your surgeon may instruct you to stop taking certain medications for a time before and after the surgery. Before getting the surgery, get your home ready. You'll need: Ice packs Loose, comfortable clothing that can be put on and off very easily Petroleum jelly Hand-held shower head and bathroom chair You'll also need someone to drive you home after the tummy tuck. If you live alone, you'll want someone to stay with you for at least the first night. Make a plan for that. This surgery can take anywhere from one to five hours. You may need to stay overnight in the hospital, depending on your case. You will get general anesthesia, which will put you to "sleep" during the operation. You will have pain and swelling in the days following surgery. Your doctor will prescribe pain medicine and tell you how to best handle the pain. You may be sore for several weeks or months. You may also experience numbness, bruising, and tiredness during that time. As with any surgery, there are risks. Though they're rare, complications can include infection, bleeding under the skin flap, or blood clots. You may be more likely to have 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. A tummy tuck leaves scars. 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 scars. Whether you're having a partial or complete tummy tuck, the area that's operated on will be stitched and bandaged. It's very important to 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. You will have to severely limit strenuous activity for at least six weeks. You may need to take up to one month off work after the surgery to ensure proper recovery. Your doctor will advise you on what you need to do or not do. Generally, most people love how they look after this procedure. That can take time, though. You may not feel like your normal self for months after the surgery. Diet and exercise can help you maintain the results. Insurance companies generally do not cover cosmetic surgery that's done without a medical reason. Yours might if you have a hernia that will be corrected through the procedure. Before you decide whether to get a tummy tuck, contact your insurance company so you're clear on what's covered and what's not. If you think you can make a case that you need the procedure for medical reasons, your surgeon may be able to help you by writing a letter to your insurer.