Abdominal wall surgery is voluntary (elective) surgery that improves the appearance of flabby, stretched-out abdominal muscles and skin. Such surgery is often called a "tummy tuck." It is a different procedure than liposuction.

Cosmetic repair of the abdomen can help improve appearance, especially after massive weight gain and loss. Abdominoplasty can help flatten the lower abdomen and tighten stretched skin.

The surgery is done in a hospital's operating room. You will receive general anesthesia, so you will be deep asleep and pain-free during the procedure. The surgeon will make a cut across the abdomen, just above the pubic area. Excessive fatty tissue and loose skin are removed from the middle and lower sections of the abdomen. The abdominal muscles may be tightened.

Stitches are used to close the surgical cut. Excess skin and fat can also be removed from the arms and legs.

Small flat tubes (drains) may be inserted to allow fluid to drain out of the surgical cuts. A firm elastic dressing is applied to the abdomen.

Abdominoplasty can be helpful when:

• Diet and exercise have not corrected severe muscle weakness, for instance, after multiple pregnancies
• Skin and muscle cannot regain its normal tone, which can occur with obesity

Abdominoplasty is not used as a substitute for weight reduction.

The risks of bleeding and infection are present for all surgeries. Additional risks of blood clots and infection also exist.

You will feel some pain and discomfort for several days after surgery, which can be managed with pain medications. Resting with the legs and hips bent may reduce pressure on the abdomen during the recommended 1 - 3 day hospital stay.

An elastic support similar to a girdle, worn for 2 - 3 weeks, provides extra abdominal support while healing. Strenuous activity and straining should be avoided for 4 weeks.

The scars will become lighter in color and flatter during the next 3 - 6 months.

Townsend CM, Beauchamp RD, Evers BM, Mattox KL. Sabiston Textbook of Surgery, 17th ed. St. Louis, M0: WB Saunders; 2004.