Whenever I am cornered at a party, getting pimped about plastic surgery, one of the most common questions I get is “how do I avoid a tummy tuck?” Here are some simple tips:

1. Avoid excessive weight gain during pregnancy. The biology of pregnancy can cause a lot of damage to a woman’s body. Excessive weight gain during pregnancy simply adds insult to injury. In the past, Obstetricians used to tell women they were “eating for two.” This false consult became a license to pig out and gain 30, 50 and even upwards of 100 lbs. Unnecessary weight gain and subsequent weight loss damages the abdominal wall in all its layers. The abdominal fascia (and rectus muscles in particular) stretches and loosens. The fibrous seam between the six-pack muscles (linea alba) weakens, and if severe enough, can lead to a perma-pregnant look. If that is you, an abdominoplasty with rectus muscle plication with permanent stitches is the only solution for restoration of your pre-pregnancy shape. In addition, the skin and its elasticity can be compromised leading to laxity and in extreme cases; an apron of skin (“pannus” in medical jargon) can develop and hang over the pubis. If this is you, you need a tummy tuck. If your abdominal wall is not blown out and you don’t have a kangaroo pouch, and all you have is a little pudge that resists diet and exercise, liposuction can be the answer. If the actual amount of fat is smaller, a non-invasive technology like Coolsculpting or BodyFX by Inmode can work. If you have a modest amount of lose skin and fat but your core is okay (no rectus diastasis), then a skin-shrinking liposuction technology like VASER (ultrasound energy), Smartlipo (ND:YAG) or more recently Bodytite by Invasix (radiofrequency energy) can potentially shrink wrap your abdomen without an incision. The bottom line is pregnancy can be a very capricious process with some women sailing through unscathed and others getting savaged. Don’t make it worse on yourself by getting fat.
2. Avoid excessive weight gain period: massive weight gain and subsequent loss is a wrecking ball on the human body. It leads to unnecessary surgery, including the bariatric procedures to surgically induce weight loss including laparoscopic gastric bypass, gastric sleeve, VBG, etc, etc. The aftermath of weight loss surgery is even worse with loose, unattractive, Sharpei dog skin requiring multiple rounds of big plastic surgery procedures such as abdominoplasty, extended abdominoplasty, circumferential abdominoplasty, thigh lifts, breast lifts, face lifts, butt lifts, etc, etc. This gets very expensive very quickly in addition to the medical risks involved.
3. Work out during pregnancy: women who are fit and exercise regularly generally recover faster and their bodies spring back to baseline more often. This includes working out during the actual pregnancy process and strengthening your core abdominal muscles. Strengthening your core will potentially protect against excessive rectus diastasis and a post-pregnancy Buddha belly. In addition, the unneeded weight gain referenced in item number one is avoided.
4. Good nutrition: this recommendation dovetails with items 1+2. You are what you eat, and stuffing your face with processed foods (rather than healthy alternatives such as fruits, vegetables, whole grains, and leaner meats) is a road to obesity.

A tummy tuck or abdominoplasty is a great procedure and can be life changing. I do them all do long and enjoy the surgery and the happy patients. That being said, if you can avoid a plastic surgery and plastic surgeons like me, please makes every effort to do so!