A tummy tuck is used to correct problems that occur either through pregnancy or significant weight loss or aging. When a tummy tuck is done, excess skin is removed and also the stretched muscle wall is tightened with some special sutures. It's important to remember that there is no way to make the abdomen completely flat because of how the abdomen is structured and how the muscles attach to the surrounding structures including the ribs and the hip bones or the pelvis. When the muscle repair is done, the bulging muscle cannot be flattened below the level of where the muscle actually attaches to the surrounding bones. Also, an important reason for some continued lower abdominal bulging that has to be assessed when someone has concerns about continued abdominal bulging are to very carefully look in a mirror from the side. What you can see, which is common in many women, is called a lumbar lordosis. This is where the lower back curves toward the front. As you can imagine, if the spine is curved toward the front this will push the abdomen outward and there is no way to correct this because this is actually the spinal column that is causing the apparent bulging, even though the muscles may be as tight as they can possibly be made. In this photo, you can see the significant curvature of the patient's lower back. When evaluating your results, make sure that you look at yourself in a mirror and understand that the rest of your anatomy always affects the results of any surgery.