One of the hardest changes a woman’s body goes through is the loss of elasticity and firmness in the stomach area after childbirth. To make room for those growing bundles of joy, the abdominal walls stretch and the skin becomes overextended in order to bear the extra weight. It makes it super hard to get a flat stomach (or the semblance of a waist) with diet and exercise only. Oftentimes, a tummy tuck is the only way to restore firmness to the loose skin and sculpt out an hourglass shape.

For Houston plastic surgeon German Newall, MD, getting the cinched-in results his patients desire is all about the technique: “The abdominoplasty I perform is different than most, it’s a lateral high-tension abdominoplasty, which allows me to define the abdominal muscles in the midline a little better, what we call the linea alba. This gives the patient a more athletic look.”

The difference between this technique and a typical abdominoplasty is the way in which the abdominal muscles are tightened. “Most abdominoplasties tighten the muscles only in a vertical line. The lateral high-tension tummy tuck that I perform involves putting the tension laterally by designing a wider area of skin where I’m going to cut on the lateral sides. I basically cinch in the waist, and that’s by design, almost like a corset,” says Dr. Newall. It’s not a new technique, but Dr. Newall says it is the best way for him to achieve such dramatic results. “When I do my abdominoplasty, I tighten the muscles in the middle in an aggressive way as well, so that it further tightens the abdomen to create a very drastic change. I also do a very aggressive liposuction to give the waist definition.”

To ensure the best possible results, Dr. Newall advises his patients to be as close to their goal weight as possible. “The thinner the patient, obviously the more dramatic the result. To get this type of waist definition on a heavier patient it can be a little bit more difficult. With patients in the 180–200 pound range, which I have good results with as well, it sometimes requires a secondary liposuction of the abdomen four months after surgery.”

As far as pricing, a procedure like this can start out at around $10,000. “That’s for your typical abdominoplasty without any liposuction,” says Dr. Newall. “If you add liposuction, the price starts incrementing. A tummy tuck with liposuction to the hips, flanks and upper back can cost anywhere from $13,000–$14,000.” One thing to keep in mind is that the cost of plastic surgery varies greatly based on several factors, including location and the experience and training of your surgeon.