The only patients for whom a tummy tuck is superior to abdominal liposuction are the relatively few women having extreme degrees of lower abdominal skin laxity, unusually extensive stretch marks, or severely stretched abdominal muscles (as a result of pregnancy). Tummy tuck surgically removes skin with severe stretch-marks (striae-distensae). Liposuction does not remove stretch marks. A tummy tuck can produce a flatter abdominal wall by tightening the abdominal muscles. Liposuction is appropriate for patients who have abdominal muscles that have not been excessively stretched out of shape by pregnancy. A tummy tuck can remove excessive amounts of loose abdominal skin. However, loose abdominal skin does not mean that a tummy tuck is necessary. After liposuction, abdominal skin often contracts to a surprising degree so that an excision is not necessary.