You are correct, the best way to get rid of loose, excess abdominal skin is with a tummy tuck.
The vast majority of patients who have loose, excess abdominal skin secondary to weight loss or pregnancy also have seperation of the vertical abdominal muscles. The speration of these vertical midline muscles adds to the appearance of lower abdominal bulging, fullnes, and roundness. During a tummy tuck, the thick, fibrous covering of these muscles are sutured back together, pulling the muscles into a normal, midline position. Note that the muscles themselves are not cut or sewn. This part of the operation, called muscle plication, adds about 15 minutes to the surgery. Failure to perform muscle plication during a tummy tuck will leave most patients with a sub-par result and continued lower abdominal bulging.
Occasionally, a patient's excess skin is limited to the lower abdomen (i.e. below the belly button) and they do not have seperation of the abdominal muscles. In the case where abdominal muscle tightening is not necessary, a mini tummy tuck can be performed to remove excess lower abdominal skin only.
I recommend you be evaluated by a plastic surgeon certified by the American Board of Plastic Surgery to find out if a mini tummy tuck or standard tummy tuck is best for you.
Jaime Perez, M.D.
Tummy Tuck Specialist in Tampa, Florida
Plastic Surgery Center of Tampa, Florida