Having a pacemaker defibrillator does not automatically mean you cannot have a tummy tuck, but it does make the procedure more complex. The key factor is careful planning and coordination between your plastic surgeon, your cardiologist, and the anesthesia team. Some surgeons and anesthesiologists are comfortable operating on patients with implanted devices, but usually only in a hospital setting with full monitoring and support. Special precautions are taken to avoid interference with the device, such as adjusting how electrocautery is used and ensuring the pacemaker is managed by your cardiology team before and after surgery. This is not a situation where every surgeon would proceed, but with the right team and environment it can be considered. The most important first step is a consultation with your cardiologist to confirm whether you are medically fit and to coordinate perioperative device management. I have also shared a detailed video where I explain how tummy tuck planning changes in patients with cardiac devices and what precautions are typically taken. — Güray Yesiladali, MD