A tummy tuck is one of the most transformative and high-satisfaction procedures in plastic surgery. It restores a flat abdomen, improves the waistline, repairs muscle separation, and removes excess skin that diet and exercise can’t fix.

But one factor determines whether the result is truly exceptional:

How much tissue should be removed?
The right amount creates a smooth, elegant abdomen.
The wrong amount can distort the torso and create tension.

This balance is where surgical expertise becomes an art form—and where Dr. John Burns has refined a trademark tummy tuck technique over 25 years.

What Actually Happens During a Tummy Tuck?

A modern tummy tuck includes three components working together:

1. Removing Loose Skin & Fat

All excess skin and fat from the belly button to the pubic area (hip to hip) is removed as one controlled segment.

2. Repairing the Abdominal Muscles

Pregnancy and weight changes often lead to rectus diastasis—muscle separation.
Muscle repair (plication) restores core strength and flattens the abdominal wall.

3. Liposuction for Contour & Hourglass Shape

Liposuction of the flanks, hips, waist, and upper abdomen enhances the hourglass silhouette—not just a flat stomach.
If you want to dive deeper into liposuction shaping techniques, explore:

👉 Lean Lipo: How Body Contouring Is Getting Smarter in 2025

The Art & Judgment Behind Tissue Removal

A successful tummy tuck removes enough tissue to flatten the abdomen—but not so much that the torso becomes short or distorted.

The goal is always:

A flat abdomen + a long, elegant waistline.

Removing too much tissue can cause:

• A short-waisted appearance
• Distortion of the pubic angle
• Increased tension → widened scarring
• Difficulty standing upright
• A boxy torso or pulled look

This is why tummy tucks must be carefully planned—not aggressively performed.

Preoperative Markings

Before surgery, Dr. Burns:
• Designs a low, curving incision hidden under underwear/bikinis
• Marks the natural tension lines for ideal closure
• Performs a pinch test to estimate the exact ellipse of removable skin
• Ensures the scar sits ~6 cm above the vaginal cleft for perfect concealment

In the Operating Room

1. Liposuction First
Dr. Burns sculpts the waist, hips, and upper abdomen to thin the flap and enhance final contour.

For patients with loose skin after weight loss or GLP-1 medications, combining liposuction with skin tightening can be powerful:
👉 GLP-1 Weight Loss & Loose Skin: Renuvion Scarless Body Contouring

2. Lower Incision & Tissue Elevation
The lower incision is made, and the upper abdominal flap is elevated to the rib cage.

3. Muscle Tightening
Rectus plication restores midline support and corrects abdominal bulging.

4. Flexing the Table to 30°
This allows the upper flap to meet the lower incision without tension, ensuring:
✔ Ease standing upright
✔ Avoidance of scar widening
✔ Maintenance of a natural torso length

What Proper Tissue Removal Achieves

When the right amount is removed:
• The abdomen is flat—even when sitting or bending
• The waist is refined and elongated
• The scar is low, thin, and beautifully hidden
• The torso maintains its natural proportions
• The pubic region remains natural and untouched
• Healing is smoother with fewer complications

This is the difference between a “basic” tummy tuck and a signature Dr. Burns result.

With thousands of tummy tucks performed over 25 years, Dr. Burns is celebrated for:
✔ Hourglass shaping
✔ Flat, sculpted abdomens
✔ Naturally positioned belly buttons
✔ Extremely low, thin scars
✔ Consistent, predictable outcomes

His credentials include:
• Board-Certified Plastic Surgeon
• Newsweek “Best Plastic Surgeons in America”
• Texas Monthly SuperDoctors
• D Magazine Top Plastic Surgeon
• Former President, Dallas Society of Plastic Surgeons
• Medical Director of an AAAASF-accredited surgical center

For patients looking to combine procedures safely, read:
👉 How Much Is Too Much? Safety in Multi-Area Surgery After Weight Loss