Some people, who only have a few extra pounds left to lose but have an "apron" get liposuction done followed by a tummy tuck. Liposuction is when they cut a slit in whatever part of your body you're having done, stick in something that looks frighteningly like the nozzle of a vacuum cleaner and suck out up to 15 lb of fat cells (I believe 15 lb is the limit for safety, but I could be wrong). The don't just stick the nozzle in the slit. They jerk it back and forth in a very rough manner and all this ugly yellowish globby stuff comes out. Apparently there's a lot of pain afterward. I don't even want to know what they do with the stuff they suck out.
I believe you can have a simple tummy tuck where they cut away a semi-circular segment of the loose skin that is hanging down, reposition your belly button and stitch everything up nice and tight. I met a woman who worked as a salesperson in a large size store and she said she had it done and her medical covered it because it was aggravating her bad back. This woman was not slim by any means. She still had a protruding tummy but she didn't have that apron of flab and skin hanging down any more and she said it was the best thing she'd ever done. I have my doubts. Having survived two C-sections, I'm not that enamored of abdominal surgery. Still, it's something I'm seriously considering. I really hate this flab hanging down. It's disgusting and it really hurts my lower back.