Each procedure tackles a different problem.
Liposuction removes fat. It does not, in my opinion, tighten the skin significantly. Even if the laser liposuction is used, I do not believe any meaningful tightening of the skin occurs without significant risk of unevenness and discoloration of the skin. If you look closely at the results of many laser procedures, the skin appears dark, mottled, and oddly contracted. If there is a significant amount of loose skin, liposuction is simply very disappointing when done without any tightening of the skin or fascia. Most tummy tucks also involve liposuction at the same time anyway. Patients should avoid promises from physicians who claim tummy tuck results from the laser alone. It will not happen.
Why doesn't liposuction alone tighten the abdomen of a post-pregnancy woman?
Tummy tucks remove extra skin. They can also tighten the deep layer, the fascia.
So depending on where the loose skin is, and where the loose fascia is, that determines what procedure will give the best result.
Why doesn't a mini tummy tuck give a great result in most postpartum women?
In most women who have had children, the deep layer (fascia) is loose. This looseness almost always reaches from below the belly button to above the belly button. The upper abdomen is an area where the mini tummy tuck does not reach. Tightening just the area below the belly button (as with a typical mini tummy tuck) often gives the appearance of a bulge in the upper abdomen with a flat lower abdomen. Most women are quite unhappy with that look. We perform many mini tummy tucks in our practice, but they accomplish very limited tightening, and are really more like scar revisions of an uneven C-section.
For patients with lots of loose skin, we perform a version of the full fummy tuck (regular incision, low incision with vertical component). We discourage the belly button float technique, where the belly button stalk is cut and the entire belly button is moved much lower.
For patients with minimal loose skin, usually women with very little weight gain during their pregnancies, we perform a Hybrid tummy tuck(R). This involves a C-section type incision with full tightening of the deep fascia, all the way up. It is a way for fit moms who don't have a lot of loose skin to avoid a long or long and high incision. It is especially suited for fit women with high belly buttons.
