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I'm concerned about my protruding my upper belly? (photo)

When I ppinch it there is a lot of fat. PS is only performing a TT and BR and says lipo is too risky to do at the same time. I weigh 177 and am 5'4"And am 51. Will he be able to reduce all the excess on my belly and waist. What kin of results should I expect? If I lose 20lbs. After the surgery what would happen with my results.

Doctor Answers (24)

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What to expect after tummy tuck.


Thank you for your questions and for your photographs.  You look as though you're an excellent candidate for breast reduction surgery.


From your photographs it appears that you carry weight both inside and outside of your abdomen.  Tummy tuck will remove the loose skin from the lower abdomen and help to flatten the abdominal wall, but how flat it will get depends upon the weight you carry inside.  When the abdominal wall muscles are tightened they will ultimately relax depending upon how much internal weight you have. 

Some people have additional fatty fullness in the external upper midline of the abdomen as well.  It looks like this may be the case with you.  In my own practice I do not aggressively liposuction this area on the same day as the tummy tuck because it can increase the risk of wound healing problems.  So in a patient of mine with upper abdominal fatty fullness we will sometimes come back a few months after the tummy has healed and do some additional upper abdominal liposuction when it is safer.  I do not mind including liposuction of the hips or flanks at the time of tummy tuck because I find that that does not impact upon the healing of the lower abdomen.

These are good questions to ask your surgeon because from the photographs it's hard to tell if the fat in the upper abdomen is on the inside, where liposuction can't get to it, or on the outside where liposuction may eventually be of benefit.

You spoke about losing weight.  It's often best to get to your goal weight before surgery.  If you have a beautiful tummy tuck and then you lose a lot of weight the skin will get loose are once again.


Best wishes.

Web reference:

Washington DC Plastic Surgeon
5.0 out of 5 stars 43 reviews

Liposuction and tummy tucks


It is risky to liposuction the upper abdominal wall as you can disrupt the blood supply to the lower abdominal wall.  I  cannot tell from looking at the photograph but it looks like you might have a large amount of intra abdominal or visceral fat.  If that is the case the best result will be obtained with you losing weight before the surgery and strengthening your core muscles so when the tummy tuck is done your PS will be able to maximally tighten your fascia. 

La Jolla Plastic Surgeon
5.0 out of 5 stars 8 reviews

Mommy makeover


I think you will be happy with the results, but if you are concerned, then you could see another surgeon who is willing to suction at the same time.

Columbia Plastic Surgeon
5.0 out of 5 stars 25 reviews

Concurrent liposuction of the abdominal skin with abdominoplasty is dangerous and often unnecessary.


Liposuction of the abdominal drape edge trauma to tissue already elevated and placed under tension. This increase the risk for wound healing and tissue loss. If a drape is too thick it can be liposuction secondarily. Seldom is it necessary.

Web reference:,21-atlanta-abdominoplast.htm

Atlanta Plastic Surgeon
4.5 out of 5 stars 6 reviews

Results without liposuction after a tummy tuck


Sure, if you lose more weight like the 20 lbs you mentioned, you will be better off.  Intrperitoneal fat( the fat under your muscles) will not be treated so some girth will remain. You can always have liposuction of the abdomen after the tummy tuck as well.

Manhattan Plastic Surgeon
4.5 out of 5 stars 14 reviews

Abdominal wall laxity



Thank you for the question and the photo.  The fullness or protrusion of your upper abdomen is likely secondary to a combination of issues including fat above the abdominal wall, abdominal wall weakness, and fat below the abdominal wall.  Tightening of the abdominal wall (muscle tightening) will correct one of these issues.  I think you would also benfit from some liposuction of this area.  Each plastic surgeon has his/her own method of doing things and of couse your plastic surgeon knows your body and medical history the best and would be able to make the most accurate decision.  If you are otherwise healthy and a non-smoker I think liposuction at the same time as a tummy tuck can be performed safely and effectively.  The link below shows an example of this.

All the best,

Dr Remus Repta

Web reference:

Scottsdale Plastic Surgeon
5.0 out of 5 stars 72 reviews

Liposuction can be done with a tummy tuck...but usually only of the hips


It appears as though you'll get a nice result with a breast reduction and a tummy tuck.  I frequently perform liposuction of the hips at the same time as a tummy tuck, but liposuction of the upper belly can endanger the blood supply to the skin.  Good luck!

Web reference:

Baltimore Plastic Surgeon
5.0 out of 5 stars 61 reviews

Liposuction At Time of Tummy Tuck Surgery?


Thank you for the question and pictures.

 I would agree with your plastic surgeon, in that too much liposuctioning of the abdominal wall at the same time as tummy tuck surgery may be dangerous and ill-advised.

 If at all possible, try to achieve as close to your long-term stable weight PRIOR  to proceeding with body contouring surgery. Doing so will decrease the chance of complications around the time of surgery and minimize chances that you will need additional surgery subsequently.

 Best wishes.

Web reference:

San Diego Plastic Surgeon
5.0 out of 5 stars 623 reviews



I would not perform liposuction with the abdominoplasty on the upper abdomen at the same time. You run the risk of having complications which are unnecessary

New York Plastic Surgeon
5.0 out of 5 stars 9 reviews

Definitely: Lipo with Abdominoplasty


Combined Breast and Abdominoplasty procedures provide some of the most dramatic results in plastic surgery.  Breast reduction provides plastic surgeons with their happiest patients. Abdominoplasty addresses muscle separation, skin excess and fatty tissue of the abdominal wall. It does not, however, address intra-abdominal fat.  Your photos demonstrate that you are a very good candidate for BR. 

Your photos show minimal fullness in the hip, buttock, and thigh regions compared to the abdomen. Abdominoplasty can be performed safely with liposuction as well as direct excision of fatty tissue deep to the superficial fascia of the abdomen.  Direct excision provides a more even result and can be complemented safely with lipo of the hips and right under the breast bone.  I tell my patients lipo touch ups can be undertaken post op if necessary as well. Related to weight, appropriate weight is always ideal, but I have a frank discussion with my patients as to what the likelihood of them achieving that goal weight pre-operatively and act accordingly.  Remember that you will likely loose at least 5 pounds with the surgery alone. 

Philadelphia Plastic Surgeon
5.0 out of 5 stars 14 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.

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