Safety of Having Tummy Tuck and Lipo at the Same Time?

Question

I am in the process of selecting a plastic surgeon for a breast augmetation, Tummy tuck & Lipo, I have narrowed it down to 2 board certified surgeons but they have different views, both have 20 years of experience, One of them refuses to do lipo with a TT, he says there are deaths related to doing these two operations at the same time, he doesn't want any part of that. I have seen 5 different surgeon plus read many reviews where people have done both procedures, Is there cause for concern?

Gregory Turowski, MD, PhD, FACS · Answer

I would generally recommend full abdominoplasty with liposuction of abdomen and flanks at the same time. I do not think you can get satisfactory results without liposuction in most cases. This combined procedure is safe as long as it is done by an experienced board certified plastic surgeon who has done lots of these combined procedures and follow safety guidelines

Ozge Ergun, MD · Answer

Thanks for the question. Yes, it is safe. If you want to get a liposuction and tummy tuck at the same time you can get. You should meeting with a Board Certified Surgeon and planning the process. After planning, everything will be better. I wish you all the best.

J. Jason Wendel, MD, FACS · Answer

As long as your plastic surgeon is skilled and careful, limited liposuction and tummy tuck can be performed at the same time.

York Jay Yates, MD · Answer

Combining liposuction and a tummy tuck certainly increases the risks of doing either procedure separately.  The question is how much additional risk are we willing to accept.  The risk depends on "how much" liposuction you are considering.

	Abdomen liposuction with abdominoplasty

	
		LIposuction of the abdomen can be done safely at the time of an abdominoplasty.  The abdominoplasty technique should be modified to preserve vascularity (lipoabdominoplasty).  


	Small volume liposuction with abdominoplasty

	
		A little liposuction of the upper hips at the time of abdominoplasty is pretty low risk and something that I frequently do.


	Larger volume liposuction with abdominoplasty

	
		The risk of DVT/ PE is increased with larger volume liposuction combined with abdominoplasty
	
		Every plastic surgeon has their own appetite for risk.  Mine is very small, it is what helps me sleep at night.  This is cosmetic surgery and my feeling is that whenever possible, risks should be minimized.  For this reason, I do not combine extensive liposuction with abdominoplasty.

David J. Levens, MD · Answer

It is routine with most surgeons to combine "tummy tuck" (abdominoplasty) with liposuction and the combination can be quite safe.  Typically, liposuction of the lower back/flank area is done to complement the improved contour in front.  Additionally, the upper abdominal wall fatty layer thickness can be carefully reduced with liposuction while elevating, removing and tightening the lower skin.

	The concerns arise with too much liposuction volume removal leading to potentially excessive fluid and blood loss and with excessive thinning of the upper abdominal tissues resulting in compromised blood flow and healing problems.  These problems can be avoided with good judgement and careful technique.

	Good luck.

Steven Wallach, MD · Answer

Certainly liposuction of some areas as well as a tummy tuck in many cases can be done at the same time. I prefer to avoid liposuction of the abdomen in conjunction with the tummy tuck for concern over blood supply to the abdominal flap.

Brian K. Brzowski, MD, FACS · Answer

As the others have said, there is a slight but very acceptable increase in risks by combining these procedures.  After thoroughly considering your options, you should select a surgeon with whom you feel comfortable and follow his or her recommendations.

Good luck!

Steven Turkeltaub, MD · Answer

Both of these plastic surgeons are right in their points of view. The issue of combining liposuction with a tummy tuck is that there would be an increased operative time which does increase the risk for a pulmonary embolus though that risk is very low. Nevetheless, a pulmonary embolus is a serious issue which can be fatal at times. EVen when precautions are taken, there are still attendant risks.

	With that said, I do combine both procedures a majority but not all of the time. This decision is based on multiple issues including the patient's health, risk for pulmonary embolus/blood clots, the amount of fat that would need to be removed and expected operative time. Knowing your personal information regarding these and other issues could help in providing you with a more accurate answer. Of course consider the saying that "it is always better to error on the side of caution".

Peter E. Johnson, MD · Answer

There are valid points to both surgeons views, as liposuction with tummy tuck can significantly increase the risks. Still many plastic surgeons are able to combine tummy tuck with some liposuction of the flank and back to enhance contour in a safe way. The issues are operative time, and volume aspirated as deaths are related to both. Hear out both. If the lipo you need is within a surgeons experience of reason and safety you should be taking a reasonable risk. Of course, there is nothing wrong with lipo after if you like the other's tummy tuck results, and he is at least placing your interests first.
	Best of luck, peterejohnsonmd.com

Mark D. Wigod, MD · Answer

Liposuction with abdominoplasty is a well established procedure, but does have increased potential problems. The most concerning of which is DVT or PE. The plastic surgery community has tried to reduce the risk of embolic phenomenon by using the Caprini scale for deciding which patient would benefit from blood thinner after an operation. I use Lovenox as a blood thinner on most, if not all, of my abdominoplasty patients to help minimize the risk of blood clots.

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Safety of Having Tummy Tuck and Lipo at the Same Time?

Answers (13)

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