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?
Safety of Having Tummy Tuck and Lipo at the Same Time?
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Safety of Having Tummy Tuck and Lipo at the Same Time?
Complex issue and plastic surgeons have differing views. What we worry most about is the risk of blood clots in the legs (DVT), which are dangerous because they can lead to a clot breaking off and traveling to the lungs (pulmonary embolus), which can be fatal. Although rare in general, they seem to occur slightly more commonly in patients having full tummy tucks. We reduce that risk by using leg compression devices during surgery, having patients get up and walk early postoperatively (and some of us encourage the use of pain control "pumps" to aid in reducing postoperative pain so that patients are more comfortable and therefore more mobile inthe early period after surgery), AND by reducing the amount of time the patient is asleep on the table during surgery. The risk of DVT/PE does seem to be higher in patients who are having multiple procedures along with a tummy tuck and who are under general anesthesia over maybe 6 hours or so. So, although patients almost always desire to have as many procedures done at the same time as possible, many of us (myself included) discourage patients from having multiple procedures (such as liposuction, long breast surgeries, etc.) performed at the same time as a full tummy tuck for safety reasons. Unfortunately, although some plastic surgeons may believe that these marathon surgeries are safe and encourage them, there are other plastic surgeons who will do these simply bowing to patient pressure or because they are afraid the patient will not return for additional surgeries if they are staged on different days. These are not valid reasons, in my opinion. Discuss these issues with your surgeon during your consultation.
Ask about Lovenox
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.
Combination of the tt and liposuction works in most cases
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
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Liposuction Combined with a Tummy Tuck
It is very common to combine liposuction at the same time as a tummy tuck. It can be safely done. Trouble can arise if too much liposuctioning is done or if liposuction is done in such a fashion as to compromise blood supply to the abdominal tissues . Liposuctioning of the hips can be an important part of obtaining a satisfactory result in some body types so as not to leave behind a "wave" of tissue. An experienced surgeon, certified by the American Board of Plastic Surgery is not likely to take risks with your health. Research your surgeons credentials and go with one you feel comfortable working with.
Tummy tuck and liposuction
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.
Safety of performing a tummy tuck and liposuction during the same operative setting
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".
Tummy tuck together with lipo
As long as your plastic surgeon is skilled and careful, limited liposuction and tummy tuck can be performed at the same time.
Liposuction with tummy tuck is okay.
The two procedures can safely be combined
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.
Is combining a tummy tuck and liposuction safe?
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.
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.