Why Do Some Surgeons Prefer Not to Do Lipo of the Upper Belly when Having a Tummy Tuck?

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upper abs

11 Doctor Answers | Asked by New Mrs. C. in Norman, OK

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Tummy Tuck With and Without Upper Abdominal Liposuction

Liposuction is not done in the central upper abdomen at the time of a tummy tuck by many plastic surgeons in an effort to a avoid wound healing complications. While it may be viewed as a 'homerun' effort and offers more complete abdominal contouring, should a necrotic skin flap develop below the belly button (no matter how small) it will make you wish it had been omitted from the procedure. It is much better to have a tummy tuck that heals well. You can always undergo a secondary... more

Avoiding liposuction in the upper abdomen

I tend to agree with all the answers here with regard to the increased risk of wound problems and skin flap death when aggressively liposuctioning this area. I would add that if your surgeon is telling you that he or she does not want to add risk to the procedure, I would take this advice to heart. Your safety as a patient should be one of the top three priorities that any board-certified plastic surgeon should be concerned with. Conversely, if you feel that you cannot have... more

Lipo of the central abdomen

I prefer not to liposuction the central abdomen at the same time as a tummy tuck because it may jeopardize the viability of the central lower skin especially if there was full undermining of the upper abdominal flap.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Liposuction during abdominoplasty (tummy tuck)

For a "regular" abdominoplasty liposuction in the central upper abdominal area is generally a recipe for skin healing problems at the lower abdomen. We need to divide some of the "normal" circulation to the skin flap that gets raised up during the procedure, and in so doing we ask the skin to "live" on an altered blood flow pattern, through the skin. If you then liposuction this area you create swelling and trauma to that area and the blood cannot... more

If it were easy anybody could do it!

This is one of the many controversies in abdominoplasty and serves to reinforce the need to be evaluated by someone who has a good deal of experience in the procedure. I have used liposuction for nearly every abdominoplasty I have performed for many years now. I do lipo the superior flap above the umbilicus because it allows me to do less complete undermining of the flap. The blood supply remains intact. I have not seed an increase in wound healing problems. One caveat is... more

Liposuction of the upper abdomen during tummy tuck can increase complications

Many will use liposuction over the hip or flank to improve the contours during a tummy tuck, though some surgeons will not suction the upper abdomen. If the upper abdominal skin is suctioned and thinned there is a risk that the circulation to the skin may be compromised and increase the risk of healing complications after.

Can liposuction and TT be done at the same time?

To answer your question I need to make a distinction in the type of TT done. A full TT elevates the skin from the lower abdomen up to the rib margins. This separates the abdominal skin from a part of its normal blood supply which comes up through the rectus muscles (the sit up muscles). The flap stays alive from blood vessels which run within the abdominal skin flap and usually does so very well. However, if in addition to full elevation of the abdominal skin flap, a... more

Jeffrey M. Darrow, MD

18 reviews

Boston Plastic Surgeon

Liposuction and tummy tuck

A tummy tuck involves elevation of the skin and fat of the abdomen to your breast bone. This can be good and bad. By elevating the skin flap, your surgeon is able to remove the excess skin and tighten your abdomen. The bad part is that it can stress out the blood supply to your skin and fat at the lower abdominal incision. We know that if we do liposuction to the upper central abdomen at the same time, it will further stress the blood supply to the lower abdomen.... more

Is liposuction of the upper abdomen necessary during a tummy tuck?

Medicine is more of an art than people realize. Plastic surgeons develop routines and habits based on their personal experiences. Although I personally will judiciously liposuction the upper abdomen for an abdominoplasty, this area is essential for the blood supply of the abdominal flap and too much surgery could result in a skin loss. Surgeons, me included, will typically alter their abdominoplasty technique to bolster the blood supply to this area and increase safety. more

The data is clear

Adding liposuction to tummy tucks does not increase risks of wound healing problems or scaring. Extended undermining does........... Read the literature. It is safe to lipo the flaps above the umbilicus and the entire world does it. Stay deep and limit undermining of the flap. The data is clear.