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Safe to Smartlipo Abdomen and Flanks During a Full Tummy Tuck Surgery?

I had smartlipo 6 months ago. I have a swollen looking belly button, long rolls of fat on both sides of my lower abdomen, and lumps left around my lower flanks which are also uneven. My physician told me it would take a year for all of the swelling to go away and that's why this is larger in some areas. Well I went to visit another PS in the same practice and was told it was definately fat that he had not removed. We talked about how loose my skin still is also. The new PS said he would give me a full TT and smartlipo my flanks, lower belly, bellybutton and uper abdomen where fat was left behind. Since talking to the new PS I have had a few friends tell me it is unsafe for the PS to perform Smartlipo on any part of my abdomen. However they were not very familiar with Smartlipo. Would it be safe for the new PS to smartlipo a few areas on my abdomen and flanks while giving me a full TT during the same surgery?

Doctor Answers (9)

Smart Lipo during Tummy Tuck

+3

98% of the success of your surgery will hinge on the plastic surgeon you choose. 2% will hinge on the lipo machine he chooses.

Especially when lipo is performed at the same time as a tummy tuck, great judgment and experience are necessary.

This patient who posted on RealSelf apparently had SmartLipo with a TT. You can judge her results for yourself with the link below. Since SmartLipo is relatively new, we don't know the dangers in combining the procedures. Since lasers coagulate blood vessels, this is a huge theoretical disadvantage with the procedure. Tumescent liposuction preserves the blood supply and does not burn blood vessels.


Beverly Hills Plastic Surgeon
5.0 out of 5 stars 90 reviews

No need for Smartlipo at the same time as the TT

+2

There is no need for Smartlipo at the same time as your TT. Smartlipo is good for small areas and for surgery when you are awake. If you are already going to asleep for the TT, then you should just have traditional liposuction at the same time. The benefit of Smartlipo (quicker recovery and less bruising) would be insignificant since you are already having the TT. Also, make sure you have a surgeon who knows what they are doing. It is very common to perform liposuction at the same time as abdominoplasty. However, maintaining good blood supply to the skin flap is of utmost importance. So, there is a limit of how much liposuction can be done at the same time. Good luck with your surgery.

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 54 reviews

Blood supply is the key to any combined cosmetic procedure

+2

HI Raachel,

We routinely perform liposuction in the lower flanks (some refer to this area as love handles) at the same time as a tummy tuck. However, I agree with the other doctors responding that doing liposuction to the lower abdomen and even the upper abdomen while doing a tummy tuck would be risky, and I would not recommend it.

The recommendation applies whether Smartlipo or any other type of liposuction is used. It is always best to err on the side of safety.

Francisco Canales, MD
Santa Rosa Plastic Surgeon
5.0 out of 5 stars 11 reviews

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Considerations for undergoing another liposuction procedure with tummy tuck

+2

Six months after a liposuction procedure, you are thinking of another contour procedure. The problem here is that the swelling regardless of whether fat is left behind is still present. If I attempted to remove the residual fat, how would I know how much of it is excess fat and how much is swelling? I wouldn't!

Therefore, I would end up over-correcting your problem and making things only worse!

As for the idea of a tummy tuck and liposuction, can they be performed together? Yes and No!

Older style tummy tucks deprive the abdomen of a great deal of blood supply, thus in these cases, liposuction should only be done in the flanks at the time of surgery. Any area on the abdomen should be avoided.

High Lateral Tension abdomenoplasties (Ted Lockwood) do not deprive the abdomen of the blood supply so that liposuction can be performed above the belly button - but not below! In any case - you should wait until the swelling goes away!

Robert M. Freund, MD
New York Plastic Surgeon
4.5 out of 5 stars 18 reviews

Safety concerns involved, but it's mainly about choice of plastic surgeon

+2

The topic of liposuction and tummy tuck is a very important one because it involves safety issues.

The abdomen and flanks are divided into areas depending on their blood. In general it is safe to liposuction the lower flank area during a tummy tuck procedure. The same does not apply to the center of the abdomen as well as the upper flanks.

This is a very technical issue and involves a lot of clinical experience as well. The key here is to trust your board certified plastic surgeon. Good Luck!

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 4 reviews

A complex question that hinges on blood flow

+2

When you do a full tummy tuck, the skin is elevated off the muscles so that the muscles can be tightened and the extra skin removed. Because of the skin lifting, the blood flow to the skin is partially compromised, but not enough in most instances to cause healing problems.

It is safe to perform some liposuction in the flanks without further compromising the blood flow to the skin. However, suctioning the elevated flap itself can possibly cause further decreases in blood flow to the point where the skin could die and result in substantially delayed healing. This situation needs to be handled very carefully and by an experienced plastic surgeon.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 47 reviews

Laser lipolysis and full tummy tuck

+1

In general, it is my opinion, that most plastic surgeons would avoid performing any type of liposuction on the central abdomen in the course of a full tummy tuck. This is associated with a higher risk of skin loss.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 41 reviews

SmartLipo during a tummy tuck

+1

A tummy tuck is a very popular and effective technique to recontour the abdomen. In our practice, we include liposuction with every tummy tuck. This is because liposuction will help us treat the fat and reach areas in the abdomen that we would not be able to with a tummy tuck alone. Smartlipo is a technique of liposuction that is effective at removing small amounts of fat. Although it is possible to perform at the same time as a tummy tuck, other forms of liposuction such as tumescent liposuction or ultrasound liposuction are more effective in this setting. Keep in mind that one of the advantages of smartlipo are the slightly smaller incisions that can be used. However in a tummy tuck setting, the liposuction will be performed through the same incision that we have created for the tummy tuck. Therefore there is no advantage for using smartlipo in this situation.
To learn more about tummy tucks, see photos, and help you decide which one is best for you, please visit us at the link below:

Pat Pazmino, MD
Miami Plastic Surgeon
4.5 out of 5 stars 58 reviews

Lipo and tummy tuck at the same time

+1

In general, liposuction of the central midline at the same time as a tummy tuck may increase the risk of necrosis (tissue death) in the central lower abdomen. If on the other hand, limited undermining is performed with the liposuction, then it is safer.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 15 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.