Do I Need Liposuction Or A Tummy Tuck?


Many times I have heard the question, “Doctor, do you think I need a tummy tuck or just liposuction?”
     The difference between them is that liposuction simply reduces the fat volume, whereas a tummy tuck (also called an abdominoplasty) includes liposuction, tightening of the abdominal muscles, and excision of excess skin. It is true that if you are young, near your ideal BMI, and your skin is nice and firm that liposuction can do wonders to flatten and contour your belly. However, if this does not describe your body type, you may be better suited for a tummy tuck. There are numerous life events that create the need for a tummy tuck, such as weight loss, the cesarean section that was needed for the twins, or a hysterectomy scar that became infected. Pregnancy is the most common culprit of abdominal wall weakness and excess skin. Many women will stretch their abdominal musculature to the point of no return and umbilical hernias can appear. Once the skin has stretch marks and other damage, you need something beyond liposuction. I know that there are many of you reading this article right now, thinking to yourself “that is my problem…” I hear you and can help!
     There are several different options out there for fat reduction to choose from. Some people offer a “quick fix” with Smart Lipo or different lasers that will reduce the fat and shrink the skin. The problem is that you cannot predict how the skin is going to shrink. That can work against you and leave you with an unwanted result. Patients come to me with significant damage to their abdominal area caused by indiscriminate use of liposuction. Unfortunately, corrective surgery has become a large part of my practice. Liposuction has become very popular and several specialties of medicine now utilize it for cosmetic reasons. So, it is easy to find a practitioner eager to do it for you. I believe liposuction is very “operator dependent”. The single most important factor determining the outcome is the experience of the operator or surgeon. Liposuction is a technique and an art, and it requires both to deliver a good product. I use liposuction alone or in larger surgeries, such as the tummy tuck or body lift. Liposuction is used to contour the thickness of the body fat in any area. While, the tummy tuck includes liposuction, used judicially, as a way to reduce the thickness of the remaining fat. An important part of any tummy tuck is correcting the abdominal muscles and repairing hernias resulting from previous surgeries. You must also recreate the belly button in an artistic way. And finally, we are left with the skin. It is the skin that can manifest many problems and liposuction will make that worse.
     How can you tell if you need liposuction or a tummy tuck? The answer is not always clear. There are some things to look for to help you decide. If your stomach has a lot of stretch marks, particularly in the lower portion, then a tummy tuck could benefit you by removing a lot of the damaged skin. If your skin has large folds of extra skin, that is another sign you need more than liposuction. Belly buttons that are shaped like a frown and cesarean scars that create a fold over the pubis also require a tummy tuck. I have corrected irregular contour from previous liposuction surgery with a combination of liposuction and fat grafting or a full tummy tuck. Sometimes, a tummy tuck is the only way to correct it.
     As you can see, liposuction only deals with the fat layer in the abdomen, while a tummy tuck deals with all three layers. Liposuction creates several very small incisions, whereas a tummy tuck will leave a much larger scar, although it should be very low and easily hidden. It is necessary to cut the skin to modify it (for now), and the improvements should outweigh the presence of a scar. Make sure you schedule a consultation with an experienced board-certified plastic surgeon with a good reputation. A great doctor should answer your questions honestly and help you make a good decision about having aesthetic surgery.

Written By: Dr. Juan A. Brou in Oklahoma City, OK. 

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Oklahoma City Plastic Surgeon