Tummy Tuck or Liposuction for the Abdomen?

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Tummy Tuck or Liposuction for the Abdomen
-Win Pound, M.D.
Which will work best for my stomach area, a tummy tuck or liposuction? This is a question I see frequently on plastic surgery discussion boards.
The old adage is that if you can “pinch an inch” then it is fat. If the stomach area has fat but little or no loose skin then liposuction may be the best option. Liposuction can remove the unwanted fat and the incisions used are very small and usually well-concealed. If the patient has good elasticity of the skin then it should tighten down very nicely giving you a good result.
If the patient has a small amount of loose skin or stretch marks (thus, poor elasticity of the skin), then the patient may still be a good candidate for liposuction, especially if laser-assisted liposuction (SmartLipo or SlimLipo) is used. The advantage of using the laser in this instance is that the laser will heat up the undersurface of the skin resulting in better skin tightening. While more expensive than traditional liposuction, the results may be worth the extra cost in borderline candidates who want to avoid a long scar across the lower stomach.
For patients with excessive skin of the lower stomach, even if there is a large amount of fat present, a tummy tuck is probably the best option, especially if the skin tends to hang. Suctioning the fat in this instance will only lead to more loose, hanging skin.
When deciding on whether to perform liposuction or a tummy tuck, another consideration is the tightness of the abdominal wall under the fat and skin. In patients who have had a pregnancy or a large weight loss, the two paired stomach muscles that run up and down the stomach may tighten back up, however, the connection between these muscles may not. This weakness in the stomach wall may cause the stomach to protrude. If patients tighten up their stomach as tight as they can, what protrudes is fat and skin. When they relax their stomach, the weakness in the abdominal wall may become apparent. This weakness can only be repaired with a tummy tuck.
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Atlanta Plastic Surgeon