Abdominoplasty with Liposuction for Fairly Large Pannus?

Question

Do surgeons include liposuction with a full abdominoplasty? I have a fairly large pannus from 2 c-sections and significant weight gain (large babies 9 lbs 11 oz and 8lbs 11 oz). I would like to have a procedure that could take care of the entire abdomen and flank area, if possible.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding abdominoplasty with liposuction for a large pannus. Many surgeons do combine liposuction with a full abdominoplasty to provide more comprehensive contouring. A full abdominoplasty removes excess skin and tightens the abdominal muscles, which is especially beneficial after significant weight gain and pregnancies like yours. Adding liposuction can further enhance the results by removing stubborn fat from the abdomen and flanks, giving you a smoother, more contoured appearance.

However, it's important to note that liposuction is often considered an additional procedure and is usually not "included" in the standard cost of a full abdominoplasty. The pricing for liposuction will depend on the areas being treated and the amount of fat being removed. I recommend consulting with a board-certified plastic surgeon to discuss the best surgical plan for your specific needs and to get a detailed breakdown of costs.

Sincerely,
Dr. Katzen

Farbod Esmailian, MD · Answer

I have discussed this in an article on my website.  It is safe to an extent.  But you must remember that alot of the pannus is excised and discarded so this may not be an issue.
You should be evaluated by a board certified plastic surgeon who can accurately go through your options.
Good luck.

George Marosan, MD · Answer

These can be done together depending on your age, health, body mass index, etc. In my practice, I always do liposuction with a tummy tuck. Although one can divide the torso into multiple cosmetic units, I like to treat this as one cosmetic unit. This way you achieve the best results all the way around including the flanks, buttocks,back and abdomen. The pannus is excised and does not need to be liposuctioned. The upper abdomen can be liposuctioned judiciously to preserve the blood supply. If a person has a large upper abdominal roll, I tell them that although they will get improvement with the liposuction and abdominoplasty, there's the possibility off further liposuction of the abdomen to refine the results. Since most of the patients I see in my practice require liposuction, my fees are all inclusive.

David Shafer, MD, FACS · Answer

If you include a picture, we may be able to give you more specific advice. However, I include minor liposuction of flanks (at no additional charge) on about 90% of the abdominoplasties that I perform. I feel that it gives you a much better overall result. If you need major liposuction, that that is a whole different story and I would need to see you in consultation to determine which procedures would be best for you. I hope this information is helpful. Good luck with your procedure.

Otto Joseph Placik, MD · Answer

Surgeons may or may not include this in the price of their tummy tuck procedure. Please realize that not all tummy tucks are the same; some are mini, some are full, some are extended, and some are combinations, etc. Many surgeons will ultimately price the procedure according to the time they think it will take them. Although, you may not want your surgeon to rush through the procedure. So shopping around for price may not be the best indication.

John P. Di Saia, MD · Answer

Hello,
You are probably looking at an extended tummy tuck plus or minus liposuction. Lipo can add to the swelling and healing time, so I try to avoid it if possible. It usually is possible.

Steven Wallach, MD · Answer

If the pannus is heavy and hanging, it may be best to reach your goal weight first. Perfoming liposuction of the abdomen at the same time as undermining the abdominal flap may cause tissue death in the central triangle below the umbilicus.

Lavinia K. Chong, MD · Answer

My approach to reshaping the abdomen is to discuss excisional body lifts as well as liposuction, before we get to the O.R. It's important for patients to realize that the redundant pannus (skin & fat) below the belly button will be discarded and so liposuction isn't so important in this area. Liposuction can be useful 1) to thin out the remaining skin, which will be redraped as well as 2) to reduce the "dog ears", which stick out of the end of the incision. Most physicians will adopt a similar approach in combining liposuction with tummy tucks. As far as including liposuction of the "flanks" or love handles with a major abdominoplasty, I am reluctant to do both at one time, because of concerns about compromising the blood supply to the abdominal flap. We aim for improved contour not delayed wound healing. Good Luck.

Peter A. Aldea, MD · Answer

The primary question should first be are you a good candidate for either Abdominoplasty or Liposuction - Stated another way, will the appearance and results of either procedure, if done on you, justify the increased risks and cost? Obviously without either photographs or an examination, it is impossible to state.
Most plastic surgeons would ask that their patients' weight be stable with a BMI of 30 or below. If this is not the case, I would save my money since the outcome may not be satisfactory.
Where I work, there will be a charge by both the facility and the anesthesiologists for any additional procedures. Depending on the extent of low back and hip fat, it would be required to either have you on your tummy for the liposuction and or turn you side to side for the procedure. In addition, different instruments and surgical covers would have to be opened for this part as well as the tummy tuck portion. So it is not unreasonable to charge for them.
I hope this was helpful.

Robin T.W. Yuan, MD · Answer

The real answer is that a surgeon will do what it takes to get the job done. There is no set method for doing an individual abdominoplasty. The object is to be able to tailor a procedure to fit the patient's anatomy and needs. A pannus is often removed with a panniculectomy or in conjunction with a full abdominoplasty. Liposuction can be used as an adjunct procedure if necessary. To what extent and in what combination is individualized.

Abdominoplasty with Liposuction for Fairly Large Pannus?

Answers (12)

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