Mini Tummy Tuck, Liposuction, or Combination for Post-pregnancy Tummy?

I have had two consultations from reputable surgeons. Doctor A states I do not need a mini tummy tuck and that I should consider liposuction. My worries are baggy, wrinkly skin. Doctor A states it will "shrink wrap", well given my skin elasticity. Doctor B is okay with mini tummy tuck with liposuction, and states that the combination will result in a concave look but believes I will be pleased with the results. Doctor A stated mini tummy tuck with Lipo would look bad because of the bubbling effect. Both doctors were surprised at the minimal abdominal separation. I am 8 months post partum from twins and had two c sections. What would be the best procedure for my tummy?

Doctor Answers 14

Mini tummy tuck vs. liposuction

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Each procedure tackles a different problem.

Liposuction removes fat. It does not, in my opinion, tighten the skin significantly. Even if the laser liposuction is used, I do not believe any meaningful tightening of the skin occurs without significant risk of unevenness and discoloration of the skin. If you look closely at the results of many laser procedures, the skin appears dark, mottled, and oddly contracted. If there is a significant amount of loose skin, liposuction is simply very disappointing when done without any tightening of the skin or fascia. Most tummy tucks also involve liposuction at the same time anyway. Patients should avoid promises from physicians who claim tummy tuck results from the laser alone. It will not happen.

Why doesn't liposuction alone tighten the abdomen of a post-pregnancy woman?

Tummy tucks remove extra skin. They can also tighten the deep layer, the fascia.

So depending on where the loose skin is, and where the loose fascia is, that determines what procedure will give the best result.

Why doesn't a mini tummy tuck give a great result in most postpartum women?

In most women who have had children, the deep layer (fascia) is loose. This looseness almost always reaches from below the belly button to above the belly button. The upper abdomen is an area where the mini tummy tuck does not reach. Tightening just the area below the belly button (as with a typical mini tummy tuck) often gives the appearance of a bulge in the upper abdomen with a flat lower abdomen. Most women are quite unhappy with that look. We perform many mini tummy tucks in our practice, but they accomplish very limited tightening, and are really more like scar revisions of an uneven C-section.

For patients with lots of loose skin, we perform a version of the full fummy tuck (regular incision, low incision with vertical component). We discourage the belly button float technique, where the belly button stalk is cut and the entire belly button is moved much lower.

For patients with minimal loose skin, usually women with very little weight gain during their pregnancies, we perform a Hybrid tummy tuck(R). This involves a C-section type incision with full tightening of the deep fascia, all the way up. It is a way for fit moms who don't have a lot of loose skin to avoid a long or long and high incision. It is especially suited for fit women with high belly buttons.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 194 reviews

Lipo vs Tummy tuck

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Liposuction generally removes fat but does not tighten loose, sagging skin.  In order to address loose skin, it has to be excised.  Unfortunately there is no way around that point.  There are many noninvasive methods that claim to take care of loose skin that has no elasticity.  I would be careful with those claims.  Good luck!

Mini or full tummy tuck?

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The simple answer is that you need to have a consultation with a board certified plastic surgeon to determine which technique is right for you. For most women, a full tummy tuck is a better option. Although there may be longer scars, you are able to address loose skin of the upper and lower abdomen and the belly button tends to stay in a more normal anatomic location than with a mini tummy tuck which may lower it.

Mini tummy tuck and liposuction procedures

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A photo would be helpful to determine which procedures would be best for you. Depending on the severity and complexity of the case, both a tummy tuck and liposuction may benefit you to achieve the best results. However, based on the information you provided, if you are worried about loose excess skin post liposuction alone, a standard (full) tummy tuck may be best. Not many women are good candidates for a mini tummy tuck, which involves only muscle repair of the muscles and removal of skin from below the belly button. This technique may leave you with a mild bulge above the belly button area. Liposuction alone may leave you with loose skin that may not bounce back depending on the quality of the skin. A standard (full) tummy tuck involves full repair of the rectus muscles, that have been stretched form pregnancy, and removal of loose excess skin in the abdominal region providing a tightened look of the abdomen area. i recommend consulting with a board certified plastic surgeon to discuss the best and safest possible options for your case. Good luck!

The best procedure for your post-partum abdomen depends on how fat you are.

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The best procedure for your post-partum abdomen depends on how fat you are. If you are fat, then the liposuction will be best for you. The skin will shrink somewhat, but I'm guessing it will still be loose. If you are not fat, then a tummy tuck with some lipo is the way to go. BUT after twins, i'm sure you'll need more than a mini-tuck. There are several different ways to do the aplasty; make sure your surgeon knows which of the choices is best for you.

G. Gregory Gallico III, MD
Boston Plastic Surgeon

Mini tummy tuck versus liposuction

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It's hard to know the best procedure for you, given that 2 plastic surgeons tell you that you have no abdominal laxity. I have never seen a patient who has had twins and did not need plication (tightening) of the abdominal wall muscles.

Most patients like you get much better results with a full tummy tuck. A full tummy tuck allows for tightening of abdominal wall muscles as well as removal of baggy, loose skin. After having had twins, although not inconceivable, it would be surprising if your skin maintained enough elasticity to fully "shrink wrap" after liposuction.

You'll get a more specific answer to your question if you include a photo. Best of luck.

Mini tummy tuck versus liposuction

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Liposuction removes fat. There may be some tightening of the skin after liposuction if you are yong and have good skin quality. You should get even more tightening if you have laser liposuction. If there is significant skin excess, or hanging over, it is best to have this skin removed with a tummy tuck. If you have mild skin excess, then a combined liposuction with mini tummy tuck woul dgive you the best possible results with a hidden incision that is about half the size of a traditional tummy tuck. If you have stretch marks, this may be a good indication that your skin has been "damaged" from pregnancy and will not tighten as much after only liposuction - another reason to have a combined procedure. I have been getting great results with this combined laser liposuction and mini tummy tuck procedure.

Abdominal improvement after children

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It is very difficult to suggest what would be better without formally evaluating you. Liposuction is good to reduce fatty volume in the subcutaneous plane. Yes, it may cause skin to be a bit loose if your skin quality is not good. A mini-tummy tuck only treats the area below the umbilicus. This will reduce excess loose skin int his region. If you have significant muscle laxity both above and below the abdomen and have loose skin above your umbilicus, then you probably need a full tummy tuck. I am not a big fan of mini-tummy tucks because I do not think they achieve what the patient really wants.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

You probably need full tummy tuck.

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1) Of course, it's hard to say definitively without examining you, but almost certainly liposuction alone will not do the job for you. It sounds like you have too much loose skin.

2) Unless your "problem" is limited to the area just above the C section scar, you will not be happy with a mini tummy tuck either. Too many "minis" are done, because they sound less scary, but in reality few women are good candidates. Most women have loose skin above the belly button. To correct this higher baggy skin, you need a full tummy tuck, even though you don't have a big muscle separation (diastasis).

3) I can think of three patients who had mini tummy tucks, and later had to have a full abdominoplasty to correct the upper abdomen.

4) The recovery from a full tummy tuck, specially if you don't need a lot of muscle work, is not as bad as most people think. We do it on an out patient basis in our office surgical suite, you walk out after about 2 hours in the recovery room, and you go home with a nurse who spends the night with you.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Tummy tuck vs liposuction after pregnancy

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We really need a photo of you to be useful in sorting this out. Maybe you need to see a third doctor and ask their opinion. Make SURE these are Board Certified Plastic Surgeons because only then can they offer ALL of the options for your abdomen and tell you the pros and cons of each for you and not just sell you on what they only know how to do.

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.