Why do some doctors do not stomach lipo during a TT?

Hi there, Some doctors have been trained to believe that liposuction will cause destruction in the vascular blood supply to the skin of the anterior abdominal skin. The concern is that the incision will not heal appropriately due to the disrupted blood supply. Overall, this thought process has been disproven and conservative to moderate liposuction of the abdomen, flanks, and back is very safe and effective and maximizes the results of your abdominoplasty. Please note, despite liposuction being performed at the same time as the abdominoplasty, it is not appropriate to be as aggressive if performing liposuction alone. So the safest approach is balancing the correct amount of liposuction in conjunction with the abdominoplasty.

Thank you for your question. Typically some doctor's won't do liposuction across the abdomen during a tummy tuck because it can compromise the blood supply. Therefore we recommend coming back minimally 3 months after surgery to do some additional liposuction. I would suggest seeing a Board Certified Plastic Surgeon in person to evaluate you and discuss your options. Best of luck to you.

Aggressive stomach lipo during tummy tuck and interfere with the blood flow to the skin that stays attached which can cause wound healing problems. Surgeons who do lipo with tummy tucks are very careful about the fat removed with lipo to maximize the chance of healing with no issues. As always, please be sure to research who performs your procedure so you can increase the changes of having the best outcome.

Liposuction with a tummy tuck has been shown to be safe but it can increase certain risks. Liposuction can decrease the blood flow to the skin so if it is done aggressively or in areas that are providing a lot of blood flow to the skin it can result in healing issues or cause some of the skin to die. For this reason when liposuction is done during a tummy tuck, it is done very judiciously. Also, liposuction can sometimes result in the body making more inflammatory fluid after the procedure. If your surgeon is planning on not using drains, they might not want to do liposuction to lower your chance of developing a fluid collection called a seroma. If your surgeon is planning on using drains then you may find that the output is higher or they need to stay in a little longer.

Dear SCali_20_20,
due to higher risk of inadequate vascularisation of abdominal flap, plastic surgeons avoid liposcution at the same time as tummy tuck. However, I perform flank liposuction in order to get better results. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Hi SCali_20_20

A form of liposuction is generally incorporated during the procedure to remove fat. If your stomach area has good skin laxity, but you still are not satisfied with how your tummy looks and feels even if diet and exercise have failed, another option is liposuction. Women interested in abdominoplasty should be past childbearing to make sure the results are not compromised. To learn more about this procedure, please visit our website.

Many patients who undergo a tummy tuck also combine it with some liposuction, often of the flanks/hip area. It is important to not aggressively suction the upper abdomen along with a tummy tuck as the blood supply to the healing tissues can be compromised. This could lead to complications including poor wound healing and infection. I encourage you to discuss your concerns and questions with your surgeon so that you can feel comfortable and confident for your surgery.

The upper abdomen can be liposuctioned conservatively during a tummy tuck so that the blood supply is not compromised. Damage to the blood supply can lead to wound healing issues and necrosis.

Many surgeons believe that simultaneous liposuction of the abdomen and a tummy tuck are not compatible because of fear of injuring blood vessels necessary for normal healing. Modern techniques in liposuction allow for safely performing both of these procedures simultaneously. Go visit a few highly experienced surgeons who do this all the time.

I almost always include some liposuction as part of the tummy tuck. The key thing is to understand anatomy and avoid liposuctioning the area where the blood supply is located. If the surgeon is not comfortable with the anatomy of the blood supply, they may not want to liposuction the abdomen to be safe. Hope this helps!

Johnson C. Lee, MD
Board-Certified Plastic Surgeon​