Getting a Tummy Tuck, Ps Says I Only Need Muscle Tightening Below the Navel and No Lipo?

Going in for a tummy tuck, but my ps said i would need full tt and he would only need to tighten the below navel muscles and i would not require lipo? Lady that scheduled my surgery was shocked that he said no lipo. Im worried about the upper belly bulge that people have complained about.

Doctor Answers 9

Tummy tuck

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When I performance tummy tuck, I usually perform a muscle tightening procedure, but not always.  However, when I do the muscle tightening, I always perform both above and below the navel to avoid the upper abdominal bulge.  Some surgeons will do lipo,of the upper abdomen at the same time as a tummy tuck and it is usually okay to do so.  Lipo can also be done on other areas at the same time as a tummy tuck, usually the hips or waist.

San Diego Plastic Surgeon
5.0 out of 5 stars 29 reviews

No lipo with TT, is that OK?

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Yes, not all women need liposuction with tummy tucks, but I would say that those women are few and far between, your upper bulge could be due to lax muscle and tightening your muscles could very well eliminate the problem. If uncomfortable, ask for an additional pre-op appointment to discuss your concerns, I am sure your PS would not mind meeting again to clarify , good luck!

Jonathan Weiler, MD
Baton Rouge Plastic Surgeon
4.9 out of 5 stars 93 reviews

Tighten Muscles Throughout

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Without seeing your photographs its obviously impossible to give you a definitive answer but tightening the muscles below the belly button ONLY would almost certainly lead to upper abdominal bulging.  You may not need as much tightening above the belly button as below so how much to tighten each area can be determined at the time of the procedure, but both should certainly be done!

Also, unless you're extremely thin you would benefit from some liposuction of the flanks and maybe even upper abdomen to prevent dog-ears in the former and bulging in the later.  Good luck...

Eric Sadeh, MD
Manhattan Plastic Surgeon

If you have questions or concerns, ask..

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Upper tummy bulge could either be due to loose muscular fascia or extra fat.  Only a proper exam can tell you that.  Furthermore, lipo in the upper abdomen is somewhat risky due to blood supply to the skin flaps.  But if you have questions, make sure you are heard.  In my practice, we work together as a team to give you the results you desire.  It may not have been appropriate for this staff member to contradict your plastic surgeon's plan without consulting him first.  They also are not the persons doing the procedure and usually do not know the technical details involved with providing a particular result.

Tito Vasquez, MD, FACS
Southport Plastic Surgeon
4.7 out of 5 stars 17 reviews

Tummy tuck and muscle question

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The usual TT includes tightening the entire length of the muscles to equalize the pressure and get a smooth abdomen. Lipo is definitely not necessary in all patients, it depends on the thickness of the fat in the involved area.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

Tummy tuck and muscle question

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I agree with other posts that if you need to tighten the lower muscle then best to tighten upper muscle as well. It only takes five minutes to do and the results well worth it. Lipo may not be needed but again I use it on 99% of my tummy tucks to help refine the results! Good Luck!

Gregory T. Lynam, MD
Richmond Plastic Surgeon
4.9 out of 5 stars 62 reviews

Muscle repair only below umbilicus? No lipo? Could this be a mistake?

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Without a personal examination, none of us can be critical of the judgment of a colleague who has had the benefit of evaluating your exact anatomy.

That being said, in 99% of the tummy tucks I perform, a muscle repair is done from the xiphoid (lowest tip of breastbone) to the pubis, precisely because of the upper abdominal "bulge" that occurs all-too-frequently when the lower abdomen is tightened and the upper is not! It's a bit like wearing a corset that is laced only half-way up! The "stuff" that was in the laced-up area bulges out in the non-laced-up area. Liposuction can help, but also can reduce circulation to the lower abdominal flap tissues, so this needs to be either avoided or judiciously performed.

Liposuction in conjunction with tummy tuck is common in the hips or in other areas of the body, but as above, only sometimes (by some surgeons) added in the abdomen itself. I do lots of tummy tucks without liposuction; thin patients with loose skin after pregnancy are common!

Discuss this with your surgeon, and come to an understanding about what will be done, and who will pay for what, if indeed you end up with an upper abdominal bulge after the recommended procedure. Either your surgeon may reconsider, or at least you will have an understanding about anticipated outcomes and what happens if it is not achieved! Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

No Lipo?

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It seems that your surgeon  examined you and felt that you have no such bulge. And it seems the surgeon feels you have no excess fat that needs treatment.

Without photos, an online consultant will not be able to comment further. I can say that I do many tummy tucks where no liposuction is needed. 

Best wishes. Do attach some photos if you wish to receive anything but the most general advice. Thanks.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Best to Tighten the Whole Muscle

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In performing tummy tuck, if muscle plication or tightening is indicated, then it is best to perform it above and below the belly button.  If not, frequently the upper abdomen will bulge due to the increased pressure in the lower abdomen.  Also, I would check with the plastic surgeon to see if they use progressive tension sutures (PTS) to eliminate the need for drains.  PTS lead to faster recovery and avoids the inconvenience of drains.

Kent V. Hasen, MD
Naples Plastic Surgeon
4.8 out of 5 stars 67 reviews

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.