My doctor recommended tummy tuck or coolsculpting, but I'd prefer lipo as I don't have much loose skin. Is this my best option?

Hi - I had twins via c-section 15 months ago and I want to have liposuction to remove abdominal fat. I had a consult with a plastic surgeon and they really pushed a tummy tuck, but I am not interested in that because of the expense, severity, and restrictions. He recommended CoolSculpting instead to avoid loose skin following lipo, but I still really want liposuction even if I have a little loose skin after. Should I go back and ask for the lipo? I don't have much loose skin now.

Doctor Answers 8

My doctor recommended tummy tuck or coolsculpting, but I'd prefer lipo as I don't have much loose skin. Is this my best option?

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Hi. Please understand that without the benefit of your photos, it's impossible for anyone in this forum to give you specifics. I have been performing tummy tucks and liposuction procedures in Miami, Florida for the past 29 years. I have frequently dealt with patients and twin pregnancies. To this day, I have yet to perform a lipo procedure without a tummy tuck in these "twin" pregnancy patients.

I feel that in the long run you will be sadly disappointed with just liposuction. Good luck

Liposuction vs other procedures

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I think that an exam in person is really critical. I can not suggest things without the evaluation.  If you have loose skin then lipo will likely make it looser.

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

Liposuction vs. Coolscupt vs Tummy tuck

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I see patients with your same concerns almost daily.   There are many considerations in choosing the right procedure between those three options.  I think it is important to understand the expected result with each option, and then you can choose the one the best lines up with your goals.  I will say that most of the patients I see in Coolsculpt consultations are not ideal candiates because they either have too much fat or too much loose skin, and I tell them this.  Their time and money would be better spent on liposuction and/or abdominoplasty surgery.  But if the do not want surgery or for whatever reason insist on Coolsculpt despite understanding its limitations in their case, as long as it is safe to do it I would let them do so.  

In your particular case, if your surgeon feels that you already have some loose skin and that liposuction may make the loose skin even worse, I think he is right to guide you towards abdominoplasty.  I see our job as plastic surgeons to provide you with all the options, but also to use our experience and judgement to guide you towards the best of those options for you.  However, the decision on what to do is ultimately yours.  In your case, you can always move forward with liposuction, and if you are not happy with the loose skin, you can have an abdominoplasty in the future.  

Samir S. Rao, MD
Chevy Chase Plastic Surgeon
5.0 out of 5 stars 36 reviews

Coolsculpting, Liposuction, or Tummy tuck

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There is a spectrum of options for addressing localized abdominal fat ranging from the non-surgical option of Coolsculpting to the surgical options of liposuction and even full abdominoplasty (tummy tuck).  If you require fat removal only, either Coolsculpting or liposuction might be reasonable options, but unable to say without photos or exam. On the other hand, if there is a large amount of skin excess (as is most commonly present after carrying twins), then anything short of a tummy tuck is likely going to be disappointing. It all depends on your goals, so make sure your surgeon understands what you wish to achieve.

Earl E. Ferguson III, MD, FACS
San Antonio Plastic Surgeon
4.9 out of 5 stars 18 reviews

My doctor recommended tummy tuck or coolsculpting, but I'd prefer lipo as I don't have much loose skin. Is this my best option?

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  Photos or an exam would be useful to provide any recommendations in this case.

Kenneth Hughes, MD

Los Angeles, CA

Liposuction after twins

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Thank you for your tummy tuck and liposuction question.
  • It sounds as though the best treatment is a tummy tuck - but you don't want it.
  • You want liposuction and your surgeon bought a Coolsculpt machine and wants you to use that. 
  • Call him and tell him again what you want - if he will not do it, see another surgeon.
  • You should understand clearly in advance, what liposuction will and won't do for you, based on the face-to-face exam.
  • If your goal is a flat tummy and you need a tummy tuck - liposuction may disappoint you. Best wishes.

Lipo vs. Tummy Tuck

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It's difficult to tell without photos if liposuction of any type will correct the problem that bothers you. If you have good thick skin elasticity in the area and the area is just fat then Liposuction should definitely address the problem. If there are stretch marks and loose skin, or separation of the underlying muscles that are causing the problem, SmartLipo or any other form of liposuction are unlikely to help. See a board certified plastic with an expertise in body contouring in your area for a detailed consultation. They should be able to answer your concerns more specifically. In my practice in the San Francisco Bay Area I have come to the conclusion that the happiest patients are those that have realistic expectation on what a procedure will and won’t do for them. Good luck! Dean Vistnes.

M. Dean Vistnes, MD
Bay Area Plastic Surgeon
4.9 out of 5 stars 51 reviews

Tummy tuck, Liposuction, Cool-Sculpting

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Loose skin after liposuction is hard to predict. If you have stretch marks your skin probably will not tighten much after liposuction. However if no stretch marks are present your skin will contract to some degree. And alternative option is Smart Lipo. Smart Lipo involves traditional Liposuction with addition of an internal laser probe that targets your subdermal collagen and causing a greater skin tightening. 

Navanjun S. Grewal, MD
Beverly Hills General Surgeon

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.