Vaserlipo or Mini Tummy Tuck - which procedure would give better results for minimizing pooch? 31 y/o 5'0 and 150 lbs. (photos)

Question

I was pretty set on Vaserlipo 360, but now possibly considering a mini tummy tuck or both. I am 31 years old, have always had a "pooch" even before my c-section. It's partly genetic. I'm 5'0 and weigh about 150. I'm fairly active and eat well. I only have one child and don't plan on any more. I am seriously having a hard time deciding what I want and what would look best. I had a surgery date set, but reconsidering due to the price. Vaserlipo 360 for 16k.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding whether Vaserlipo or a mini tummy tuck would give you better results for minimizing your pooch. Based on your photos and description, it seems that Vaser liposuction alone would leave you with excess skin on your abdomen, particularly because of the overhang you're experiencing. Vaser lipo could help to contour and remove fat, and it can provide minimal skin contraction, but it’s unlikely to fully address the loose skin and muscle laxity, especially after your C-section and with your genetic predisposition for a "pooch."

I would recommend a full tummy tuck with muscle plication (tightening of the abdominal muscles) in combination with liposuction of the flanks. This would give you a flatter stomach and a more defined waistline. Liposuction of the lower back could further enhance the results, giving you even more of an hourglass shape.

While the mini tummy tuck is less invasive, it may not provide the comprehensive results you're looking for since it typically only addresses the lower abdomen. The full tummy tuck would remove the excess skin, tighten the abdominal muscles, and contour the entire abdomen for a more complete transformation.

I understand that the cost is an important factor in your decision, but I believe the combination of a tummy tuck and targeted liposuction would give you the long-term results you're hoping for. I encourage you to discuss these options with your plastic surgeon to determine the best approach for your goals.

Sincerely,
Dr. Katzen

Mark Edward Hennessy, MD · Answer

A stubborn bulge frequently develops post C-section. Based upon your photos I believe that you are enjoying good skin elasticity and assuming that you do not suffer from any chronic medical disorders I would recommend that you consider Liposuction. If the price was the only factor which deterred you from pursuing same, then I would suggest performing a Google search for inexpensive Lipo. Also, Realself has a list of price ranges for Lipo and you might consider reaching out to another Realself patient whom has already had Lipo in your city.
Hope this is helpful.

Jerimiah Mason, MD · Answer

If you undergo liposuction alone (even with vaser) you will end up with a fair amount of loose skin. Combining it with a mini tuck will probably give you better results as it will eliminate some (potentially not all) of the loose skin.

Giuseppe Fiore, MD · Answer

Hi, thank you for your question and photos. 
I know this could be a tough decision. 
In my clinical practice and in similar cases, I always recommend two surgical options. The first option is abdominoplasty (tummy tuck) and Vaser liposuction on your flanks and lower back. This option is for patients who want to achieve a flatter and more toned abdomen. A tummy tuck involves removing excess skin and tightening the underlying muscles to provide a more contoured and firm abdominal appearance. However, this procedure involves an extensive scar on the lower abdomen.
The second option is a less invasive approach: Vaser liposuction combined with Renuvion/J plasma or Bodytite on the upper and lower abdomen, flanks, and back area. The second option is ideal for patients who want to achieve body contouring and improve the waistline with less extensive scars; however, this procedure does not remove excess skin. The combination of Renuvion with Vaser liposuction can increase the likelihood of skin tightening, and my preferred method involves circumferential body Vaser liposuction (360-degree approach) and Renuvion/J plasma, which is an excellent option for women or men who want to improve their body contour and silhouette with fewer scars and avoid a tummy tuck.
Renuvion only requires one session and is typically performed under general anesthesia or sedation in a hospital setting. Bodytite requires one session in combination with Morpheus 8 (three sessions four weeks apart).
Before undergoing Vaser liposuction, it's essential to have a preoperative assessment to determine if you are a suitable candidate. Factors such as a BMI less than 30-32, overall health, and medications you are taking will be evaluated. It's important to note that liposuction is not a weight loss procedure and should not be used as a substitute for a healthy diet and regular exercise. Additionally, while Vaser Liposuction can effectively remove unwanted fat, it may not address loose skin or stretch marks. Therefore, it's important to have realistic expectations and understand the limitations of the procedure.
I would suggest making an appointment with a surgeon expert in body contouring and skin tightening who can assess your specific situation and recommend the best course of treatment for you. They can also discuss any potential risks and benefits associated with the procedure.

Hope this helps. All the best,

Dr. Giuseppe Fiore

George Marosan, MD · Answer

Thank you for your question and photos. Based on these photos, you would do best with a full tummy tuck and VASER lipo 360 degrees. This will give you an hourglass figure. Your back cannot be evaluated from these photos. The abdominoplasty incision needs to be placed at the pubic bone level so you can wear a bikini afterwards.
See a board certified plastic surgeon experienced in advanced body sculpting techniques for an in person consultation/evaluation. Good luck.

Navjot Singh, MD, FACG · Answer

Thank you for your question. Different skin tightening treatments are available. Renuvion is great for treating skin laxity. I use this skin-tightening device while my patients are fully awake, I numb the area so they don't feel anything. It allows them to go back home right after. The downtime is very minimal, and the treatment is effective.

Darryl J. Blinski, MD · Answer

Based on the nicely posted photos you need full TT with lipo of waist. Fee from $7,000. Vaser lipo fir $16,000 outrageous! 
Best to virtual consult with…

Mats Hagstrom, MD (license on probation) · Answer

Choosing the correct procedure it should be based on first having a clear understanding of the underlying problem is.
The process should begin by having in person consultations at which time you get a proper assessment with recommendations based on a clear understanding of what the underlying problem is.
In other words the process begins with a correct diagnosis followed by prescribing an operation that treats the underlying problem.
Pregnancy related changes create skin laxity and muscle separation. Pregnancies do not create changes in fat distribution.
Liposuction only address is fat distribution and has no impact on skin laxity or muscle separation.
The type of liposuction is irrelevant. Liposuction only reduces subcutaneous fat. The name of the equipment is irrelevant in comparison to who does the procedure.
There are four variables that determine what someone’s abdomen looks like.
In other words if someone doesn’t like the way their belly looks it is because of one or more of for different reasons.
These four variables are skin laxity typically due to previous pregnancies or weight fluctuations, excess subcutaneous fat(The fat layer between your skin and muscle that you can pinch), muscle separation from previous pregnancies causing the muscle wall to bulge and lastly excess visceral or intra-abdominal fat.
To differentiate each variable can try the following.
Put your skin under tension by lifting up on your abdominal skin and see if it improves your contour it. You can do this while looking in the mirror, have someone else take pictures or use the timer on your camera to take pictures.
Using the timer on your camera is a far better option than taking pictures in a mirror.
To assess your subcutaneous fat layer taking your fingertip and gently press against your skin until you feel the underlying muscle wall. it’s a very gentle touch and does not require much pressure at all. your subcutaneous fat layer on your mid abdomen is probably 1-1.5”. Liposuction can remove 75% of that fat which means it will reduce the front of your abdomen by just over 1 inch.
You can assess your muscle wall the same way you measure the thickness of your subcutaneous fat layer. Gently pressed against your skin until you feel your muscle wall.
A tight flat muscle wall should create a B line between your sternum and your pubic bone.
Based on your pictures your muscle wall is bulging most likely due to muscle separation from previous pregnancy.
Excess visceral fat can also cause muscle bulging. to differentiate between muscle separation and excess visceral fat try pressing your abdomen flat with your nondominant hand. if it’s easy to do and does not require much pressure and the problem is more likely muscle separation. On the other hand if it feels tight and requires a significant amount of pressure or when laying on your back your muscle while still bulges then visceral fat is probably contributing more than muscle separation.
Regardless, your muscle ball is currently bulging and Liposuction will not correct this.
Liposuction will do its best reducing your love handles waist and back but will still leave your abdomen bulging most likely due to muscle separation.
A mini tummy tuck will address skin laxity of your lower abdomen but will not address skin laxity above your belly button or muscle separation.
If you want a tight flat abdomen you will need a full tummy tuck.
In the end it simply comes down to what you’re trying to achieve and what you’re willing to go through.
Liposuction will reduce the front of your abdomen by 1 inch but that will not give you a pre-pregnancy abdomen or a tight flat abdominal wall.
For that to happen requires a full tummy tuck.
To find the right provider I suggest patients have multiple in person consultations avoiding virtual consultations whenever possible.
Patients are well advised to stay local whenever possible.
During each consultation ask each provider to open up their portfolio and show you their entire collection of before and after pictures for the procedure you’re interested in. Let each plastic surgeon make their own assessment and listen to what they recommend in regards to what is the best procedure.
If someone needs a tummy tuck an opt for liposuction then you need to recognize the inherent limitations of the procedure.
The best procedure to get a tight flat abdomen in your case is no question it going to be a full tummy tuck.
For tummy tuck results look carefully at the plastic surgeons who gets the most natural looking belly buttons with a very low set scar that follows anatomic contours naturally. The torso should look balanced proportionate, attractive and appropriate from all angles including from behind.
Being shown a handful of preselected images most likely representing the best results of a providers career is insufficient to get a clear understanding of what average results look like in the hands of each provider regardless of what procedure you choose.
To get a good understanding of the skill and experience of each provider and properly vetting plastic surgeons patients should push providers to open up their portfolio and show their entire collection or at least as many before and after pictures as they’re willing to. an experience provider should have no difficulty showing you at least 50 sets of before and after pictures of commonly performed procedures like abdominal liposuction or a full tummy tuck.
Delivering consistent quality liposuction results is more difficult than most people believe and this includes plastic surgeons. The number of plastic surgeons who can consistently deliver quality results as less than most people believe. being a board-certified plastic surgeon with overall good reputation is not sufficient to confirm someone has mastered body contouring with Liposuction.
Four Liposuction results look carefully at before and after pictures making sure there are no skin irregularities anywhere on any treated body area. Ask the surgeon to review before and after pictures with you asking them to point out what areas were treated and what areas were not treated. Look carefully a transition zone between treated and untreated areas.
For Liposuction make absolutely sure you know what areas will be included with the procedure. Personally I view the torso as a single anatomic unit and believe in cheating the entire torso when doing Liposuction. A full torso includes upper abdomen, lower abdomen, I love handles, waste, full back and under arm areas all the way to the side of the breast. by treating the entire torso patients are left with a thin even natural fat distribution or without transition zone between treated in on treated areas.
In the end the choice of procedures should be based on input from plastic surgeons who have proven skill and experience you trust combined with what you’re hoping to achieve in relationship to what you’re willing to go through.
Nobody wants to have a full tummy tuck but for some patients it is the only procedure that will give them a tight flat abdomen. For some individuals that justifies having the procedure and for others it does not.
No one needs to have a tummy tuck.
Likewise no one needs to have Liposuction.
Did not expect Liposuction to deliver tummy tuck results.
In the end choosing the best provider is most likely the most important decision. Pick the right plastic surgeon and everything falls into place.
When in doubt slow down and schedule more consultations.
Best,
Mats Hagstrom MD

Randy Dean, MD - Account Suspended · Answer

Hi and welcome to our forum!
From your photos, I note that you appear to demonstrate a full abdomen with a small lower abdominal pannus. 
I am unable to ascertain if the fullness represents accumulation of fat beneath the skin, internal visceral fat or a separation of your anterior abdominal muscles as the result of previous pregnancy or weight loss.
Superficial fat is addressed with liposuction, abdominal wall repair is accomplished with abdominoplasty, and visceral fat is addressed with a regimen of diet and exercise. A physical examination is required to differentiate among these entities. If you have borne children, muscle separation is most likely.
Liposuction will not address your loose skin and soft tissue. A mini-tummy tuck will not address the probable muscle separation and only partially remove loose skin. Only a full tummy tuck with muscle repair will tighten the abdominal wall and remove your loose skin and soft tissue.
Best wishes...

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