Lipo360 or tummy tuck? What are my options? (photos)

Thank you for your question and pictures. I would recommend you a tummy tuck with liposuction for betters results. If you're willing to travel, Surgeons in the Dominican Republic have experience and very high standard of excellence when it comes to plastic surgery. I'm positive you can get what you're looking for

Dear Adoloresc,
it is hard to tell for sure without an examination. Based on your photos, it looks like you would benefit from liposuction. If you are considering surgery, I would suggest you 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

Liposuction is a contouring technique. The patient must have adequate skin elasticity to allow for skin retraction after surgery.
Healthy people at their ideal weight with a BMI of 30 or less should have the best overall recovery from a TT and lipo, but some of this will depend upon the surgical technique and adherence to postoperative protocols. Liposuction, combined with the standard TT, will allow you to have stubborn fat resistant to exercise and diet removed from unwanted areas. A TT with muscle tightening will create a flat abdomen and would also provide the benefit of placing your incision along the lower pubic region. The TT also creates a more youthful belly button. If the waist was smaller at one time, the waist can likely be reduced to those same measurements or smaller provided the muscular and fascial integrity has remained the same.

It is important to have an in-person consultation with a board certified plastic surgeon to evaluate if a tummy tuck is necessary. There could be two reasons: 1) you have muscle diastasis and 2) you have significant skin redundancy. If only skin redundancy is present then there are alternatives to a tummy tuck such as modified abdominal skin resection, which still allow your plastic surgeon to liposuction your abdomen. The Gold Standard for superior liposuction results requires use of the advanced technology of ultrasound-assisted VASER liposuction. As an official trainer of VASER liposuction, I perform full body liposuction cases every week. VASER liposuction has been the only modality that has consistently resulted in outstanding liposuction outcomes. VASER liposuction ensures a smooth contour regardless of degree of excess fat by virtue of being able to remove any and all remaining fat comprehensively and uniformly. If skin redundancy is observed, Renuvion technology can be simultaneously applied to tighten your skin to optimize your overall contour outcome. A Skype or FaceTime consultation with a VASER specialist will help you get an accurate recommendation and pricing.

Respectfully,
Arian Mowlavi MD, FACS
Realself 100 Hall of Fame Inductee

Plastic surgeons evolve their practice based on a multitude of factors and opinions can differ based on each persons training, experience and personal philosophy.

Decision makings for appropriate procedures should be based on an underlying ideology based on an assessment.

In other words a person needs to have a diagnosis or a clear understanding of what the primary, secondary or tertiary problems are contributing to the issue at hand.

For example for the front of the abdomen there are four variables that can contribute to change in contour and appearance.

If someone doesn’t like the way their belly looks than it is generally always because of one or more of these four variables.

Each of the variables has its own form of treatment and understanding which is the first, second or third problem in order should help clarify which treatment will have the greatest impact.

Took go back to the example of the abdomen those four variables are as follows.

1) skin laxity. skin laxity can contribute significantly to shape and contour and people often differentiate loose skin for being excess subcutaneous fat. to differentiate skin laxity simply put the skin under tension by pulling on the skin above the area of concern and see if it changes the contour much. if putting the skin under tension completely fixes the problem then the problem is most likely directly related to skin laxity. The only treatment that works for abdominal skin laxity is sometime of skin excision basically some form of tummy tuck.

2) excess subcutaneous fat. The second variable or excess subcutaneous fat is the fat layer between the skin and the muscle. Assess the thickness of subcutaneous fat by gently pushing your fingertip into your skin until you feel the underlying muscle wall. on your midabdomen your subcutaneous fat it’s probably somewhere between one and 1 1/2 inches thick.

3) muscle separation a.k.a. diastasis recti. Muscle separation from previous pregnancies called the diastasis recti can cause the abdominal wall to bulge out basically creating a partial appearance of being pregnant or simply having a large protruding or bulging abdomen.

A straight flat abdominal wall should create a bee line between your sternum and pubic bone. If you gently pushing with your finger on your mid abdomen and a standing position until you feel where the muscle wall is you can determine yourself if this is in front of a line created from your pubic bone to your sternum. Muscle separation can only be treated by muscle tightening through a full tummy tuck.

4) excess visceral or intra-abdominal fat. Fat around our internal organs or viscera is called visceral fat and those who have excess visceral fat can have a bulging abdomen that looks similar to muscle separation.

To differentiate muscle separation from visceral fat patience should see how much pressure it takes to hold their abdomen flat with one hand. This last step is a little bit difficult and may be better done with an examination by a plastic surgeon.

By looking at your pictures I don’t see significant skin laxity or evidence of previous pregnancies. In that sense you look like the quintessential perfect candidate for Liposuction.

Delivering consistent high-quality Liposuction results is more difficult than most people believe.

For plastic surgeons who have not mastered this procedure they may be apprehensive to recommend liposuction because results may not be consistent in their hands.

A tummy tuck will for sure deliver results but may be excessive for those who don’t really need one.

For those interested in body contouring procedures it is imperative to find a really talented and highly experienced provider.

This is especially true for Liposuction procedurs.

The variation in outcomes and Liposuction results varies more than any other procedure I’ve ever seen simply based on who does the surgery.


To minimize the chance of undesirable outcomes patients need to find the most experienced and talented provider for this procedure.

Do that by having multiple in person consultations with local board-certified plastic surgeons in your community.

During the consultation ask each provider to show their entire collection before and after pictures for abdominal liposuction.

Seeing a handful of example results which in reality represent the very best outcomes of that provider‘s career is insufficient to get a clear understanding of what average result will look like for that provider.

This is why patients should insist providers show as many before and after pictures as possible including a results that are above average, average and below average.

This will give you an understanding of how many procedures that surgeon has performed and what average results look like not just the best results of their career.

An experienced provider should have no difficulty showing you 50 or more sets of abdominal liposuction before and after pictures.

Highly experienced surgeons will have hundreds or even thousands of before and after pictures for just abdominal liposuction.

Lastly I recommend reading all reviews on various physician review websites.

Avoid providers with any significant number of justified negative reviews.

The absence of justified negative reviews is far more important and far more telling than having an abundance of positive reviews.

Justified negative reviews are organic and the same cannot be said for positive reviews.

Continue having consultations until you feel like you found someone who has truly mastered Liposuction and can clearly deliver the type of results you looking for on a consistent basis.

When reviewing before and after pictures always look and ask exactly what areas were included in the treatment and look carefully from all view. Look carefully at the transition from the waist to the hips and the waist to the buttocks. do the patients look like they have a natural transition zone or does it look like part of their body was treated while other parts were untreated.

Personally I view the torso as a single anatomic unit and typically either treat the entire torso or don’t do with Liposuction at all.

A full torso includes upper abdomen, lower abdomen, love handles, waste, full back and under arm area.

Good luck with your decision making and possible upcoming procedure.

Best,

Mats Hagstrom MD