I'm concerned about my protruding my upper belly? (photo)

When I ppinch it there is a lot of fat. PS is only performing a TT and BR and says lipo is too risky to do at the same time. I weigh 177 and am 5'4"And am 51. Will he be able to reduce all the excess on my belly and waist. What kin of results should I expect? If I lose 20lbs. After the surgery what would happen with my results.

Doctor Answers 25

Liposuction and tummy tucks

It is risky to liposuction the upper abdominal wall as you can disrupt the blood supply to the lower abdominal wall.  I  cannot tell from looking at the photograph but it looks like you might have a large amount of intra abdominal or visceral fat.  If that is the case the best result will be obtained with you losing weight before the surgery and strengthening your core muscles so when the tummy tuck is done your PS will be able to maximally tighten your fascia. 

La Jolla Plastic Surgeon
5.0 out of 5 stars 25 reviews

Tummy Tuck & Liposuction Surgery

When patients present for abdominoplasty surgery, they often have redundant abdominal wall tissue, stretch marks, weakened abdominal muscles, and localized fat collections of the abdomen and flanks. Although this procedure can remove excess skin, stretch marks, and tighten weakened abdominal wall muscles, it doesn’t impact the subcutaneous layer of tissue. When this layer of tissue demonstrates significant thickening, supplemental liposuction may be necessary.

The timing of supplemental liposuction is somewhat controversial. Although there are some plastic surgeons who perform abdominal wall liposuction at the time of abdominoplasty, the majority delay extensive liposuction for at least 3 to 6 months. They feel that this improves the results of liposuction and ultimately decreases the complication rate.

When liposuction of the abdomen is performed at the time of abdominoplasty, there’s the potential to damage the blood supply to the skin flaps. This can result in skin necrosis and wound breakdown. For these reasons, most plastic surgeons prefer staging these procedures.

The vast majority of patients are extremely happy with the results of abdominoplasty surgery. In some cases, patients continue to have thickening of the abdominal wall because of increased subcutaneous fat. Even these patients are happy, but many of them want additional improvement and therefore request liposuction of the abdominal wall at a later date.

If you’re planning on undergoing abdominoplasty, it’s important to discuss these issues with your plastic surgeon. Your surgeon should be able to explain what option is best for you.

Mommy makeover

I think you will be happy with the results, but if you are concerned, then you could see another surgeon who is willing to suction at the same time.

Concurrent liposuction of the abdominal skin with abdominoplasty is dangerous and often unnecessary.

Liposuction of the abdominal drape edge trauma to tissue already elevated and placed under tension. This increase the risk for wound healing and tissue loss. If a drape is too thick it can be liposuction secondarily. Seldom is it necessary.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 25 reviews

Results without liposuction after a tummy tuck

Sure, if you lose more weight like the 20 lbs you mentioned, you will be better off.  Intrperitoneal fat( the fat under your muscles) will not be treated so some girth will remain. You can always have liposuction of the abdomen after the tummy tuck as well.

Steven Wallach, MD
New York Plastic Surgeon
4.0 out of 5 stars 23 reviews

Abdominal wall laxity


Thank you for the question and the photo.  The fullness or protrusion of your upper abdomen is likely secondary to a combination of issues including fat above the abdominal wall, abdominal wall weakness, and fat below the abdominal wall.  Tightening of the abdominal wall (muscle tightening) will correct one of these issues.  I think you would also benfit from some liposuction of this area.  Each plastic surgeon has his/her own method of doing things and of couse your plastic surgeon knows your body and medical history the best and would be able to make the most accurate decision.  If you are otherwise healthy and a non-smoker I think liposuction at the same time as a tummy tuck can be performed safely and effectively.  The link below shows an example of this.

All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 144 reviews

Liposuction can be done with a tummy tuck...but usually only of the hips

It appears as though you'll get a nice result with a breast reduction and a tummy tuck.  I frequently perform liposuction of the hips at the same time as a tummy tuck, but liposuction of the upper belly can endanger the blood supply to the skin.  Good luck!

Liposuction At Time of Tummy Tuck Surgery?

Thank you for the question and pictures.

 I would agree with your plastic surgeon, in that too much liposuctioning of the abdominal wall at the same time as tummy tuck surgery may be dangerous and ill-advised.

 If at all possible, try to achieve as close to your long-term stable weight PRIOR  to proceeding with body contouring surgery. Doing so will decrease the chance of complications around the time of surgery and minimize chances that you will need additional surgery subsequently.

 Best wishes.


I would not perform liposuction with the abdominoplasty on the upper abdomen at the same time. You run the risk of having complications which are unnecessary

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 14 reviews

Definitely: Lipo with Abdominoplasty

Combined Breast and Abdominoplasty procedures provide some of the most dramatic results in plastic surgery.  Breast reduction provides plastic surgeons with their happiest patients. Abdominoplasty addresses muscle separation, skin excess and fatty tissue of the abdominal wall. It does not, however, address intra-abdominal fat.  Your photos demonstrate that you are a very good candidate for BR. 
Your photos show minimal fullness in the hip, buttock, and thigh regions compared to the abdomen. Abdominoplasty can be performed safely with liposuction as well as direct excision of fatty tissue deep to the superficial fascia of the abdomen.  Direct excision provides a more even result and can be complemented safely with lipo of the hips and right under the breast bone.  I tell my patients lipo touch ups can be undertaken post op if necessary as well. Related to weight, appropriate weight is always ideal, but I have a frank discussion with my patients as to what the likelihood of them achieving that goal weight pre-operatively and act accordingly.  Remember that you will likely loose at least 5 pounds with the surgery alone. 

Ronald A. Lohner, MD
Philadelphia Plastic Surgeon
4.5 out of 5 stars 19 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.