Cutting out Fat for Mini Tummy Tuck Instead of Liposuction?

I had a mini Tummy Tuck 3 weeks ago, and the doctor cut out the fat instead of liposuctioning it. I was wondering, does it matter how he took out the fat?

Doctor Answers 20

Direct approach may be best with tummy tuck

With abdominoplasty, whether a mini or full, my preference is to remove the fat from the central portion by directly cutting it out. Using liposuction on the part that is raised up as a flap may pose some additional risk, but it is commonly used on adjacent areas such as the waist or hips. By thinning the flap with direct removal of the fat, it gives a lot of control to the thickness and creates a surface for sutures called "progressive tension" which means less drainage (your drain can come out in a couple of days at the most) as well as good shaping and less tension along the skin closure, which contributes to good healing with minimal scar.

Seattle Plastic Surgeon
4.9 out of 5 stars 52 reviews

Surgical removal of fat with mini-tummy tuck: What’s the best technique?

Liposuction is a broad term that defines the surgical removal of fat utilizing a small hollow tube (cannula) with holes on one end and a vacuum source on the opposite end. Today, there are different types of liposuction being performed There are four categories of liposuction fat extraction:

· Standard Liposuction

· Ultrasonic Assisted Liposuction

· Power Assisted Liposuction

· Laser Assisted Liposuction

What they all have in common is that fat is being removed to contoure the body and improve a person's appearance. Without question, the most important part of liposuction procedure is your choice of the surgeon…not the device. The experience, wisdom, skills, and talents of your surgeon are essential to all successful outcomes.

A mini-tummy tuck is, simply, a smaller version of the full tummy tuck operation. With a mini-tummy tuck, it is customary for a limited amount of fat and skin to be excised. Also, it is common for a surgeon to perform liposuction at the same time as a tummy tuck or mini-tummy tuck to further optimize the results, if needed! Your surgeon’s choice of excising the fat rather than performing some form of liposuction was a clinical decision made by him, specifically for what was best for you. This is the art and science of plastic surgery. It most likely does not matter what technique was used to remove the fat.

Thanks for your question.

Stephen A. Goldstein, MD

Stephen A. Goldstein, MD
Englewood Plastic Surgeon

The fat is not the only issue

When performing a mini tummy tuck, it's important for the surgeon to not only address any excess fat that may be present, but also to evaluate the abdominal wall muscles as well as the quality and the amount of skin. In most cases I will directly excise the fat so as to precisely control the thickness of the skin and fat that remains, and then plicate or tighten the muscles of the abdomen before removing any excess skin that's present. You can achieve good results with liposuction of this area first, but the surgeon must be cautious so as to avoid damaging the blood supply to the skin, which could cause a delay in healing. In the end, a lot of this comes down to your particular anatomy as well as the preference of the surgeon, and either technique can create very nice results.

Shahram Salemy, MD, FACS
Seattle Plastic Surgeon
4.9 out of 5 stars 149 reviews

Many ways to peel an apple.

If you are thin and only have a little extra fat just below the belly button, cutting the fat out may be less traumatic then liposuction. Liposuction is still ideal for removing the fat in areas where there is no easy access through a surgical incision. Relax and enjoy the results!

Robert M. Freund, MD
New York Plastic Surgeon
4.8 out of 5 stars 33 reviews

The liposuction cannula is just an instrument, like a scalpel.

Fat can be removed by cutting it out or with different types of liposuction. The main advantage of liposuction is that you avoid an incision (and a scar). Since you had an incision anyway for the mini tummy tuck , cutting the fat out is probably fine. It depends on where exactly the fat was.

I assume you also had some loose skin and that's why you had the mini tummy tuck approach? Anyway, if you look good, you had the right operation.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

Liposuction and Abdominoplasty can go hand-in-hand


With most cases of abdominoplasty and mini-abdominoplasty, I perform both liposuction and the fat excision. However, it all depends on your fat distribution and amount of redundant or loose skin. So, there really is not a one-answer-fits-all solution as to whether cutting the fat out or if liposuction is the best answer - usually they go hand-in-hand. Hopefully, you are happy with the results you received.

David Shafer, MD
Shafer Plastic Surgery

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 75 reviews

Usually both are done

Mini-tummy tucks usually consist of 1) small excision of skin and subcutaneous fat of the lower abdomen, sometimes 2) liposuction of the abdomemn and hips, and 3) tightening of the lower abdominal musculature. If you are very thin and only had loose skin in the lower abdomen, then it may have only required some skin and fat excision.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Lipo vs. Mini Tummy tucks

In my practice near San Francisco we encourage patients to think of their abdomen as two parts. The first is abdominal volume, the second is the skin envelope around the abdomen. Each may have a need for cosmetic improvement and the approach for managing a particular patient must be carefully tailored for that patient.

Lipo is great for targeted permanent fat removal but not as good for skin envelope reshaping. Even with new gadgets like "laser lipo" most of the time if there is significant excess skin it needs to be removed by excision. Lipo is also not always appropriate in situations where there is a great deal of fat and in these situations excision of the fat or additional weight loss prior to surgical treatment gets patients better results.

A mini tummy tuck traditionally deals with both the skin and the abdominal volume. Some argue a greater ability to "shape" the underlying fat with lipo but few would argue the ability to remove redundant skin.

Hope this helps!

Steve Williams, MD

Steven H. Williams, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 49 reviews

Liposuction versus direct removal of fat

The main difference between an excisional lipectomy (cutting out the fat) and liposuction is the technique. Direct excisional lipectomy allows for quick sculpting of the fat without distortion from tumescent solution. However, many feel that liposuction allows for preservation of sensory nerves, blood supply, and lymphatic vessels which improve postoperative sensation, wound healing, and lower rates of seroma or fluid collections. Many surgeons will perform both procedures to complement each other. The technique used is really dependent upon your anatomy and desired goals. In summary, both are acceptable methods of fat removal.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 25 reviews

Different problems can require different solutions

Liposuction works best for discrete areas of local excess fat covered by skin with good elasticity that can shrink down after the fat is removed. This leads to improved contour. When the overlying skin is loose than liposuction alone can result in more sagging skin. As a result excess skin and its attached fat is often removed in this scenario. In a 'mini-abdominoplasty' the improvement in body contour achieved is focused on areas below the belly button. A full tummy-tuck carries the job up to the level of the bottom of the breast bone. Sometimes the belly muscles also will need to be tightened especially if they were pushed apart by a pregnancy. So adressing the three main layers of the abdominal wall, skin, fat and muscle are all important to achieve optimal results. As patients differ in their goals and objectives, no one approach works for all clincial situations. A 'one size' operation definitely does not fit all!

Robert T. Grant, MD
New York Plastic Surgeon
3.5 out of 5 stars 7 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.