Different Doctors' Opinions on Tummy Tuck and Liposuction?

I was told by a PS that I do not need Liposuction with my Tummy Tuck procedure. In fact, he told me that he couldn't turn me over on my stomach during the procedure to give me lipo.

I was told by 4 other doctors that I needed a little Lipo on the back just to make the Tummy Tuck more appealing. This doctor said otherwise. Is he just be lazy or are all the other doctors just trying to rip me off?

Doctor Answers 8

Liposuction and Tummy Tuck

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First, if four surgeons tell you the same thing and one tells you something different the odds are the one is wrong. And, in this case he is. Liposuction on the back or flanks or almost anywhere is often done at the same time as a tummy tuck.

The liposuction is performed first then the surgery is completed with the tummy tuck. So I suggest that you go to a surgeon who will do what you desire.

Tummy tuck and liposuction.

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1) Turning you is not a problem. Liposuction of the back is done first, with you face down. Then, you are turned face up and we do the tummy tuck. This is assuming you really need liposuction of the back. Most of our tummy tuck patients do not. Many just need liposuction of the love handles.

2) When tummy tuck is combined with other operations, the risk of complications can go up. So we would do both liposuction of the back and a tummy tuck only if you are young and thin and completely healthy.

3) Liposuction of the stomach and waist is done routinely when we do a tummy tuck. That is really just part of the tummy tuck.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Doctors' opinions on Tummy Tuck and Liposuction

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Dear Scared2death,

As a former New Yorker, I would like to answer your question as best I can.

If the score is 4 to 1 FOR the procedure, I THINK you already have at least a partial answer. It does not mean you original surgeon is necessarily "lazy" but it does mean that his vision / experience is not shared by the other 80% of the surgeons who had the opportunity to examine you.

I have a significant experience in body contouring surgery and in examining my results, I have increasingly seen that a lot of abdominoplasty patients GREATLY benefit and have MUCH BETTER results from back liposuction done in conjunction with a tummy tuck.

As the tummy is tightened, your waist will be narrowed narrowed. But, if you have a significant amount of fat on your low back / upper buttocks, that fat would now look exaggerated since the waist just above it will be narrowed. Liposuction on the other hand defines the upper buttocks and lower back IN THE RIGHT PEOPLE.

Lastly, on a personal note, if you really ARE "Scared2death" and think that 80% of the plastic surgeons you saw are "just trying to rip you off" MAYBE you should NOT be having surgery. After all, this IS " I WANT surgery" not "I NEED surgery" and something bad MAY happen to you and validate your worst fear. I am by NO MEANS saying it will happen, but if your inner voice tells you NOT to do it, you should listen to it and not do it.

I hope this was helpful.

Peter A. Aldea, MD
Memphis Plastic Surgeon

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Best results are seen when liposuction is done as part of the tummy tuck

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Liposuction is now generally done with almost all tummy tucks. Turning you is not a problem. The latest technique of tummy tucks are done with you awake and under only local anesthesia with a little IV sedation. This allows you the advantages of safety and the mobility of you turning yourself to assist in the procedure.

David Hansen, MD
Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 46 reviews

Different doctors' opinions on Tummy Tuck and Liposuction?

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Not being present at any of your consultations - the good news is that you have more than one - I cannot give you advice about "he said, she said" regarding your condition. I do not know what you look like so making any recommendations would be speculative and the response, not what you maybe be looking for.

Liposuction is almost always a good addition to a tummy tuck.

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To get the very best results with your surgery your whole body should be evaluated to determine the best combination of procedures. I personally almost always include liposuction of the abdomen and sew the superficial facia to the abdominal wall facia when i perform a tummy tuck. This gives a much better looking abdomen, decreases the pain, and precludes the need for a drain. Most of the time I also perform liposuction on the hips together with a tummy tuck. If this is need and it usually is needed that to not do liposuction on the hips will make the hips seem unusually large. This is also the time to evaluate the other parts of the body, lateral thighs, medial thighs and knees, back, and buttocks to determine if it would be a good idea to carry out liposuction of these areas. I feel that the best course of action is to do all the liposuction at the time of the first operation together with the tummy tuck. It is also reasonable to address the breasts at the same operation if there is a desire to do something to improve theirs size or shape. Find a board certified Plastic Surgeon who has experience with all of these procedures. The total operative time should be under 6 hours. Why one surgeon recommends against combining liposuction with a tummy tuck is any ones guess but if they are not comfortable with it they should not do it. You should find a surgeon you are comfortable with and who is comfortable with all these procedures.

Interesting perceptions

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When one considers the area between the rib cage and the hips it should be looked at in total, as a cylinder. In addition you need to look at the components or layers: the skin, the fat under the skin, the muscle layer and the internal fat.

The tummy tuck will only take care of the front and will not help the hips or spare tire areas. That area can be treated with liposuctioning and that can be done at the same time as the tummy tuck.

The procedure is started with the patient on his belly and the liposuctioning is performed. The patient is then turned over and the tummy tuck is done. Alternatively some liposuctioning of the hips can be done with the patient on their back at the same time as the tummy tuck but the results are not as good.

The problem you may be running into is what is included in the cost of the tummy tuck. Some doctors may include liposutiong in the fee some may not.

Tummy tuck plus lipo on back - practical issues

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It sounds like the majority of doctors who have examined you have concluded that you need the lipo for best results. It then comes down to a practical issue of how to change position during surgery in order to accomplish this. There are ways to do it and I think most would probably want to make it happen. It isn't a matter of laziness, some surgical facilities just aren't set up to do it that way, or it may be a matter of perference.

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.