Abdominal Lipo AFTER a Tummy Tuck?

The results of tummy tucks vary with your pre-operative weight, body shape, degree of skin laxity and muscle laxity.  The best results are seen in those with ideal body weight with no intra-abdominal or extra-abdominal fat and only loose skin and muscles.  If this does not describe your situation, then a traditional tummy tuck alone is less likely to restore the feminine "hour-glass" figure that most patients desire.  This happens because tightening of the muscles pushes intra-abdominal fat (fat around the organs) up towards the top of your abdomen and out to the sides making your waist line square.  When these findings are present before surgery, then one should consider adding liposuction to a tummy tuck to enhance the results by removing additional extra-abdominal fat.  The lipo-abominoplasty is the procedure that combines these two procedures with excellent results in the ideal patient performed by an experienced surgeon.  Alternatively, liposucton can be performed after a tummy tuck to further enhance your body contour if there is still fat under the skin.  Skin laxity and contour irregularities are less likely to be a problem for you because the skin has been tightened by removing the excess at the first procedure.  Hope this helps!

You've raised a very good question with regards to tummy tuck surgery. It is a point that I always cover with my patients pre-operatively. I am comfortable liposuctioning the flanks and mons pubis area during the tummy tuck surgery, but I am not comfortable with liposuction of the upper central abdomen (unless it's to create the median raphe only). I think it adds to increase risk of poor wound healing and potential tissue necrosis. For surgeons who can liposuction the mid-abdomen aggressively and not have a complication, I extend my admiration. But for patients and surgeons who have to deal with the resulting complication, it is a huge problem. So for patients with a thicker mid-section, I will often recommend a safer two-stage procedure. Three to six months after the tummy tuck procedure, return to aggressively liposuction the central abdomen, flanks, hips and/or back area. I wouldn't be too concerned about having loose skin again (of course, I don't have pictures to see). I think your surgeon made a prudent decision.

There are two differing schools of thought regarding combining liposuction with abdominolasty surgery.

Some surgeons believe that performing these two elements at the same time may increase the risk of wound healing and other complications. I agree that this can be the case when performing "wide undermining" of the skin.

Other surgeons will argue (myself included) that one can safely combine liposuction and abdominoplasy my modifying the way the abdominoplasty is done. In fact, a "lipoabdominoplasty" does just this. In our experience, we have achieved excellent results with lipoabdominoplasies and no increase in complication rate.

I can't comment too much without the opportunity of looking at photos. Many surgeons feel the risks of doing liposuction in the same area as open surgery for a TT outweigh the benefits.  The TT wipes out a lot of blood supply needed for wound healing, and the liposuction takes out more, and there certainly are some patients who have had bad outcomes with this combo. 

Now that you incisions have healed, it is quite likely that doing liposuction would not present a significant hazard.

Thank you  for your question, all the best.

Hello,

Thank you for the question.  Liposuction during a tummy tuck procedure is still somewhat debated among plastic surgeons although much less than before.  The idea is that liposuction hurts some of the vessels that will help with tummy tuck healing.  I have not seen this with my tummy tucks and continue to perform liposuction with just about every single one of my tummy tucks.  If the fear of blood supply prevents liposuction during a tummy tuck the same should not be the case before or after the tummy tuck procedure.  At this stage you can receive liposuction of the tummy tuck and surrounding areas without concern.

All the best,

Dr Remus Repta

Your plastic surgeon was wise to not liposuction the upper central abdomen during your tummy tuck as the risk of major healing problems is significant at the incision line. Thus many tummy tuck patients will have an upper abdominal fullness after their tummy tuck due to a persistently thick fat layer. This can be addressed in 3 to 6 months after surgery by liposuction to thin it down and put the finishing touches to your tummy tuck result. It will not cause any extra loose skin. It is far better to have two surgeries done safely than reaching for the perfect result and suffer a major wound healing problem which can be devastating and takes months to heal.

I do not usually perform liposuction of the central abdomen at the same time as a full abdominoplasty.  I will perform liposuction on other areas at the same time. If the patient needs liposuction of the central abdomen, then I will often do it after the tummy tuck has healed.

I do liposuction at the same time as tummy tuck in about 80% of my patients

There are some plastic surgeons who are not comfortable combining the two

I do not see a problem with having liposuction after doing a tummy tuck

It may be best to wait at least six months between the two procedures

You can of course have liposuction after your tummy tuck if you feel the contour is still wanting. Don't forget though that you might also be able to execise and strengthen now that you are two months out and some of the excess can be reduced on your own with an added health benefit.

It is hard to be specific without seeing photos and reviewing the medical records.  Some surgeons prefer not to do lipo at the same time because of the potential to increase risks such as seromas and interfering with circulation to the skin.  Liposuction can be performed after a tummy tuck and sometimes can make a significant difference.  Also, as one improves one area of the body, another area may now "standout" and be more obvious.  Discuss this with your surgeon and see if you are a good candidate for lipo at this time and if it will achieve what you want.  Surgeons usually have a good reason for doing things a particular way because of past experiences.  Give your surgeon a chance to explain.