Flank Area Forgotten?

Hi, I  had full tt with flank lipo 5 wks ago. never had bruising/any discomfort to flank areas. Flanks look exactly the same as before surgery. Nurse at ps office said incisions healed and are "invisible". PS looked at flanks for time then said "curved" canula used and went thru tt incision. I fear area was accidently forgotten. By the way- I am a nurse and my husband a surgeon. Can't ask my husband as he is not happy with my desire for surgery .

Doctor Answers 12

Liposuction and Tummy Tuck: Modern Abdominoplasty

A tummy tuck or abdominoplasty removes excess skin on the abdomen as well as tightens the muscles. This can be combined with liposuction, though the classic training cautions against liposuction during these body contouring procedures for fear of skin healing problems and blood clots. In the properly selected patient, a lipoabdominoplasty (tummy tuck with liposuction) can be safely performed to achieve improved contouring, especially in the flanks and central abdomen. The majority of my tummy tuck patients start in the prone or face down position to really have control on contouring this area with liposuction. They are then re-positioned onto their backs to complete the procedure and achieve a well three dimensional change in this area.

I always tell my body contouring patients to be patient with the areas of liposuction as they may take upwards of 3 months to see somewhat of a final result. It is likely too early so be patient.   

Austin Plastic Surgeon
4.9 out of 5 stars 45 reviews

Liposuction of the flanks is essential in liposuction

I am sorry to hear about your disappointment after tummy tuck and flank liposuction. I routinely incorporate liposuction of the flanks from a posterior and anterior approach during abdominoplasty. Nevertheless, you should have access to the operative report and nurse's or report to confirm liposuction and volume. 5 weeks is early and swelling may still be an issue.

Frank Agullo, MD
El Paso Plastic Surgeon
4.9 out of 5 stars 140 reviews

Flank area After Tummy Tuck?

Thank you for the question.

Treatment of the flank area should be discussed prior to surgery. Although liposuction  of the area maybe helpful  in some cases it may be insufficient to achieve the patient's goals.

In those cases, treatment of the stubborn flank (muffin top) may involve excision (lipectomy) of excess skin and adipose tissue (extended tummy tuck). Liposuction  surgery alone  will potentially leave  patients with loose skin and an  unsatisfactory result.

Therefore, patients who are undergoing a standard tummy tuck procedure  should be aware  that often an “extended” tummy tuck is necessary to treat the muffin top area. This extended tummy tuck procedure involves flank and back skin and adipose tissue excision as well as liposuction surgery. If liposuction alone is done the patient may still end up with the muffin top and require further surgery to improve the waistline in the future.

I hope this helps.



Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 reviews

Forgotten flanks?

It may be that your surgeon tried to remove the flank lipodystrophy from your tummy tuck incision and maybe it needs to be redone with you in a prone position.

Robert Brueck, MD
Fort Myers Plastic Surgeon
4.9 out of 5 stars 62 reviews

Flank liposuction

It may be a bit early for you to appreciate the finla results of your flanks.  Swelling after liposuction can take months to resolve.  I would like to think that your surgeon is honest and did what he said that he did.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Big dilemma if you don't believe your surgeon.

What you describe sounds curious.  I am not sure how the flanks can be suctioned with a "curved" canula, but there maybe a technique that allows access.  I would get a copy of the operative note.  If the procedure were done, it would be dictated as such.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

Lipo of flanks during abdominoplasty (tummy tuck) called into question

I understand the difficulty of this situation as essentially you are calling the surgeon's integrity and honesty into question and it is coming down to a matter of he said/she said. You could ask for a copy of the operative report to see the documented amount removed. I doubt this would be fabricated. However, it may jeopardize your relationship with the physician. The other approach is to ask for more lipo at a later date and simply observe their response.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

Flank lipo with a tummy tuck

I presume as a nurse and with a surgeon husband that you chose an excellent plastic surgeon to do your surgery.  All you can do is trust him that he did what he said he did, since the liposuction is typically done through the TT scar so there are no scars from it.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Flank liposuction "forgotten" during tummy tuck surgery?

While this is possible, the fact that you are even considering this scenario is a concern that your patient-surgeon relationship is "on the rocks." You can ask for a copy of your medical records, but be aware that this signals to your doctor you may be questioning his/her veracity or considering legal action! So unless you have solid reason to disbelieve what you have been told, let's examine reasons why you "feel" this may have been inadvertently skipped, even though it wasn't.

Tummy tuck surgery is significantly more uncomfortable and attention-getting than liposuction of the flanks (perhaps what I call the hip rolls, just lateral to the abdominoplasty incision) which can easily be done through the open tummy tuck incision. Swelling tends to go towards this area when you are supine, and to your legs when you are upright, so not seeing results at 5 weeks is not surprising and even probable despite very nice sculpting in these areas. You should see results at 4-6 months (if your weight remains stable).

Lack of pain in these areas is relative to the abdominal pain, and may well be accurate. I have my patients tell me all the time that when I do a tummy tuck, the liposuction areas "don't hurt at all" or their breast surgery "hardly bothers them!"

Please give your surgeon the benefit of the doubt, and if your before and 6-month post-op photos (assuming your weight is stable) don't show the desired changes, he or she would likely be happy to address your concerns (especially since you are a nurse and a fellow surgeon's wife)!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews


Without photos it is difficult to assess, but it's likely that it was done; however, using the abdomen may not be the best approach for the flanks.Still, additional time is required for the swelling to subside.

Shahin Javaheri, MD
San Francisco Plastic Surgeon
4.4 out of 5 stars 6 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.