Does liposuction of fat from the sides interfere with blood flow to the lower abdomen? (photos)

Question

I consulted with two surgeons. The first wanted to do two operations, one for tuck and the other for liposuction of sides His said risk of skin death if one operation. His charge for both was $8,000. The second Dr. said one operation for both, operation risks outweighed skin death, and her charge was $8,000. I am headed for a third opinion. I'm early 40s, 2 pregnancies, competitive figure skater on ice about 5 hours a week, no health issues but high cholesterol which lower using statin.

Jose Perez-Gurri, MD, FACS · Answer

Hi. I frequently perform a tummy tuck with lipo of the hops and flanks. As pointed out previously, the limit to how much fat can be removed with a tummy tuck is limited to 1000 cc of what is called supernatant fat. It appears, as Dr Blinski pointed out, that you would not have more than 1000 CCs removed. Therefore it is my opinion that you could have both procedures done at the same time.It looks like you still have not gotten to a point in all of your consults where you have felt secure in the consulting surgeon's opinion. I would encourage you to keep looking and education yourself.I encourage you to look at many, many photographs. You need to determine if there is consistency to the work. Are the results of that particular surgeon reproduced more often than not? Your surgeon should be certified by the American Board of Plastic Surgery and have countless years of experience. I encourage you to look at the reference link below where the tummy tuck is explained step by step in the actual surgery.I am certified by the American Board of Plastic Surgery and have been performing tummy tucks in the Miami area for the past 29 years. I encourage you to look up the surgeon you eventually select and make sure they have years of experience in performing tummy tucks and liposuctions. Furthermore request to see before and after photos of previous patients by that doctor....not a clinic or surgery center. Do your homework......research and verify the doctor's credentials. Have they had problems with the Board of Medicine, disciplinary or otherwise. Any law suits? How about the center, clinic or facility? Are they accredited by a national organizationor do they just have State approval. Understand that at the current time, there are three nationally recognized organizations responsible for the highest levels of patient safety, AAAASF, AAACH and JCHO. You owe it to yourself to position yourself for the best possible results but under the most stringent safety regulations, If you have kids, even more so.How about anesthesia? Will you have a medical doctor certified by the American Board of Anesthesiology or a certified nurse anesthetist (CRNA)? Understand that there is no substitute for research. Cosmetic surgery, no matter how simple it may be to the patients, are invasive procedures and as such carry certain risks and complications. Miami is filled with mom and pop cosmetic surgery clinics offering bargain basement prices. Buyer beware. Now that you are a mom, every decision that you make whether directly or indirectly affects your kids. Research, research and then research some more.In our office we use TouchMD which is a web based program in which patients have the ability to load their picture unto the program. I then evaluate them and can actually draw on the picture to show a potential patient where the incisions would be located and how the procedure is to be realized. It's all done to comply with HIPPA which is the federal law that protects the patient's medical information. Look them up. I would encourage you to contact our office. Submit your photos and I'll work on them and give you an opinion to what is best in your case. I hope this information has been beneficial.good luck, Dr PG

Thomas Trevisani, MD · Answer

You appear to be a good candidate for abdominoplasty with flank liposuction. I perform these combination procedures all the time- provided patient is a candidate.

Robert Brueck, MD · Answer

I do not think you need to have them done in  two separate surgeries.Especially if you are not a smioker.I have done both in one session.

Michael J. Yoo, MD · Answer

Barring any other medical or surgical hx you may not have shared, based on your photos and healthy lifestyle, concommitant liposuction of the flanks and a TT should not pose a problem to wound healing.  Lipo of the abdomen and a TT at the same surgery definitely does pose an increased risk.  Best wishes.

Darryl J. Blinski, MD · Answer

The reason for your posting was not because of the blood flow issue in my opinion. Butter of the office surgery rules restricting the lipo removal of only 1 liter in combination with a full TT. I think the #1 surgeon feels you need more than 1 liter of fat removed. While the second is ok with just the 1 liter. Lets see what #3 PSs says. In my over the internet opinion I think 1 liter with a TT is just fine for you.

Megan Jack, MD · Answer

Great question and I am happy to hear that you are thinking about this issue as you choose a surgeon.  I generally have no issue with doing liposuction on the back and/or flanks during the same operation as a tummy tuck because the blood supply should not be affected in most cases.  I tend NOT to do liposuction on the abdomen at the same time because of the risk of injuring the blood supply (even if this complication is unlikely, I prefer to minimize risk for my patients).  Of course, a consultation is really necessary to give true recommendations but based on the photos you provided my guess would be that you are a reasonable candidate for 1 surgery - liposuction to posterior trunk/flanks & tummy tuck at the same time.  Please make sure that you are consulting with board certified/eligible plastic surgeons!  Good luck!

Mats Hagstrom, MD (license on probation) · Answer

It is well known that the blood supply of the skin on the lower abdomen is drastically changed during an abdominoplasty.Liposuction can also alter blood supply.The combination of the two procedures can potentially increase complications, such as skin creases.There's no set right or wrong answer for how to proceed with this surgery.It's a clinical decision that each surgeon makes.Many surgeons will perform limited liposuction in conjunction with an abdominoplasty.I personally look at a multitude of factors including the overall health of the patient, obesity, potential history of cigarette smoking, etc.I also rely on assessments during the procedure itself to measure the blood supply of the skin.Based on this, I can proceed with liposuction to a level that is appropriate for each patient.Splitting the procedure into two operations has certain advantages and, obviously, disadvantages.If a patient will have an overall better outcome from aggressive liposuction, then it is often better to split the procedure into two operations.If limited liposuction is sufficient to get an ideal outcome, then the procedure can often be done in one operation.I would strongly suggest to avoid finding the lowest price but, rather, go with the surgeon you feel can deliver the best care.Best of luck,Mats Hagstrom, M.D.

Donald Nunn, MD (retired) · Answer

Generally liposuction of the hips and flanks can safely be done with abdominoplasty.  Liposuction of the anterior abdomen must be done cautiously to prevent compromise of the blood supply to the tissue.  Donald R. Nunn MD  Atlanta Plastic Surgeon

Does liposuction of fat from the sides interfere with blood flow to the lower abdomen? (photos)

Answers (8)

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