Is it possible to achieve good results from a tummy tuck without the use of any liposuction? (Photos)

Hello, and thank you for your question regarding whether it's possible to achieve good results from a tummy tuck without the use of liposuction. Thank you for your history and your pictures. Most experienced, board-certified plastic surgeons would agree you need a tummy tuck or abdominoplasty. During a tummy tuck, excess skin and fat are removed. Additionally, the pubic region is reduced and reconstructed. The belly button is also repositioned on a new area of skin. Usually, rectus abdominis muscle plication is also performed. Most experienced, board-certified plastic surgeons agree that all you need is a good tummy tuck or abdominoplasty. In your case, liposuction is not necessarily needed. Therefore, you will get excellent results with an abdominoplasty alone. There is a saying in plastic surgery, "Why suck when you can cut." That means when performing a tummy tuck, and you are looking at the fat, why use liposuction when you can use a scalpel? I hope this helps to answer your question regarding whether it's possible to achieve good results from a tummy tuck without the use of liposuction. Good luck! Sincerely, Dr. Katzen, MD, MBA (Plastic Cosmetic and Reconstructive Surgeon, President of the American Society of Bariatric Plastic Surgeons, Certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Thanks for your question. There are certainly a lot of ways you could proceed. I think circumferential (ie 360) liposuction will improve your overall contours more than just a tummy tuck. I tend to do liposuction with all tummy tucks - we do spare the central abdomen to avoid compromising blood supply but otherwise you’re more prone to boxier outcomes.
This can be done drainless as well.
Ultimately go with who you felt most confident with and liked their before and afters the most. And make sure their board certified plastic surgeons. Thanks!

It is very common for surgeons to give different recommendations in this situation, because the decision to add liposuction depends on several factors: the actual amount of fat in the flanks, the quality of your skin, the contour you want to achieve, and the surgeon’s philosophy on safety and combining procedures.
If there is very little fat, excision during the tummy tuck alone may give a good result without lipo. If there is more fullness in the love handles or waist, liposuction can help refine the contour. Some surgeons prefer to combine procedures for maximum effect, while others stage them to reduce operating time and risks. Both approaches are valid.
Neither opinion you received is “wrong.” It comes down to whether your priority is to have fewer procedures and combine your arm lift, or to aim for the most aggressive body contouring with lipo included. The key is choosing the surgeon whose plan, safety approach, and aesthetic style align best with your goals.
I have also shared a detailed video where I explain how surgeons decide whether to add liposuction to a tummy tuck, with examples of results with and without it.
— Güray Yesiladali, MD

Congratulations on your impressive weight loss! Liposuction does not have to be added to a tummy tuck, though it's very common to do so. It gives your surgeon the opportunity to sculpt and optimize the results from your tummy tuck (and all of your hard work from losing the weight). If you are against liposuction you can always elect to have it done at a later date if you choose, but combining it with the tummy tuck is more convenient.

Tummy tuck removes excess skin and tightens the area. Muscle repair also occurs during the surgery which enhances the results. In some cases, without liposuction patients see significant improvements. However, the best results are achieved with the combination with liposuction.

A tummy tuck cuts out skin and fat. Where the incision ends is usually a dog ear, which is extra fullness. Most surgeons use liposuction at the dog ear region to decrease them. Liposuction may be necessary in your case. Also, you may have skin extending circumferentially, however I cannot tell because the underwear is covering posteriorly. You may benefit more from a circumferential body lift without liposuction than a tummy tuck with liposuction.

Best Wishes,

Gary Horndeski, M.D.

Dear Peaceful538618,

yes, it is possible to get tummy tuck without liposuction. Based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. I would suggest you to consult a board-certified plastic surgeon because only after a thorough examination you will get more information and recommendations.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Abdominal contouring after massive weight loss is usually challenging. We usually recommend patients to undergo 360 abdominoplasty (circumferential abdominoplasty/ lower body lift) with or without liposuction. In your case I strongly recommend to have 360 abdominoplasty to have a better contour, liposuction of the back and also love handles should be added, not necessary

If you are looking for the best result, than there is no way liposuction would not be a part of the surgical plan. You have substantial fat stores in your hip and flank (waist) area that needs to be addressed so that your torso and buttocks has the best shape. Liposculpting your abdominal area will also enhance the natural contours of a lean abdomen by creating vertically oriented troughs mimicking your abdominal wall.

To give the best answer, I course would have to do a thorough physical exam. Looking at your photographs, it seems you would definitely benefit from liposuction, perhaps of a few different areas. It is often desirable, in a case like yours, to do liposuction of the abdominal flaps and flanks and lower back. It is often safe to do all of this at the same time. Your health and other factors, including your expectations, must be taken into account. Recommendations from other patients and pre-and postoperative photos are important to take into account to choose a plastic surgeon.