Liposuction and tummy tuck being done in two steps - which procedure should I have done first? (photos)

Question

MLocal board certified plastic surgeon will not do any lipo during my full tt procedure. My concerns include the current extra fat along my sides/flanks, as well as the extra fat and skin on my abdomen that Dr says will be removed during tt surgery. I’ll have to have two separate procedures. My question is should I have the liposuction of my flanks completed before the full tummy tuck procedure? Or should I have the liposuction of my flanks done after the full tummy tuck procedure?

Elisa A. Burgess, MD · Answer

For most of my patients that have a tummy tuck with automatically include liposuction of the flanks. This will really define a nice waist beyond the improvement provided by the abdominal wall or rectus diastasis repair. Make sure to see a board certified plastic surgeon with experience.

Ricardo Vega, MD · Answer

Thank you for your inquiry, in my opionon based on photos if everything is well medical wise you are a candidate for a full tummy tuck with muscle repair combined with liposuction 360 in order to obtain good results, both procedures can be done at once an aviod going under anesthesia twice and also having one recovery. Of course pre op blood work and EKG should be done to make sure you are in conditons for surgery if so they can be done at once without any problem. I suggest seeking expereinced board certified plastic surgeons to discuss further details. Best of luck!

Geuris Cruz Quiroz, MD · Answer

Thank you so much for your question. 
Based on your pictures I can recommend you to have a combination between Liposuction and Tummy tuck in one round, if you prefer to have it separate I can recommend you to have a tummy tuck procedure first and then liposuction. Good luck!

Daniel Barrett, MD · Answer

Dear Aquar78,
I understand your concern. It is best however that you consult with a board certified plastic surgeon to determine whether you can have several aesthetic surgeries in one session, as this would depend on various factors including but not limited to your general health condition, the type of anesthesia that will be used, and the type of surgeries that will be performed among others.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Finny George, MD · Answer

Hi, thank you for sharing your question. You can safely undergo both procedures at the same time but if your surgeon prefers to do two procedures, I would suggest doing the liposuction first.

Yily De Los Santos, MD · Answer

Thank you for your pictures and question. I would recommend combining both procedures in a single surgery. Getting a combination of Liposuction, BBL (fat transfer to buttocks and hips) and Tummy Tuck is actually a very common combination. I suggest losing weight before your surgery, which will lower risks and help you get closer to the best shape possible.

If you're willing to travel, Surgeons in the Dominican Republic have experience and very high standard of excellence when it comes to plastic surgery. I'm positive you can get what you're looking for.

If you're willing to travel, Surgeons in the Dominican Republic have experience and very high standard of excellence when it comes to plastic surgery. I'm positive you can get what you're looking for.

Douglas Taranow, DO, FACOS · Answer

I perform both liposuction of the sides and lower back combined with an abdominoplasty.  Your central abdomen is also quite fatty so you may consider doing liposuction of the upper abdomen with the sides and lower back prior to doing an abdominoplasty one month later.  This two part procedure makes the belly even flatter than the one part procedure of lipo sides and lower back combined with the abdominoplasty

Darryl J. Blinski, MD · Answer

Nice posted photos. Each Plastic surgeon has their own beliefs. In Florida by the office surgery Board of Medicine rules only 1 liter of supernatant fat can be lipo with a TT operation. That allows the flanks and waist to be nicely sculpted with the TT. Fees from $8,000. Best to virtual consult with....

Mats Hagstrom, MD (license on probation) · Answer

There are a lot of variables to take into consideration and plastic surgeons have different opinions about how to approach liposuction with a tummy tuck.
I would point out that while there is variation in outcomes for all plastic surgery procedures Liposuction has more variation of an outcome depending on who does the operation then any other plastic surgery procedure. I unfortunately some plastic surgeons see Liposuction as a highly simplistic procedure that has a very low learning curve.
There is a stunning amount of difference and discrepancy and liposuction results depending on who you choose as your provider
Personally I do not like patients to have liposuction of their abdomen prior to having a tummy tuck
Liposuction creates a diffuse Nettwerk of scar tissue in the subcutaneous fat layer that is permanent.
Scar tissue is rigid and does not have elasticity the way virgin tissues do.
Scar tissue does soften up and mature over about six months from the date of surgery.
In my opinion individuals have had previous abdominal liposuction are limited to how much skin can be successfully removed during a tummy tuck. this is especially true if the tummy tuck is done within six months of having the liposuction. Liposuction done in areas that does not involve tummy tuck tissue is somewhat irrelevant.
This is one reason why I recommend having the tummy tuck done first.
there are other reasons I recommend doing the tummy tuck first.
Of the two procedures it is the one operation that is going to deliver far more improvement compared to the other.
Liposuction can definitely help improve your body contour but it is minor in comparison to what a quality tummy tuck can do.
In planning your tummy tuck there’s also an important decision to be made in regards to how extensive the tummy tuck should be. Individuals who have fullness in skin laxity and a lateral abdomen or hip area may want to consider a slightly extended or fully extended tummy tuck. Doing this can in some ways reduce the indication for liposuction later.
A substantial number of individuals will have some contour issue after a tummy tuck especially at the end of the incision. Fullness at the two lateral ends of the scar called dog ears happen in probably a third of all tummy tuck cases. 
If you have a second procedure scheduled like liposuction then any revision work could be added at that same time.
Doing liposuction correctly on your love handles waist and back requires turning your body either on its side or face down.
This is very difficult to do in combination with a tummy tuck unless the liposuction part is done first before the tummy tuck begins.
Turning patients under general anesthesia is cumbersome and takes time.
It’s very important that this be discussed during your consultation so that you know exactly how you’re going to be treated and the type of results you’re going to get.
For example if a surgeon suggest a tummy tuck and liposuction as a combined procedure then you should always know in advance what position your body is going to be in during surgery when they do the liposuction. You also need to look at lots of before and after pictures to be very clear on what results look like of that combination of surgery on a previous patient.
In the end the most important variable and what you should be focusing on is finding the best providers.
Whether you choose separate providers for the liposuction and tummy tuck or have the same provider do both procedures you need to absolutely confirm that your surgeon or surgeons have mastered the operations you are signing up for.
Of the two procedures delivering consistent quality results seems to be more challenging for Liposuction than doing a tummy tuck despite a tummy tuck in being a more complex procedure.
Too many plastic surgeons believe Liposuction does not require any significant learning curve and these providers continue to deliver unacceptably bad results.
When it comes to Liposuction please be more selective than you think you need to be.
Judge tummy tuck results primarily based on who gets the most natural looking belly buttons and central abdomen‘s. The second variable or indication of a quality tummy tuck is a very lowest that scar that follows an atomic contours naturally and it’s even on both sides leaving the torso looking attractive it from all angles.
From Liposuction look at all before and after pictures and make sure there are no skin contour irregularities in any area treated.
Confirm it with the provider exactly what areas were treated with Liposuction and what areas were not treated. look very carefully at transition zone between treated and untreated areas to make sure they look natural.
Personally I view the torso as a single anatomic unit and generally prefer to do liposuction of the entire tour so when doing Liposuction. By treating the torso as a single anatomic unit there are no transition zones between treated and untreated areas. A tummy tuck will thin the subcutaneous fat layer to some degree on the upper and lower abdomen by pulling the skin tight. this helps to some degree but generally when I do liposuction on the torso of patients who have had a previous tummy tuck I generally still treated the entire torso. A full torso includes upper abdomen, lower abdomen, love handles(all the way down to the top of the hip dip), waist, full back and under arms (armpits )all the way to the side of the breast.
I recommend most patients schedule at least five in person consultations with local board-certified plastic surgeons before choosing a provider. The more consultations you have the better your chance of finding the best provider. there are major differences in outcomes depending on which provider you choose. their results from both procedures are going to be permanent and irreversible.
I cannot emphasize enough the importance of provider selection and having a thorough vetting process and choosing among multiple providers.
Avoid virtual consultations whenever possible.
During each consultation ask each provider to open up their portfolio and show you their entire collection of before and after pictures for the procedures you’re interested in.Bring pictures of your own body to use for reference to make sure providers are only showing you before and after pictures of patients who have similar body characteristics to your own.
There’s no point at looking at results of patients who had completely different candidacies for the procedure.
An experience provider should have no difficulty showing you at least 50 set a before and after pictures of commonly perform procedures like abdominal liposuction or a tummy tuck.
Ask providers to show you examples of excellent results, average results and results that did not turn out as well as they had hoped for. ask them what their revision rate and revision policy is.
Get familiar with what quality before and after pictures should look like looking very carefully and before pictures to make sure they have similar body characteristics to your own. Create a rating system for quality results.
Take careful notes during each consultation especially when reviewing before and after pictures taking notes of the quality and quantity of before and after pictures shown.
If you have any doubts slow down and schedule more consultations.
Being board-certified in plastic surgery with an overall good reputation and years of experience does not mean somebody has mastered either Liposuction or doing a tummy tuck.
There are major variations and outcomes of both of these procedures especially Liposuction .
Be more vigilant and more selective than you think you ever needed to
Pick the right plastic surgeon and everything falls into place.
Good luck,
Mats Hagstrom MD

Liposuction and tummy tuck being done in two steps - which procedure should I have done first? (photos)

Answers (9)

More Liposuction Questions

What is the most effective way to get a a full body makeover? What procedures would I need? (photos)

6 moths post op - Are there procedure options that can help improve contour irregularities? (photo)

Best liposuction for upper legs (inner & outer thighs)? (Photo)

Researching lipo for abdomen & flanks (want smoothest results) - what do you recommend? (Photo)

Am I a good candidate for liposuction after a previous abdominoplasty and pregnancy? (photos)

Can the appearance or cankles be minimized with liposuction? What can I do to achieve more feminine ankles and legs?

WE SEND PRETTY
EMAILS