Safe for upper abdomen, flank, and mons lipo with Tummy Tuck - advice? (photos)

Question

I’m in the process of getting consultations for abdominoplasty. One surgeon recommended Lipo to abdomen (including upper), flanks and mons. Is this combination safe with TT? I’ve been reading about concerns re: compromised vascularization/necrosis. Would greatly appreciate your clinical judgment and/or feedback!

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding what to do with your abdomen and whether liposuction could compromise the blood supply to the abdominal skin during a tummy tuck or abdominoplasty. During a tummy tuck the intra-abdominal wall is undermined and the blood supply to the skin is transected. The abdominal skin then relies on blood supply from the love handle region. To be perfectly safe and to minimize any vascular compromise to the abdominal flap, liposuction should not be done in the love handle region. Liposuction can safely be performed in the mons or pubic region during a tummy tuck and should not affect vascularity. With that said, plastic surgeons still perform liposuction in the love handle region during a tummy tuck. Even though this is riskier for the abdominal skin flap, if your plastic surgeon is not too aggressive during the liposuction of the love handles, these combined procedures can be performed. In consideration of your case and if you have a smoking history, I would suggest you could undergo a tummy tuck and conservative love handle liposuction at the same time. If you’re overly concerned about abdominal skin necrosis with combined liposuction and an abdominoplasty, don’t have a liposuction. Thank you for your question. I hope this helps answer your concerns regarding a tummy tuck and liposuction of love handles.

Finny George, MD · Answer

Hi, thank you for sharing your question. I don’t think you need a tummy tuck. You will have an amazing result with 360 Liposuction without any resultant loose skin. You are correct in saying that many patients, but not all, can develop terrible skin necrosis when combining abdominal wall liposuction with tummy tuck.I hope this helps.

Jason Emer, MD · Answer

You need a formal evaluation by an expert in body shaping and contouring to determine what is best. The best in body contouring not only removes fat with energy devices like VASER ultrasound but also internally heats the skin with radiofrequency devices such as Renuvion (J-Plasma), InMode BodyTite, and ThermiRF to heat the undersurface of the skin and tighten it at the same time as fat removal. These combinations are called 4D HI-DEF VASER Liposuction and can only be done by a well-trained body contouring specialist. At the same time, fat should be harvested and purified, with PRP and stem cells added, and then injected into muscles, indentations and cellulite to get body shaping and contouring. For a Brazilian butt lift (BBL), we inject the fat into the buttock for contouring and lifting, but fat can also be used in areas such as the chest/breast, arms/shoulders, calves and face. Cellulite should also be treated with a combination of QWO or Cellfina, subcision, and/or fillers such as Bellafill, Renuva synthetic fat, or Sculptra. If skin is very loose before surgery, then it will need to be removed: tummy tuck/abdominoplasty for lower abdominal skin; breast lift for excess breast skin; and/or a brachioplasty for loose arm skin.

Overall, you need a full assessment, but simple liposuction alone will not tighten skin and needs a combination of various methods -- fat removal, skin tightening, defining, fat grafting, skin removal -- to get the best in body contouring and body sculpting. See an expert. Best, Dr. Emer.

Overall, you need a full assessment, but simple liposuction alone will not tighten skin and needs a combination of various methods -- fat removal, skin tightening, defining, fat grafting, skin removal -- to get the best in body contouring and body sculpting. See an expert. Best, Dr. Emer.

Daniel Barrett, MD · Answer

Dear kellibelli,
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

Darryl J. Blinski, MD · Answer

Avoid any lipo over elevated TT skin flap. Lipo on flanks . mons is ok though. Best to request more consultations either in person or virtually.

Arian Mowlavi, MD, FACS (license on probation) · Answer

You would likely benefit from a modified abdominal tummy tuck coupled with advanced technology of ultrasound assisted VASER liposuction. Liposuction of your different treatment areas can be safely combined with a Tummy Tuck granted it is performed by a skilled surgeon. As an official trainer of VASER liposuction, I perform full body liposuction cases every week.

The tummy tuck procedure would comprehensively remove excess skin and fat in the abdominal region. The abdominal muscle would also be 'tightened' to create the appearance of a flatter stomach.  A Skype or FaceTime consultation with a tummy tuck specialist will help you get an accurate recommendation and pricing.

Respectfully, 
Arian Mowlavi MD, FACS
Realself 100 Hall of Fame Inductee

Gokhan Temiz, MD - Account Suspended · Answer

Hello and thanks for your questions. Each medical procedures has some risks involved. My main goal in any procedures is performing the best and safest procedure to my patients. Liposuction is commonly combined together with the tummy tuck operation in order to improve the result of the surgery. There are different factors that have to pay attention while deciding the combination of the treatment. These factors are; patient's age, weight, health, disease history, smoking history and etc. Before any operations, these factors has to be double-checked during the regular pre-operation process and decide to the combination according to the result of the consultations. According to your pictures you are a perfect candidate for the tummy tuck and liposuction operation. If your medical background is okay, you can go ahead with the procedure. I strongly advise you to have a consultation and procedure with board certified surgeon in a all around hospital.

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