Do I need aggressive Liposuction, a Tummy Tuck or both? (photos)

I'm getting quotes of different surgeons and one of them told me I don't need TT (only 1 of 5). I just don't want to look awful after paying for a Sx. I want a beautiful shape. Please explain your answer!

Doctor Answers 18

Tummy tuck alone would be safer

Abdominoplasty treats the skin excess and muscle weakness of the abdomen, as well as any fat that is between the belly button and the pubic hairline. Liposuction treats only fat. It can be used to thin out the abdomen, but the skin must be in good condition with no excess, and there should not be muscle weakness. I do not like to combine abdominoplasty with liposuction because of the added risks of fluid collection under the skin, and wound healing problems.

Aggressive liposuction with tummy tuck is dangerous.

A full tummy tuck with aggressive liposuction at the same time will certainly put you at an unacceptably high risk for a potentially fatal pulmonary embolism (PE), venous thromboembolic event (VTE) as well as fluid under the tummy tuck skin (seroma), loss of the skin of the tummy tuck (necrosis) wound failure (dehiscence) and hematoma, among other things. The literature is complete with this information. The science is the science. This is a risky combination. Furthermore, you look like a candidate for a tummy tuck alone. The only way to tell is to feel the skin and determine how much fat vs. skin laxity there is.

Some study outcomes in the Plastic Surgery Literature:

Results: One hundred twenty-five patients underwent abdominoplasty with flank liposuctionand 75 patients underwent abdominoplasty alone. The incidence of seroma formation was 16.0 percent in the abdominoplasty-alone group and 31.2 percent in the abdominoplasty with liposuction group (p < 0.05).

The combination of abdominoplasty and liposuction procedures can still overwhelm the body's ability to resist these shear forces by the fact that more surface area is available to “shear” and thus produce seroma fluid. Not so much as an additive effect but synergistically, such that the seroma fluid from the flanks flows into the adjacent abdominal space and resists the ability of the upper abdominal flap to close over the abdominal wall. Patients must be counseled about their risk for seroma formation and treatments aimed at resolving them including frequent postoperative visits for needle drainage and the rare case requiring operative drainage in the face of a persistent seroma.

San Antonio Plastic Surgeon
4.9 out of 5 stars 135 reviews

Do I need aggressive Liposuction, a Tummy Tuck or both? (photos)

Often times patients like you do very well with a two stage procedure.  Aggressive liposuction first and then, after waiting a while, a tummy tuck performed as a second procedure. Having said that I think you would be surprised at how much better you might look after the first procedure alone.

David A. Caplin, MD
Saint Louis Plastic Surgeon
5.0 out of 5 stars 33 reviews

Tummy Tuck or Lipo

 In my opinion, from the photographs you provided, but tummy tuck would be better. The tummy tuck does liposuction as well as removes the excess skin and tightens the abdominal muscles. Without an in person exam, how much of your abdomen protuberance is due to muscle laxity is hard to tell. You might also want to consider a two-stage procedure where more aggressive liposuction can be done without the tummy tuck and then wait several months and decide should you want to tummy tuck done. This may cost more if the second stage is chosen but gives you the opportunity to see if the liposuction is enough. Find a board-certified plastic surgeon in your region with experience in cosmetic abdominal contouring. 

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 54 reviews

Do I need aggressive Liposuction, a Tummy Tuck or both?

Based upon the posted photos and the MANY other postings you need a FULL TT! But your real issue is gong out f country! What is your life worth? The very higher risks in out of country surgeries must be addressed. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Do I need aggressive Liposuction, a Tummy Tuck or both? (photos)

Thank you for your question and series of photographs. I think you would most benefit from a full tummy tuck and liposuction of your waist, hips and flanks. The tummy tuck will tighten your stomach muscles, helping to achieve a flatter appearance, while removing excess skin and adipose tissue. Liposuction can be used to enhance your tummy tuck results by narrowing your waist and removing isolated areas of diet and exercise resistant fat. Hope that this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 65 reviews

Tummy tuck

Hello and thank you for your question. Based on your photographs, you are a great candidate for an abdominoplasty with liposuction.  Liposuction alone will not help you.  The most important aspect is to find a surgeon you are comfortable with. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 124 reviews


You may do well with liposuction, but a tummy tuck will remove the excess skin. You may also have some internal prominence which is not addressed with surgery. Doing just liposuction first will be able to remove more fat than liposuction with a tummy tuck.

Connie Hiers, MD
San Antonio Plastic Surgeon
4.6 out of 5 stars 13 reviews

Do I need aggressive Liposuction, a Tummy Tuck or both?

Based on your photos I recommend a tummy tuck with liposuction. The tummy tuck will remove excess skin and tighten your abdominal muscles. Consult with a board certified plastic surgeon. 


Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 457 reviews

Tummy Tuck and Liposuction

Thank you for your question. From what i can see, you have excess fat and skin in the abdomen as well as laxity of your abdominal wall. These are best addressed through Tummy Tuck with liposuction to adjacent regions.
Tummy tuck, also know as abdominoplasty, is a procedure to remove excess skin and fat from the lower abdomen and to restore the weakened abdominal wall, giving a firmer and smoother appearance. We nearly always add liposuction to our tummy tucks to sculpt the body 360 degrees to achieve an ideal feminine figure.
Both are very powerful techniques in the right hands, and can have dramatic results if done correctly. You definitely have to choose your surgeon correctly and make sure that he/she has the training and experience to meet your goals with absolute safety. Don’t settle for less than a Board Certified Plastic Surgeon with specialized expertise in these procedures.

Alex Campbell, MD
Colombia Plastic Surgeon
4.8 out of 5 stars 62 reviews

Lateral Tension Abdominoplasty tummy tuck

Thank you for your question and for positing appropriate pictures. You seem to be a good candidate for a tummy tuck and liposuction. A special kind of tummy tuck I perform is called a lateral tension abdominoplasty. The Tummy Tuck will tighten the abdominal muscles creating a flat tummy and the liposuction will contour and give you the shape you desire. You will need to have a consolation with a board certified plastic surgeon for precise recommendations. 

Kevin Tehrani, MD, FACS
New York Plastic Surgeon
4.8 out of 5 stars 95 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.