Abdominal lipo or tummy tuck? (Photo)

After gaining 50 pounds with my first child 4 years ago(I was 95 pounds prior to pregnancy).. I have yet to look this muffin top. Makes me look 5 months pregnant still. Want to achieve a flatter look but not looking for perfection. Would a tummy tuck be my only option? Or can I do lipo?

Doctor Answers 13

Lipo or Tummy Tuck?

Ultimately an in person consultation would be necessary to make specific recommendations. Your photo suggests that you have some thickening of the fat layer and probably also separation of your rectus muscle from pregnancy which results in abdominal distention or muscle wall bulge. Your skin quality looks reasonably good without a lot of skin excess. Liposuction can really only accomplish one thing which is thinning of the fat layer. It your skin quality is good you can anticipate reasonable skin retraction which is important in achieving a good result. We always perform liposuction using Laser Liposuction or SmartLIpo. One of the benefits of this type of liposuction is that produces an extra element of skin tightening that does not occur with other types of liposuction, but it is not a miracle machine.

Tightening your muscle wall will require some type of abdominoplasty or tummy tuck which may be needed to give you a significantly flatter abdomen. A tummy tuck can also remove extra loose skin if that is necessary. Sometimes a combination of both liposuction and muscle wall tightening, so called lipoabdominoplasty is the optimal solution. Again, an in person consultation is needed to decide on best treatment plan for your circumstances.

Abdominal lipo or tummy tuck?

From your photos it looks like you have some muscle separation (rectus diastasis) which is common after childbearing.  While the rectus muscles can be strengthened with core exercise, the position of the muscles cannot be corrected without a tummy tuck.  After a tummy tuck, many ladies feel their core is much stronger and their posture is better. 

I think lipo alone would not get you the result you are hoping for. 

It's important to make sure you are done with childbearing prior to having a tummy tuck.  So if you are of the "one and done" crowd, I'd recommend a tummy tuck. 

Lisa Lynn Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 67 reviews

Tummy Tuck or Abdominal Liposuction

Thanks for adding your photos. The answer to your question really depends upon you goals. Liposuction of your abdomen will bring your girth down and make you look somewhat better in clothing, but it will not give you a flat stomach, nor get rid of the extra “baby” skin. For that, you would need an abdominoplasty or tummy tuck.

Many women are reluctant to have a tummy tuck because they are worried about the recovery but with a rapid recovery technique you should do well and considering your comments would likely give you the results that it sounds like you would like.

I have added a web reference and video for you to learn more about all of this.

I hope that helps.

Best regards.

Brian Windle, MD
Kirkland Plastic Surgeon
4.9 out of 5 stars 56 reviews

Tummy tuck or liposuction

What is best for you depends on your expectations.  If willing to hold your tummy in, liposuction alone should be good enough.  If wanting to be as flat as possible, without holding your tummy in, then a tummy tuck would do better BUT now there are more scars, risks, costs, and a longer recovery time.  And don't forget to have your flanks (aka muffins) suctioned at the same time.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

Liposuction or Tummy Tuck?

Although an in person consultation is imperative to gain the most accurate recommendation, you seem to need a tummy tuck (Abdominoplasty). Liposuction will only address the outer layer of fat and it will not address the significant laxity of your abdominal wall. Although liposuction is used for flanks, the true method by which the flanks can be reshaped is an extension of the tummy tuck towards the back. This will once and for all get rid of the excess skin of the sides. Liposuctio of the flanks will only reshape you but will NOT get rid of the excess skin. It is that excess skin that causes the muffin top. Good luck.

Sepehr Egrari, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 48 reviews

Lipo vs tummy tuck - or both

A lot depends on an in-person exam to evaluate skin tone, whether there is a muscle separation (diastasis), and internal vs external abdominal fat. My guess is that you would do best with a tummy tuck and lipo to the muffin top.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 47 reviews

Abdominoplasty or liposuction

Thanks for your question and in general for most patients who have had children, an abdominoplasty tends to be a better option as it can also address muscle wall laxity and loose skin.  Liposuction only addresses excess fat and relies on your skin to tighten.  The best way to know for sure what options you have is to set up a consultation with a Board-Certified Plastic Surgeon to go over all of your questions and options in detail.  Good question and good luck!

Shahram Salemy, MD, FACS
Seattle Plastic Surgeon
4.9 out of 5 stars 144 reviews

Abdominal lipo or tummy tuck?

There are a variety of surgical procedures or combinations that can produce good results in patients with abdominal laxity, depending on multiple factors including their anatomy and degree of desired improvement: Liposuction, a mini tummy tuck, an umbilical float modified tummy tuck, a full abdominoplasty. Each of the tummy tuck variations can be performed with or without liposuction. They produce different degrees of improvement.

It is generally recommended that you complete having your family before a tummy tuck, since future pregnancies may undo the muscle correction.

Following the advice of anyone who would presume to tell you what to do based on two dimensional photos without taking a full medical history, examining you, feeling and assessing your tissue tone, discussing your desired outcome and fully informing you about the pros and cons of each option would not be in your best interest. Find a plastic surgeon that you are comfortable with and one that you trust and listen to his or her advice. The surgeon should be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS). You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

Abdominal lipo or tummy tuck?

Thank you for your pictures and questions. The question of tummy tuck vs lipo is one that is often asked by patients. I think that for you and for many patients, the answer depends on your goals. If your goal is to just improve your contour and remove some stubborn adipose tissue, then liposuction may be an option for you. If you are young and healthy and have good skin quality, liposuction can give very nice results. It will not, however, tighten the skin or address the laxity in the abdominal wall. If you have weakness in the abdominal wall and stretching of the muscles from pregnancy along with stretched excess skin that needs to be removed, then you may need a tummy tuck. If your goal is to have a completely flat and tight abdomen back like it was before pregnancy, then you may need a tummy tuck. Have a consultation with a local board certified (ABPS) plastic surgeon to have an exam and discuss your exact goals. This will allow you to find out what options would be best for you.

Good luck!

Tummy tuck- definitely

Briefly, if you have excess skin or laxity in your skin and fat, removal of that tissue would be of benefit.If your muscle contour is not what it used to be or it not optimal, a procedure to tighten your “core” may be necessary.This is especially important in the post-pregnancy population as during your pregnancy, your muscles were forced to adapt to a growing baby inside. Most times, those muscles don’t go exactly back to where they were before.Some come back really darn close, but rarely to their exact pre-pregnancy position.If you don’t have the musculature issues addressed, and you only have the skin and subcutaneous tissues removed, your contour will not be optimal and I believe you will be dissatisfied with your results. It’s paramount to fix the foundation (the musculature) before building the house.

The next question to address is what to do with your belly button.Depending on the amount of upper abdominal laxity, you may have your belly button brought through a new place in your skin (belly button stays where it is on your abdominal wall, but by stretching skin downwards, it needs to come out in a new place or it would look tethered and not natural) or you may need to leave it where it is or potentially “float” it down the abdominal wall an inch or two (it actually ends up being lower on your torso than where it started).Decisions about pre-surgery position of your belly button and tradeoffs between potential scar placement vs. keeping your belly button in a naturally-appearing position are used to determine that.

As you can see, there are lots to consider when discussing abdominoplasties.You really need to discuss all of these issues with a board certified plastic surgeon and see pictures of their results. Who cares if someone does “drainless tummy tucks” if their results do not look great.Likewise, tummy tucks that are done overly tight do not look natural and defeat the purpose of having your abdomen rejuvenated in the first place.What good is getting a tummy tuck if you aren’t excited to show it off?Hope this helps!

-JGH

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.