Does It Look Like I Need Liposuction on my Back or Flanks? (photo)

I have gotten two different opinions, one doctor says he will lipo my back, flanks with the tummy tuck (no vertical scar). The other doctor says I do not need lipo and he will just make sure to pull the skin tightly from my waist..he also says I will have a short vertical scar. Your opinions would be greatly appreciated. Thank you.

Doctor Answers 7

Abdominoplasty vs. liposcution vs. exercise and diet

I do not know if I am missing something here but I do  not see a need for any surgery in your posted photos other than suture plication of the muscle in the midline if you have a diastasis. I don't think the difference after surgery (liposuction/abdominoplasty) will be significant enough to warrant the cost, skin scars etc.
I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Los Angeles Plastic Surgeon
5.0 out of 5 stars 1 review

Yes, liposuction coupled with the tummy tuck can do a great job to dial in your contour and help it look natural.

Thank you for the photos. Yes, you would likely enjoy the benefits of modest liposuction to the lower flanks on your back at the same time of your tummy  tuck. 

To be sure, see two or more board-certified plastic surgeons in your area for a full and complete evaluation to make sure you are a good candidate and that it is safe for you to have surgery.

Best wishes and good luck.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 182 reviews

Liposuction vs abdominoplasty vs exercise

Prior to considering any cosmetic body contouring surgery, remember cosmetic surgery is an adjunct to, not a substitution for, a good diet and exercise.  That said, it appears that you may have experienced stretching of the connective tissue between your rectus abdominus muscles, causing the bulging around your belly button.  This bulge can be corrected by tightening the space between the abdominal muscles in an abdominoplasty, but will not be corrected by liposuction alone.  It is possible to also have liposuction at the same time as the abdominoplasty.  In your case a small amount of liposuction over the flanks may be warranted.  Although, one can never guarantee that a small vertical scar would not be necessary in a full abdominoplasty, you may be a candidate for a mini abdominoplasty which could alieviate the need for this scar.

Vincent D. Lepore, MD
San Jose Plastic Surgeon
4.8 out of 5 stars 56 reviews

Liposuction of the flanks with abdominoplasty

It's difficult to tell how much liposuction will be necessary in the flank area from the photos you posted because your arms are elevated, which can change the shape or contour of the waist, especially in the flank region.  Additionally, without examination, I can't say whether it is likely you will need a vertical component to your horizontal abdominoplasty scar.  I usually do flank liposuction in combination with abdominoplasty, because this gives a better definition to the waist that tummy tuck alone cannot do.

Michael Leff, MD (retired)
Bellevue Plastic Surgeon
5.0 out of 5 stars 10 reviews

Tummy tuck and liposuction options

I like to assess the patient in terms of what we are tryng to achieve rather than certain procedures. Both opinions could be correct but you need to understand why.

First there is obviously an issue with the muscle layer under the skin of the abdomen. This is corrected with "plication" of the muscle layer. When this is doe you will have some additional excess skin. So the skin is lifted up and pulled downward. In order to be able to pull the skin downward effectively you need to cut around the belly button and free the skin from its attachments to the belly button. This will create a hole in the skin. If the Dr. made a very low incision initially that hole might not come out with the excess skin that is removed so you would end up with a small vertical scar. If the lower incision was made higher then perhaps the Dr would be able to get the belly button hole out with the skin that is being removed. BUT, now the entire horizontal incision and scar are higher and perhaps even the pubic hair gets pulled up too high. I prefer to make my incisions as pow as possible and accept a small vertical scar vs a high horizontal scar.

Should the flanks be liposuctioned? It all depends on the result you are trying to achieve and the "cost" of achieving those results. From a purely result point of view the results will be better than if you do not liposuction. BUT, the surgery is longer and there will be a slight increase in the complication rate. I tend to add liposuctioning on most of my torso contouring procedures unless I think the results will not be much better than without the liposuction.

John P. Stratis, MD
Harrisburg Plastic Surgeon
4.5 out of 5 stars 34 reviews

Liposuction with Tummy Tuck?

Thanks for your question and inclusion of photos. It makes answering questions about surgery easier.  It is not common to leave a vertical scar with a tummy tuck, even when we keep the main scar very low, but I always warn patients it may be necessary. With the technique where we loosen the skin clear up to and over the ribs we can usually bring enough skin down that the vertical scar can be avoided. However, it is better to keep the main scar low and put up with the small vertical scar than to raise the lower scar. As to the liposuction, from the photos, I doubt I would recommend it. I can't see where it would make enoujgh difference to be worth the cost, but it's hard to be sure without an exam..

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

Liposuction with tummy tuck

Thank you for the photos. Bothy of your doctors are right to a degree. You don't need it, but liposuction of the hips and lower back could improve your asymmetry. You will also end up with a small vertical scar above the pubic area. Looking at your photos, it does not look like you have enough skin laxity to avoid a small vertical scar (physical exam might differ from what the photo shows). Good luck.

George Marosan, MD
Bellevue Plastic Surgeon
4.8 out of 5 stars 38 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.