Will More Lipo Make my Stomach Worse?

I had a mini tt one year ago and my upper stomach is still loose. I went to see my doc a week ago and let him know my concern, he told me he would do more lipo but it might make it worse. I am not at all fat but would like to wear pants with out my fat roll hanging over the top. I really want to get more lipo but hope it would not be a big mistake!!!

Doctor Answers 8

Upper Tummy Tuck

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Not infrequently I see patients in whom there is as much skin laxity in the upper abdomen as there is in the lower abdomen. In fact, some patients after pregnancy will have fairly 'toned' lower abdominal skin, but very lax and redundant upper abdominal skin. In these situations, the removal of skin in a vertically downward direction ( a conventional tummy tuck) is not adequate to correct the upper abdominal skin laxity. Such patients are often very good candidates for what I refer to as a 'reverse upper' abdominoplasty.

This surgical technique involves removing excess abdominal skin vertically upwards using incisions hidden in the inframammary folds underneath the breasts. In general, this operation is best reserved for patients with fairly full or at least slightly droopy breasts, which serve to nicely conceal the inframammary folds. An important part of this procedure is the placement of permanent lifting sutures that elevate the lower skin edge, following removal of excess skin, to the upper skin edge in the inframammary fold. These permanent sutures ensure that the resulting surgical scar remains hidden within the inframammary fold.

A great advantage of this procedure is that the patient's original belly button is preserved, and thus there are absolutely no surgical scars that are visible when wearing a two-piece swimsuit or typical underwear (bra and panties). Additionally, because this procedure generally requires less skin undermining and thus less interruption of the normal blood supply of abdominal skin, more thorough liposuction of the waist and back can be performed at the same time.

Many patients having this surgery, therefore, undergo a reverse upper abdominoplasty combined with a lower 'mini' abdominoplasty, tightening of the entire length of the rectus abdominis muscles, and liposuction of the circumferential trunk - and keep the belly button with which they were born. I usually refer to this operation as 'reverse upper / modified lower abdominoplasty'.

Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Loose skin on abdomen

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If you have loose skin, you are better off having some sort of excision procedure.  Most likely a full tummy tuck is what you will need.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

The Solution to Upper Tummy Skin Looseness is a FULL Tummy Tuck NOT a Mini Tummy Tuck

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Regarding :"had a mini tt one year ago and my upper stomach is still loose" - I am afraid you made one mistake and are about to make another
- The Solution to Upper Tummy Skin Looseness is a FULL Tummy Tuck NOT a Mini Tummy Tuck - A mini Tummy Tuck will ONLY  only remove loose skin below the belly button not above it.

- Liposuction will ONLY remove fat - it will rarely really tighten skin. "I am not at all fat but would like to wear pants with out my fat roll hanging over the top". If you the roll you are referring to is a loose skin roll and you do not have fat deposits in your upper tummy there is no point in having liposuction there.

I would encourage you to see another Plastic surgeon for a second opinion before having anything else.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Liposuction is a great adjunct to a tummy tuck

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Hello - It sounds like you might benefit from more liposuction, but it's difficult to tell without actually seeing you.  Also, after a tummy tuck some people have excess skin in the upper part of the abdomen.  This is because a tummy tuck only removes the lower excess skin from the abdomen.  If this is true, a "reverse tummy tuck" can be done to eliminate this excess upper abdominal skin.  However, this involves an incision underneath the breasts, but the results can be superb.  In this case, you may want to elicit the opinion of several other plastic surgeons before getting anymore surgery.

Upper abdominal looseness and a mini tuck

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Upper abdominal looseness is not treated with a mini tummy tuck. 

If the upper abdominal skin is loose already, more liposuction will likely make it looser.

It may be best if the upper abdomen bothers you enough to convert your mini tummy tuck to a full tummy tuck.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 194 reviews

Options for upper abdominal skin laxity after mini tummy tuck

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Without pictures or more information, it is hard to give specific advice but a couple of things come to mind: first, liposuction will not tighten skin, so that is why your plastic surgeon said it could be worse after lipo. Second, as the other posts have pointed out, it sounds like the full tummy tuck may have been the best choice initially, but there is no going back now; doing a full tummy tuck after a mini doesn't usually work.

There is the option of a reverse tummy tuck, in which the incisions are made under the breasts so the skin can be pulled up instead of down as with the standard version. That may be your best choice.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

Only full tummy tuck will correct upper looseness.

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1)  People do mini tummy tuck because it sounds less scary, and this is completely understandable.  But the sad truth is that very few women are helped this way.

2)  From your description, you need a full tummy tuck, which is not as bad as it sounds, and we keep getting better at it.

3)  Liposuction will not help you.  Sorry to tell you what you did not really want to hear!

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Why opt for a mini tummy tuck with upper abdominal skin laxity?

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Why did you decide to have a 'mini' tummy tuck when one your pre-operative issues was upper abdominal laxity? For patients with both upper and lower abdominal laxity, a 'full' tummy tuck is the only operation that is going to treat the entire problem. You should consider a revision of your mini TT to a full tummy tuck.

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.