Tummy Tuck with Liposuction on my Back?

Thank you for your question. It is hard to provided with a valid medical opinion without photos.  I would suggest to be treated by board certificated plastic surgeon with experience in this procedure, to get the best desired results.
Kind Regards,Dr. Emmanuel Mallol Cotes.-

Dear beauty01,

Congratulations on your decision to pursue a tummy tuck and your interest in enhancing your body contour further with liposuction on your sides and back. Your journey towards achieving your weight goal is commendable, and planning your surgical procedures to complement this achievement is a significant step.

Your doctor’s advice regarding the limitations of combining a tummy tuck with liposuction on your back raises an important discussion about surgical techniques and the customization of body contouring procedures.

Tummy Tuck vs. Circumferential Body Lift:

A tummy tuck (abdominoplasty) primarily targets the front of the abdomen, removing excess skin and fat and tightening the abdominal muscles. It's an effective procedure for enhancing the abdominal profile, particularly after significant weight loss or pregnancy.

Liposuction is a versatile procedure that can be performed on various parts of the body, including the sides (flanks) and back, to remove stubborn fat deposits. It's not uncommon for liposuction to be combined with a tummy tuck to refine the contours further and achieve a more harmonious overall appearance.

However, your doctor’s mention of extending the incision from the front to the back suggests a more comprehensive approach, often referred to as a circumferential body lift or belt lipectomy. This procedure goes beyond the traditional tummy tuck by removing excess skin and fat from the abdomen, hips, lower back, and buttocks in a single, continuous incision. It's particularly suited for individuals who have experienced significant weight loss and have excess skin around the entire lower torso.

Why Not Just Liposuction?

While liposuction alone can remove fat from the back and sides, it does not address excess skin. If there is significant skin laxity, liposuction without skin removal may result in more pronounced sagging of the skin in these areas. Your surgeon’s recommendation might be based on an assessment of not just fat removal but also achieving the best possible contour with skin tightening.

Moving Forward:

Clarification and Options: It's crucial to have a clear understanding of why your surgeon recommends a specific approach. Don't hesitate to ask for further clarification on why liposuction alone might not be advised for your back and sides in conjunction with a tummy tuck.

Second Opinion: Consulting with another board-certified plastic surgeon can provide additional perspectives. This can help ensure you’re making an informed decision that aligns with your aesthetic goals and the realities of your body’s condition.

Comprehensive Planning: Ultimately, the choice of procedures should reflect a balance between your desired outcome, the feasibility of the surgical techniques, and the recovery process.

Your proactive approach in seeking information and planning for your procedures is key to achieving results that will be satisfying and align with your goals. Open dialogue with your surgeon will ensure that you feel confident and informed about your surgical plan.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic and Aesthetic Surgeon

Hello dear!!
Thanks for the question and provided information as well.
Unfortunately, without pictures, it is very difficult to give you a proper answer. l recommend you to make an appointment with a board certified plastic surgeon to talk about your goals and anything you need to know.
Good luck :)

There are many options for treatment of the back in conjunction with a tummy tuck. Perhaps the surgeon was suggesting a circumferential excision procedure because your lower back is very loose?

Tummy Tuck (Abdominoplasty) CAN and often SHOULD be done with Liposuction of the back and hips.
Even in women who are at or near ideal weight, stubborn fat deposits on the back and hips make the buttock appear flat. As the tummy is flattened and waist is narrowed by the tummy tuck, these fat deposits, IF LEFT UNTREATED, may make the hips appear larger after the tummy tuck procedure is completed.
On the other hand, liposuctioning of the back WILL define the buttock cheeks and the V zone between them as well as narrow and define the hips. It can GREATLY enhance the results of a Tummy Tuck in many women.
IF you have such fat deposits, I cannot explain why your Plastic surgeon refused to do your liposuction and offered you a Lower Body Lift instead. In my opinion, this operation is much more complicated and requires a lengthy recovery. It should be reserved to massive weight loss cases with serious drooping of the thighs and buttock.
Dr. P. Aldea

If your doctor told you the only way to treat your back was to "cut me all the way around," then you likely have a significant amount of extra skin and rolls in the back area. Few plastic surgeons are going to do a circumferential abdominoplasty unless you really need it. I am basing this answer on this assumption.
Combined with a tummy tuck, liposuction is usually safe in the lower back/flanks but not in the upper bra fat area as the blood supply to the tummy tuck will come from here and can be damaged with liposuction. A circumferential procedure as you were offered is a very powerful way of eliminating all of the extra skin, fat, and rolls that many patients have.
I would stay away from Smartlipo for this issue just based on the fact that I do not find (in my practice anyway) that Smartlipo is anywhere nearly as strong as a procedure as the excisional technique you were offered. If you are looking for the strongest result, it will be from the excisional procedure.

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There is no one right answer, as literature varies in what is considered safe. In appropriate candidates, I think it is safe to perform liposuction of the flanks (your "sides") at the same time as a tummy tuck. I would not perform liposuction of your upper back in conjunction with a tummy tuck, as a significant component of the blood supply for the tummy tuck flap follows the direction of the ribs (it travels from your back to the front, traveling downwards.) Liposuction can traumatize these little vessels, and interfere with blood flow to the furthest portion of the flap. This could lead to wound healing problems, or even loss of the skin from your belly button down.

Hi.
1) We often do liposuction of the sides (waist and love handles) and of the back together with a tummy tuck. The only reason to "cut all the way around" (body lift) is if you have a great deal of very loose skin in the back. We see this only in people who have lost a massive amount (like 150 pounds) of weight.
2) Also you don't need to be at your absolutely ideal weight to benefit by these procedures.

If you need a tummy tuck for your abdomen because of post-pregnancy changes and have some redundant fat in the flanks (ie a "muffin top"), it is possible to do some flank liposuction at the same time as the tummy tuck.
If you have more issues in the back than that and if you do not have significant extra skin in the back area, liposuction can be done to the back but it is safer to do it at a second procedure.
The only reason to "cut you all the way around" is if you have substantial extra skin in the back such as can occur with massive weight loss requiring that this skin be removed because it will not shrink with liposuction alone. This is still safer, in my opinion, to deal with at a second operation rather than at the same time as a tummy tuck.