I plan on having a tummy tuck in a few months after I get to my weight goal and I would also like to have liposuction on my sides and back. My doctor told me that he couldnt do the back and the only way was to cut me all the way around from the front to the back. Is this true? why can't he just do liposuction on my back & sides?
Tummy Tuck with Liposuction on my Back?
Doctor Answers 7
Tummy Tuck and Liposuction
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.
Tummy tuck can be done together with liposuction of sides and back.
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.
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Let's sort this out
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.
The excisional technique is probably better than back liposuction
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.
Tummy tuck and liposuction of the back
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 be done with Liposuction of the back
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
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.