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