Liposuction with Skin Excision?

I'm getting Liposuction on my abdominal area. After I had two children, I have a bit of wrinkles on my skin. I don't have loose skin hanging when I'm standing but when I bending over it sort of hangs. Do I need skin excision or should I only get Lipo first then see if I need the skin excision procedure after?

Doctor Answers 2

A tummy tuck is the way to go

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Most women have significant changes in their abdominal wall as the result of child bearing. Like you, many of these women are seeking ways to correct these changes. Usually we see loose or excess skin, muscle separation, and some increase in the layer of fat beneath the skin. Liposuction will only address the fat content of the abdominal wall. And, unfortunately, it will make loose skin even looser. So this is probably not going to give you the results you want.

Truthfully, there is no way to tighten loose skin short of surgically removing it. There have been many things that have been tried, including laser technologies, but none of these have made a significant difference. So, to treat your tummy, you need to have this skin removed by an abdominoplasty, also known as a tummy tuck.

In the past most tummy tucks have not done much to decrease the fat layer. However, many surgeons like myself are employing a technique known as a lipoabdominoplasty, which allows skin removal with significant fat reduction as well. This technique was developed by our colleagues in Brazil (and France) and is now being done by many plastic surgeons in the this county. About three years ago I have adopted this technique for almost all of my abdominplasties. And, I think the results are much better than with traditional abdominplasty.

The traditional abdominoplasty is excellent at skin removal, and repair of the rectus abdominis muscles (the sit up muscles) which become separated during pregancies. However, little or no liposuction was peformed because this could significantly interfere with the healing of the skin. However, the lipoabdominplasty is done is such a way that a significant amount of fat can be removed with liposuction, and not affect the healing process.

So, in your case, if you just have liposuciton alone it’s a pretty good bet that this skin of your abdomen will be looser that it is already. Your best result in terms of improving the contour of your abdomen will be with a lipoabdominplasty.

Liposuction and Skin Excision

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Following pregnancy, weight fluctuations or the inevitable aging process, the abdominal skin can go through a cycle of stretching, relaxing, stretching, relaxing, etc... Determining the amount of skin elasticity (think of a rubber band pulled and bouncing back. Sometimes, if the rubber band has been used many times it loses its ability to bounce back) is crucial in choosing the appropriate procedure.

Your surgeon will assess your abdominal area and determine whether you simply need excess fat removed or if you would need loose skin or a bulging muscle addressed as well. Liposuction alone can address the excess fat, however, if your skin has lost its ability to 'spring back' then you may be left with loose, hanging skin. This can be addressed by a tummy tuck procedure which will also tighten the stomach muscles and can be complemented by liposuction as well.

When you bend over, the skin will often fold on itself which is not necessarily an indication for removal of this 'apparent' skin excess. Trust your surgeon's judgment and remember that when you bend over, skin will fold whether its loose or tight.

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.