37, 2 C-sections - Do I need Liposuction or Tummy Tuck? (Photos)

Based on what you described and what I can see in your photos, a tummy tuck (abdominoplasty) would likely give you the most complete and transformative result.
After pregnancy—especially after 2 C-sections—it’s very common to experience abdominal wall laxity or rectus diastasis, which means the abdominal muscles and the connective tissue between them have stretched and separated. I see that in the picture from the side leaning forward slightly, there is some protrusion along the entire length of the abdomen. Even with consistent workouts and a strong fitness routine, exercise alone usually can’t repair this.
Here’s how each option compares for your situation:
• Liposuction:Great for removing stubborn fat, but it won’t tighten weakened abdominal muscles or remove loose skin. If muscle separation is present, liposuction alone may leave the area looking flatter in some angles but still protruding from the side.
• Tummy Tuck:Addresses all of the key concerns you mentioned:Repairs and tightens the abdominal muscles for a flatter, stronger coreRemoves excess skin and stretch-related laxityCan dramatically improve the side/profile view→ Often the most effective choice for women who have had children and want a pre-pregnancy-like abdominal contour.
If your goal is a naturally flat, toned abdomen similar to your pre-pregnancy shape, a tummy tuck would likely give you the best outcome.

Dear roseox,

based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. Flanks liposuction would give you a better shape. I would suggest you to consult a board-certified plastic surgeon because only after a thorough examination you will get more information and recommendations.


Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thank you for your question. Liposuction alone won’t resolve the excess skin caused by pregnancy and scar tethering. You’ll achieve a smoother, flatter appearance with a tummy tuck combined with targeted liposuction for waist definition and rectus plication if a true diastasis is present. Schedule an in-person examination with a board-certified surgeon to assess skin distribution, check for diastasis, and determine whether a full or mini abdominoplasty with adjunct lipo best aligns with your goals and activity level.

Liposuction only removes fat and does not address loose skin. You have both. For the best result, you need a full tummy tuck and liposuction of the flanks. If you only perform liposuction, you will have excess skin that will hang over the waistline.

Concerns about the appearance of the abdomen are very common among patients consulting with a plastic surgeon. Just like every patient is different…so too is every abdomen. Different problems require different solutions. Your board certified plastic surgeon is uniquely trained to identify the problems as well as the appropriate solution.

These areas are commonly addressed via liposuction or abdominoplasty (“tummy – tuck”). Which procedure is best is dependent upon the source of the problem. Excess fat deposits underneath the skin can be addressed via liposuction. However, commonly patients concerns are centered around issues of excess skin as well as fat. A third factor, which is often overlooked by most patients is abdominal wall muscle laxity (typically seen in post partum mommies). Despite the commonly held misconception, neither liposuction nor tummy tuck is intended as a weight loss tool nor is it a solution for stretch marks on the stomach.

The tummy tuck, also known as abdominoplasty is a surgical procedure designed to eliminate excess skin and fat and tighten the muscles in the abdominal wall to create a smoother and slimmer contour. The tummy tuck is designed to target areas of the abdomen that have not responded to diet and exercise, making it particularly popular among people that have a lot of loose or sagging skin around the abdominal area due to significant weight loss, as well as women with excess skin and stretched abdominal muscles following pregnancy and childbirth. Candidates for tummy tuck should be already at or near their ideal weight for optimal results. It is recommended to women that are planning on becoming pregnant to postpone the procedure until they are finished having children.

The procedure will typically take anywhere from two to three hours to complete under general anesthesia. An incision is made between the hip bones at the bikini line (easily camouflaged by most undergarments). There is typically an incision around the navel to elevate it to a higher position depending upon the amount of skin that needs to be excised. In many cases, liposuction may be performed as an adjunct at the same time to refine the results.

During the recovery period, the patient will need to wear a special support garment to help the abdominal area recover from the surgery. A small drain may also be placed in the area to remove excess fluid and to alleviate swelling. In most cases, patients are able to recover from the surgery within 4 weeks. In fact, many patients are able to return to work and other normal activities within two to four weeks, though strenuous activities and exercise will need to be postponed for four to six weeks.

To determine if you are a candidate for abdominoplasty or other body contouring procedures, consult with a board certified plastic surgeon (ABPS).

From your photographs, it certainly seems like you are an excellent candidate for a tummy tuck. You have extra skin of the lower abdomen that would not retract with just liposuction. It would be left more loose and floppy. It seems you also may have a stretched muscle, maybe from having a baby, even though you work out often. This muscle can be repositioned and even work better when tightened with sutures with a tummy tuck. Often liposuction would be used to sculpt your waist.

After two C-sections, it’s very common to have a small area of lax skin or resistant fat around the lower abdomen that no amount of training can fix. The good news is, there is a beautiful solution, it just depends on what your skin is doing beneath the surface.
If your skin is still firm and elastic, 360° liposuction or radiofrequency-assisted lipo can sculpt the waist and smooth the lower abdomen beautifully, giving you a defined, athletic silhouette that matches the work you put in at the gym. It’s ideal when the concern is mainly stubborn fat rather than stretched skin.
However, if you notice loose skin or that gentle “fold” from your C-section scar that never seems to tighten, a mini or full tummy tuck may give you a more complete, lasting transformation. It not only removes the extra tissue but also refines the waistline and restores the flatness you remember, often combined with subtle lipo for sculpting.
At our clinic, we design each plan around your body, your lifestyle, and your goals, whether that means precision liposculpting or a tailored tummy tuck with an elegant, natural finish. The goal is always the same: to give you back that smooth, confident shape you’ve worked so hard for, effortlessly fit, feminine, and completely you.
Dr. Sibel Atalay, MDBoard-Certified Plastic Surgeon & Destination Doctor

It looks like you have loose skin above and below your belly button, which means a full tummy tuck would be more suitable than liposuction.

Liposuction with skin removal and umbilical transposition will take care the fluff and address the skin laxity. The question is your abdominal muscles. Do you have significant diastasis? An exam would help, but it can be difficult to assess the amount of diastasis and how that will affect your expectations. Having said that, I have been impressed at how liposuction can flatten a tummy with much less risk and recovery and meet the patient's expectations. See attached case of a liposuction patient that had liposuction with skin removal and umbilical transposition. A thoughtful exam and discussion with an experienced body cosmetic plastic surgeon will lead to a good decision. I hope this helps.

Thank you for your question and congratulations on your healthy habits!
By looking at your photos, I’d recommend a tummy tuck. You have some skin laxity that would benefit from tightening, and liposuction alone could leave you with more loose skin and a less refined result.
In my practice, I usually combine the tummy tuck with gentle lipodefinition to enhance your natural contours and create a smooth, balanced result that still looks very natural.