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.

Hello, thank you for your question regarding the fact the fact that you are 37, years old female with 2 C-sections and whether you need abdominal liposuction or a tummy tuck. Thank you for your history and pictures. Find, let’s analyze your pictures. You have excess lower abdominal skin (cutis pleonasms), loose lower abdominal skin (dermatocholosis), excess lower abdominal fat (lipodystrophy), and weakened rectus abdominis muscle due to your pregnancies and c-sections. Because of these conditions and your age, your abdominal skin will not be predictably affected by liposuction. Liposuction may remove the abdominal fat, but your abdominal skin will not contract well. Also, your rectus abdominis muscle needs to be repaired. Abdominal liposuction does not correct loose rectus muscle. Therefore, most plastic surgeons would agree that you need an abdominoplasty or tummy tuck. Most plastic surgeons offer free virtual or in-office physical consultations.  Therefore, explore what other plastic surgeons have to say. If you have any more questions about a panniculectomy, tummy tuck, abdominoplasty, or abdominal liposuction, contact an experienced plastic surgeon. Since the tummy tuck surgery is a big procedure, please seek an experienced, board-certified plastic surgeon with significant experience in performing panniculectomies and tummy tucks.  Do your research.   If you cannot find an experienced plastic surgeon for a panniculectomy or tummy tuck in your neighborhood, consider traveling out of state.  Sincerely, Dr. Katzen, MD, MBA, FACS, FICS. ( Plastic Surgeon, President of the American Society of Bariatric Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and  member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

Hi This is Dr Özge,
After seeing your photos, I have determined that you have significant skin excess (laxity) below your belly button due to your previous births.
This condition is beyond the capacity of skin tightening methods such as liposuction combined with J Plasma. Considering your current body type and skin quality, you are an ideal candidate for a Full Abdominoplasty (Tummy Tuck).
Our proposed comprehensive body contouring plan involves the following steps:
1. Liposuction of the Entire Waist Area: We will perform liposuction on the entire waist area, including the flanks, to slim the torso and achieve better overall body proportions, complementing the tummy tuck result.
2. Diastasis Recti Repair (Muscle Tightening): We will surgically repair the separation of your abdominal muscles (diastasis recti) caused by pregnancy, effectively creating an internal corset. This step is crucial for flattening the abdomen and restoring the integrity of your core.
3. Full Abdominoplasty: Finally, we will excise the excess, stretched, and lax skin below the naval, tightening the remaining abdominal skin to achieve a smooth and dramatic abdominal contour.
This combined procedure will provide the most effective and long-lasting solution for your post-pregnancy body changes.

Thank you for your inquiry! We would love to sit down with you to discuss your concerns. Liposuctioin removes fullness, leaving the excess skin. A tummy tuck consists of liposuction, repairing the muscle, mons lift and removing the excess skin. Schedule a consultation with a Board Certified Plastic Surgeon to help you reach your goals.

My advice is to find a board certified plastic surgeon near you who performs a lot of tummy tucks. Schedule a consultation with them to discuss further. After taking a history from you, they will examine you, then discuss treatment options. Based on your history and the photographs you have submitted, you appear to be a good candidate for a combination of liposuction to remove unwanted fat and a tummy tuck, a procedure we call a "lipoabdominoplasty". Hope this helps. Good luck!

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