Does Liposuction to the Upper Abdomen Prior to a Full Tummy Tuck Give a Better Result?

I have buldging in both my upper and lower stomach. I joke that I have two stomachs because I kind of do. My waist does not buldge like it does above and below. Would I get a better tummy tuck result by having lipo to the upper abdomen prior to my tummy tuck.

Doctor Answers 16

Liposuction vs. Tummy tuck

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Lipo or tummy tuck or both?

For ladies who have never had children, or for those fortunate women who have not developed an abdominal bulge after childbirth, lipo is just the ticket.  Often local anesthesia or IV sedation are possible.

Lipo removes fat.  It doesn't tighten the deep layer (fascia).  Lipo doesn't fix hernias.  Lipo doesn't remove extra skin.

There are many types of short incision tummy tucks for ladies who have had children, maybe have some fat but also have a loose deep layer.

The question you should ask yourself is not how can I get a pretty good result, but how can I get the best result.

Generally patients who have a lot of extra weight they just can't shake should have lipo first.  Aggressive lipo with a tummy tuck is not a good combination and has a higher complication rate for the patient.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 195 reviews

Liposuction of the upper abdomen almost always gives a better tummy tuck result.

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The problem with just doing a tummy tuck is that it doesn't address the fullness of the upper abdomen.  You will almost always need to liposuction the upper abdomen, either prior to, during or later.  Ideally you would want your surgeon to do it at the same time as the tummy tuck to get it all done at once.

David Hansen, MD
Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 46 reviews

Reverse Tummy Tuck - Remove excess skin and fullness from Upper Abdomen With NO SCAR Between the Breasts

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Not infrequently I see patients in whom there is as much skin laxity in the upper abdomen as there is in the lower abdomen. In fact, some patients after pregnancy will have fairly 'toned' lower abdominal skin, but very lax and redundant upper abdominal skin. In these situations, the removal of skin in a vertically downward direction ( a conventional tummy tuck) is not adequate to correct the upper abdominal skin laxity. Such patients are often very good candidates for what I refer to as a 'reverse upper' abdominoplasty.

This surgical technique involves removing excess abdominal skin vertically upwards using incisions hidden in the inframammary folds underneath the breasts. In general, this operation is best reserved for patients with fairly full or at least slightly droopy breasts, which serve to nicely conceal the inframammary folds. An important part of this procedure is the placement of permanent lifting sutures that elevate the lower skin edge, following removal of excess skin, to the upper skin edge in the inframammary fold. These permanent sutures ensure that the resulting surgical scar remains hidden within the inframammary fold.

A great advantage of this procedure is that the patient's original belly button is preserved, and thus there are absolutely no surgical scars that are visible when wearing a two-piece swimsuit or typical underwear (bra and panties). Additionally, because this procedure generally requires less skin undermining and thus less interruption of the normal blood supply of abdominal skin, more thorough liposuction of the waist and back can be performed at the same time.

Many patients having this surgery, therefore, undergo a reverse upper abdominoplasty combined with a lower 'mini' abdominoplasty, tightening of the entire length of the rectus abdominis muscles, and liposuction of the circumferential trunk - and keep the belly button with which they were born. I usually refer to this operation as 'reverse upper / modified lower abdominoplasty'.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Many people who think they need a "tummy tuck" benefit from liposuction alone.

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Many people who think they need a "tummy tuck" benefit from liposuction alone. If after a consultion with a surgeon one decides to have an abdominoplasty, it is safer to liposuction the upper abdomen separately, before or after. This can be done with only local anesthesia. See link below.

William P. Coleman III, MD
Metairie Dermatologic Surgeon

Does Liposuction to the Upper Abdomen Prior to a Full Tummy Tuck Give a Better Result?

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No I would recommend doing the tummy tuck first with recti repair to see if that resolves the issue. From MIAMI DR. Darryl J. Blinski


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I perform liposuction during tummy tucks on virtually all my patients, including liposuction in the upper abdomen.  Once considered an unacceptable risk, combining these procedures has become mainstream and perfectly acceptable so long as the surgeon adjusts his  or her technique to maintain adequate blood flow to the abdominal wall tissues.  Staging the procedures is fine but this adds significant cost to the final result. 

Brian M. Braithwaite, MD
Chicago Plastic Surgeon

Liposuction before a tummy tuck

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Liposuction may be performed before or after an abdominoplasty. Some plastic surgeons do both together but it is important to asks about the surgical risks of doing these two procedures at the same time. You need an examination to determine if you are a candidate for either the abdominoplasty, liposuction or both.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Lipo of Upper Abdomen with Tummy Tuck

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It is difficult to predict the best procedure for you without a physical exam or pictures.   Many patients can have an upper abdominal bulge due to skin excess or muscle laxity.   This will be corrected by the tummy tuck.  

If the primary problem is a thick fat pad, I would not recommend central upper abdomen liposuction in conjunction with a tummy tuck.   This carries a higher risk of wound healing complcations.  

If necessary, I would perform the liposuction in a 2nd stage procedure if necessary.

Paul S. Gill, MD
Houston Plastic Surgeon
4.8 out of 5 stars 95 reviews

Liposuction and Tummy Tuck

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For many years liposuction with a tummy tuck was felt to increase the risk of decreased blood flow to the stretched skin below.  Keeping the surgical approach to the upper midline muscle repair narrow has made it possible to minimize this risk.  Since only the area of the muscle repair is elevated, the area over the ribs (which provides the blood flow) is left intact and can be reduced in bulk by liposuction.  Using this technique, improvement in the upper abdominal fat excess can be addressed during a tummy tuck without compromising the skin or the final result. 

Ricardo Izquierdo, MD
Oak Brook Plastic Surgeon

Liposuction prior to, during, or after tummy tuck

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In some cases the tummy tuck will "unfurl" the fat in the upper abdomen and treat this roll as well. However, liposuction is discouraged with the tummy tuck in the areas you mention. Therefore I tend to perform the liposuction at a later date if needed.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

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.