Abdominoplasty with upper abdomen lip?

I plan to consult with 2 or 3 ABPS surgeons for a male Abdominoplasty and lipo. I am 5'8" and weigh 174 pounds. I have lost 35 pounds. I understand that lipoabdominoplasty is a variation of the TT procedure which allows for upper abdomen lipo since there is less undermining or dissection of the upper flap. Since I have some upper ab bulge, would it make sense to find a surgeon in the NY metro area two performs this technique? Or is this technique similar to a traditional TT? Thanks.

Doctor Answers 9

Candidate for an abdominoplasty?

Far more important than deciding if a tummy tuck is for you is the skill and experience of your plastic surgeon. Choose your surgeon rather than the technique and let him explain why one technique may be better than another and if you need a tummy tuck. Many board certified plastic surgeons provide a free first time consult and you should take advantage of that!
See the below link on some suggestions on finding the most qualified Plastic Surgeon for you!The best clients are patients who are healthy but have EXCESS SKIN OR FAT that does not respond to diet and exercise. Patients who have undergone SIGNIFICANT WEIGHT LOSS and have hanging skin. Women with loose skin and stretch marks FOLLOWING PREGNANCY, as in your case. Anyone with LOSS OF SKIN ELASTICITY. Patients who are unable to tighten the abdominal wall with exercise. If you have loose or sagging abdominal wall skin; often associated with relaxation of the anterior abdominal wall muscles (frequently secondary to multiple pregnancies)

Orange County Plastic Surgeon
4.9 out of 5 stars 154 reviews


Thank you for this question.  Liposuction can be performed safely at the time of an abdominoplasty with some variation on the traditional abdominoplasty technique. I do this operation routinely with excellent reults.  As you have stated, the key is to avoid wide undermining to maintainn blood supply to the abdominal skin flap.  The bulge in your upper abdomen may be due to excess subcutaneous fat which is present, or may be due to laxity of the abdominal wall and separation of the rectus muscles that can occur with age and weight loss.  The best thing is to discuss these concerns during consultation with an ABPS board certified plastic surgeon.  

Brian A. Pinsky, MD
Long Island Plastic Surgeon
5.0 out of 5 stars 5 reviews


I think that you would be most comfortable with a surgeon who performs this technique regularly. It truly addresses the bulge of fat above the belly button. Another good technique is SAFElipo in combination with your TT


Carlos Burnett, MD, FACS
Westfield Plastic Surgeon
4.9 out of 5 stars 37 reviews

Abdominoplasty with upper abdomen liposuction.

Your surgery needs to be customized to your needs. If you have skin laxity involving the upper abdomen then a regular abdominoplasty with full undermining of the skin and repositioning of all of the skin is what you need. If the skin is not loose in the upper area you may be able to do just liposuction of the upper abdomen and a more limited "mini tummy tuck" for the lower abdomen. In men the abdominal wall is often less stretched than in women who have been pregnant several times.

I would leave this decision to your experienced plastic surgeon.

Rodney A. Green, MD
Cleveland Plastic Surgeon
4.8 out of 5 stars 24 reviews

Abdominal Contouring

I recommend you find someone in your area that is comfortable utilizing all techniques to address abdominal excess whether it be skin or fat. With weight loss you may need skin correction as opposed to liposuction but the approach in a man may be a little different than a woman. I recommend you see a plastic surgeon that is comfortable operating on men and that you like. Best of luck. 

Erica Anderson, MD
Reston Plastic Surgeon
5.0 out of 5 stars 4 reviews

Liposuction With Tummy Tuck

Thank you for your question and congratulations on your weight loss. The procedure you should have really depends on what your examination shows. If the bulge is upper abdominal fat between the skin and the tummy muscles and you have loose skin, then liposuction of the abdomen with a tummy tuck would be the way to go.

If the upper abdominal bulge is due to fat below the abdominal muscle, fat around the organs, then liposuction of the upper abdomen will have no effect.

If the bulge is due to loosening of the abdominal muscle or a hernia, then muscle tightening with skin excision would be the way to go.

The plastic surgeons with whom you consult, can give you a better idea of your options, once they examine you.

Matthew A. Galumbeck, MD
Virginia Beach Plastic Surgeon
3.8 out of 5 stars 14 reviews

Abdominoplasty and lipo

I often stage the lipo of the upper abdomen depending upon how full it is . I think in most cases it is safer to stage it especially when performing a wide undermining for the tummy tuck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Upper abdominal liposuction with tummy tuck

Your questions have been a point of controversy for years among plastic surgeons.  The debate is whether suctioning the upper abdomen causes damage to the blood flow to the abdominal skin thereby increasing the risk of sloughing off the lower abdominal skin.  Here's my take on it.  It all depends on how the upper tissues are suctioned.  What I mean is this.  The blood flow to the flap is very superficial.  If the liposuction is performed in the deep layers, it's safe.  Using this technique, I have suctioned over 2,000 tummy tucks in the past 20 years and only had 1 incidence of a small area of dead skin in a diabetic patient (who are high risk to begin with).  Be sure to choose your PS wisely.

Victor Ferrari, MD, FACS
Charlotte Plastic Surgeon
5.0 out of 5 stars 36 reviews

Upper abdominal Liposuction with tummy tuck.

Thanks for this excellent question. There is a lot of controversy surrounding upper abdominal liposuction done with a tummy tuck. The basic concern is that the upper abdominal tissue needs a good blood supply so that when it is elevated and pulled down there are no healing issues in the new lower abdomen. Elevation of the tissues alone alters the blood supply and liposuction technically adds more tissue injury from the get go and can increase the risk of tissue loss or necrosis.

Those who make a point of liposuctioning the upper abdomen at the time of surgery generally elevate less, leaving more attachments and in my opinion get out less skin in order to preserve more blood supply.

There is no absolute answer here, but I will share my opinion with you.

Why take the risk?. Without lipo most patients won't need the upper liposuction any way, as the upper roll pulls down. I also feel that more skin can be safely removed when the upper abdomen is not lipoed first. For the rare patient that will still desire some liposuction it is far safer once the tummy has healed and restored its blood supply. Also, liposuctioning a tight tummy such as after a tummy tuck often give more even results.

I have no problem with back or flank liposuction. These areas do not as readily impact the  blood supply of the upper abdominal skin.

The second patient in the link below has had extensive flank liposuction, but no upper abdominal liposuction-- I hope the example helps.

Best wishes.

Adam Tattelbaum, MD
Washington DC Plastic Surgeon
5.0 out of 5 stars 104 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.