Is it common to have liposuction in the upper/mid abdomen after a full tummy tuck? (Photo)

Question

I had a full tummy tuck with muscle tightening 4 months ago. My PS created "fake abs" (I was not aware he was going to do this. Needless to say, I ended up with this bulgy look. I had a recent follow up visit with my PS and he says he could do "touch up lipo" in the mid section. Is this common and what are the chances of me getting ripples due to liposuction? I've seen botched liposuctions on the abdomen and wondering what causes the ripples. Advice? Recommendations?

Kenneth Hughes, MD · Answer

In my experience, rippling with liposuction following tummy tuck is not something that I have seen.Kenneth Hughes, MDLos Angeles, CA

George Marosan, MD · Answer

Thank you for your question and photos. You have a nice improvement and what your surgeon did is not "fake abs", it is your rectus muscles brought closer together. I, personally, would not recommend "touch up lipo", but rather would do VASER Hi Def Lipo to define your abdomen better, remove fat from your back, waist and hips to give you an hourglass figure. The VASER helps with skin tightening. What you are afraid of is botched liposuction which is a result of a surgeon's poor technical ability and understanding of the underlying muscle anatomy. If you trust your surgeon, go ahead with his/her plan or seek a second opinion from a board certified plastic surgeon experienced in advanced body sculpting techniques. Good luck.

Michael M. Omidi, MD, FACS · Answer

Thank you for the question. I would advise to perform a tummy tuck and liposuction together because this way you will save on downtime and have just one recovery period for both procedures. That being said, you can certainly get liposuction some time after a tummy tuck once you complete your recovery period. 
A tummy tuck offers the most effective way to correct loose skin and muscle separation in addition to eliminating excess fat. Liposuction will also remove fat, but it can't address flabby, hanging skin that typically persists after weight loss. For this reason, many patients who have experienced a massive weight loss or recent pregnancy tend to opt for a tummy tuck. This procedure can also be combined with liposuction for maximum effect.  
An in-person exam with a board certified plastic surgeon is always the best way to fully assess your needs and address your concerns. Best of luck!

Curtis Wong, MD · Answer

for me and may patients because there are always small irregularities that my patients wish to improve.  And what you have probably resulted from a high lateral tension closure that makes the lateral contours great but adds some soft tissue centrally.  This can be flattened with liposuction but if too aggressive, can cause the dimples that you fear.  So, yes, its very common to have liposuction after tummy tucks in my practice.

Andre Aboolian, MD · Answer

You would need an in person examination to determine this.  Getting loose skin is a real concern, however.  This shoud have been discussed pre surgery.  Can you include a sitting photo of your tummy?  it seems like you have some extra/loose skin above the belly button?

Luis A. Fernandez Goico, MD · Answer

Hello, Thanks for your question and photos. Liposuction of the abdominal flap at the same time of a Tummy tuck is very dangerous, as it can compromise its blood supply. What your PS is offering is completely logical in order to give you an even better aspect of your abdomen, but taking the right precautions and doing it in a second stage. Good luck on your recovery, Dr. Fernandez Goico

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