Lipo to upper abdomen during abdominoplasty?

Without photos, it is difficult to comment on your particular case. If you have "total confidence in her", then you should not be asking this question on a forum like this. Every surgeon is different on their approach, based on training and continued medical education, reading of the plastic surgery literature and what they feel is safe to introduce and adapt in their practice. Depending on your BMI, one can do liposuction with good all around contouring prior to an abdominoplasty, which can be done 4-6 months later. If your BMI is less than 30, liposuction of the abdomen can be done with the abdominoplasty. I, personally, do this routinely in all my abdominoplasty cases. There's also an upper limit of fat that can be removed safely in an outpatient setting. Good luck with your surgery.

If there is extra fat under the skin in the upper abdomen, I prefer to reduce it at the time of abdominoplasty and this can be done either by liposuction or directly thinning the fat from under the flap when it is being raised. each situation is a little bit different and your surgeon is the one who has examined you and made a plan, so I would not recommend changing it based on statements from any of us online. 

Thank you for your question. Liposuction to the upper abdomen during a TT is determined by the plastic surgeon. If you are unsure, you may want to obtain a second opinion through an in person consultation. All the best, 

As you can see from the responses, there is no unanimity of opinion on whether liposuction should be done with a tummy tuck.  In my opinion, it boils down to a judgment call and experience.If there is considerable tightness resulting from the procedure, liposuction would be riskier.  If there were less tension, less risk.  Older patients, heavier patients or less healthy patients are at greater risk.  High volume liposuction is riskier than lower volume liposuction.If a doctor never does liposuction in the upper abdomen under any circumstance, they will never have a complication from liposuction in that area. However their result might not be quite as optimal, or the patient may feel the need to have liposuction at a later date.

Your surgeon is recommending the safe approach due to the potential for harming blood vessels supplying the lower abdominal skin and causing more complications. A surgeon can safely do a very limited amount of liposuction of the deep fat only in the right candidate or perform direct excision of subscarpal fat during an abdominoplasty. If you are also having liposuction of your waste then direct excision of fat would not be recommended because she will want to minimize skin undermining superior to the umbilicus to lower the risk of skin necrosis. If you have a lot of abdominal fat then a staged operation with liposuction first then a tummy tuck 6 months later may be beneficial. Good luck!Josh Olson MD

Abdominoplasty
treats the skin excess and muscle weakness of the abdomen, as well as any fat
that is between the belly button and the pubic hairline. Liposuction
treats only fat. It can be used to thin out the abdomen, but the skin
must be in good condition with no excess, and there should not be muscle
weakness. I do not like to combine abdominoplasty with lipoosuction
because of the added risks of fluid collection under the skin, and wound
healing problems. Liposuction of the upper abdomen in combination with tummy tuck is extremely risky.

Liposuction on the upper part of the abdomen during tummy tuck can be safely performed in the appropriately selected patients.  Factors such as previous operations, smoking history, how much skin laxity, and quantity of fat to be removed are a few factors that I would consider.Best Wishes,nana Mizuguchi

Thank you for the question.Liposuction is a tool that is often used during tummy tuck surgery. The concern with excessive liposuction surgery done at the same time relates to the blood flow to the abdominal wall " flap" and the potential for problems with wound healing and/or tissue necrosis.In my practice, judicious use of liposuction surgery during tummy tuck surgery is very helpful in improving results. I hope this, and the attached link, helps. Best wishes.

as a safe and sound technique for tummy tucks?  Its certainly more conservative to not do them together but with discontinuous undermining used in lipoabdominoplasty, blood supply issues are now a distant thought.  You can ask your surgeon if she does this type of procedure or get a second opinion understanding that you are considering changing surgeons and losing any scheduling fee you have already paid.  Even with liposuction of the upper abdomen, its often a spot that still bulges post op and requires revisions to achieve the best outcome possible.

It is not possible to comment on your specific situation without an exam or at least good quality photos, but this is an area where surgeons don't agree. In our practice we have not had problems doing liposuction of the upper abdomen, but are conservative in this. Your doctor is trying to be safe with you and not cause problems. It is always OK to go back later for the liposuction. Some surgeons worry about the blood supply being damaged, but the true blood flow comes from the sides of the upper abdomen as shown in many anatomic studies and as long as that area is avoided, there will generally be no problem. The skin irregularities are another matter entirely.