I wanted to know why is it that some doctors say no to lipo of the stomach with tummy tuck and some say it's OK? I'm confused

Doctor Answers 10

Tummy tuck and liposuction

Hello dear, thanks for important question.

Liposuction and Tummy Tucks ARE routinely done at the same time, BUT certain considerations apply.
There are 2 reasons WHY this is even an issue:

1. Blood Supply injury - The tummy skin has 3 major sources of oxygen providing arterial blood supply. From the groin (Femoral) arteries on both sides, from several rows of blood vessels that go forward through the tummy muscles like a peach orchard (PERFORATORS) supplying the fat and skin above and from the continuation of several vessels that normally run under the lower ribs. All three networks inter-communicate in keeping the skin alive.

When a tummy tuck is done, the blood supply from the groins is divided followed by the blood supply from the perforating vessels - leaving ONLY the extensions from the under the rib (intercostal) branches to supply everything.

With no other Back-up arterial blood supply systems, any injuries or narrowing (as seen in smokers) in these vessels may result in death of the tummy skin under the belly button and wound separation.
THEREFORE - while we routinely would do liposuction of the back and hips we either do not liposuction the areas of the tummy which had been or will be lifted OR if we do liposuction such areas, the surgeon is VERY careful and does not liposuction as much as he would otherwise.

2. Operative Time. The longer the surgery the higher the risk of complications. The most ominous being clots in the deep veins (DVT) which if they become detached, can travel to the lungs (Pulmonary embolism) and may even be fatal


I recommend to make an appointment with a board certified plastic surgeon to talk about your concern and also for a person evaluation. Good luck :)

Tummy tuck and liposuction

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Hello dear, thanks for important question.

Liposuction and Tummy Tucks ARE routinely done at the same time, BUT certain considerations apply.
There are 2 reasons WHY this is even an issue:

1. Blood Supply injury - The tummy skin has 3 major sources of oxygen providing arterial blood supply. From the groin (Femoral) arteries on both sides, from several rows of blood vessels that go forward through the tummy muscles like a peach orchard (PERFORATORS) supplying the fat and skin above and from the continuation of several vessels that normally run under the lower ribs. All three networks inter-communicate in keeping the skin alive.

When a tummy tuck is done, the blood supply from the groins is divided followed by the blood supply from the perforating vessels - leaving ONLY the extensions from the under the rib (intercostal) branches to supply everything.

With no other Back-up arterial blood supply systems, any injuries or narrowing (as seen in smokers) in these vessels may result in death of the tummy skin under the belly button and wound separation.
THEREFORE - while we routinely would do liposuction of the back and hips we either do not liposuction the areas of the tummy which had been or will be lifted OR if we do liposuction such areas, the surgeon is VERY careful and does not liposuction as much as he would otherwise.

2. Operative Time. The longer the surgery the higher the risk of complications. The most ominous being clots in the deep veins (DVT) which if they become detached, can travel to the lungs (Pulmonary embolism) and may even be fatal


I recommend to make an appointment with a board certified plastic surgeon to talk about your concern and also for a person evaluation. Good luck :)

Liposuction

The combination of liposuction with abdominoplasty is very dependent on the training and preferences of the individual surgeon. The older teaching held that they should not be combined in the interest of safety. Simeon Wall, Jr. M.D., has reported a new technique known as SAFELipo, which is a safe and effective way to do circumferential liposuction of the trunk in combination with abdominoplasty and the results are both impressive and reproducible. Specific discussion of his technique can be found on SAFELipo.com.

Liposuction

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The combination of liposuction with abdominoplasty is very dependent on the training and preferences of the individual surgeon. The older teaching held that they should not be combined in the interest of safety. Simeon Wall, Jr. M.D., has reported a new technique known as SAFELipo, which is a safe and effective way to do circumferential liposuction of the trunk in combination with abdominoplasty and the results are both impressive and reproducible. Specific discussion of his technique can be found on SAFELipo.com.

I wanted to know why is it that some doctors say no to lipo of the stomach with tummy tuck and some say it's OK? I'm confused

Thank you for the question. It is extremely common to receive different opinions from different plastic surgeons about the best way to treat a specific “problem”. Each plastic surgeon may have his/her opinion that is based on their specific/unique education, experience, and personal preferences. Their opinions may also be shaped by unfavorable results they have encountered in their practices. It is quite amazing how adamant each plastic surgeon can be about the superiority of his/her recommendations…

 Liposuction is performed in conjunction with a tummy tuck to help improve body contours. There may be some limitations to how much adipose tissue can be removed safely.  Excessive liposuction done at the time of tummy tuck may compromise blood flow and wound healing.
You may find the attached link and video, dedicated to tummy tuck surgery concerns, helpful to you as you learn more. Best wishes.

I wanted to know why is it that some doctors say no to lipo of the stomach with tummy tuck and some say it's OK? I'm confused

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thank you for the question. It is extremely common to receive different opinions from different plastic surgeons about the best way to treat a specific “problem”. Each plastic surgeon may have his/her opinion that is based on their specific/unique education, experience, and personal preferences. Their opinions may also be shaped by unfavorable results they have encountered in their practices. It is quite amazing how adamant each plastic surgeon can be about the superiority of his/her recommendations…

 Liposuction is performed in conjunction with a tummy tuck to help improve body contours. There may be some limitations to how much adipose tissue can be removed safely.  Excessive liposuction done at the time of tummy tuck may compromise blood flow and wound healing.
You may find the attached link and video, dedicated to tummy tuck surgery concerns, helpful to you as you learn more. Best wishes.

Why or Why not lipo stomach with TT

A Tummy tuck starts with a cut from Hip to hip. That cut goes down to muscle. On the surface of the muscle, a plane is developed to the bottom of the ribcage. If the distance from cut edge to ribcage were measured distances of 8 to 12 inches would be common. Circulation in that extensive flap of skin and fat resides for the most part in a system of little arteries and veins just under the surface of skin. That circulation was thought to be interfered with if structures, suction canulas, traversed the fat of that flap. For much of the previous century surgeons performing TT's were taught not to suction that flap because it would cause skin breakdown because  the circulation was throughout the flap. As the anatomy has been better defined liposuction of the abdominal flap of a TT is suctioned more often.

Why or Why not lipo stomach with TT

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A Tummy tuck starts with a cut from Hip to hip. That cut goes down to muscle. On the surface of the muscle, a plane is developed to the bottom of the ribcage. If the distance from cut edge to ribcage were measured distances of 8 to 12 inches would be common. Circulation in that extensive flap of skin and fat resides for the most part in a system of little arteries and veins just under the surface of skin. That circulation was thought to be interfered with if structures, suction canulas, traversed the fat of that flap. For much of the previous century surgeons performing TT's were taught not to suction that flap because it would cause skin breakdown because  the circulation was throughout the flap. As the anatomy has been better defined liposuction of the abdominal flap of a TT is suctioned more often.

I wanted to know why is it that some doctors say no to lipo of the stomach with tummy tuck and some say it's OK? I'm confused

Great question. But some self tummy posted photos would also help. The answer has to do with the vascular/blood supply to the most dependent part of the dissected inferior flap of skin/fat. If to aggressive middle abdominal liposuction is done than the inferior flap has very high risks of vascular compromise and necrosis. Most boarded PSs will offer lateral, waist/hip liposuction. Very very few PSs will do middle superior liposuction. I hope this clears up the confusion. 

I wanted to know why is it that some doctors say no to lipo of the stomach with tummy tuck and some say it's OK? I'm confused

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Great question. But some self tummy posted photos would also help. The answer has to do with the vascular/blood supply to the most dependent part of the dissected inferior flap of skin/fat. If to aggressive middle abdominal liposuction is done than the inferior flap has very high risks of vascular compromise and necrosis. Most boarded PSs will offer lateral, waist/hip liposuction. Very very few PSs will do middle superior liposuction. I hope this clears up the confusion. 

Tummy Tuck with Lipo

As the other surgeons have explained the safety of combining liposuction with tummy tuck depends on blood supply, In order to perform liposuction and abdominoplasty safely your surgeon must be aware of the blood supply to avoid potentially disatrous complications with healing and skin loss.
Another very important consideration that most plastic surgeons may not tell you, is that it is illegal in the state of Florida to perform more than 1 litre of liposuction at the same time as an abdominoplasty in their office based surgical facilities. In order to perform more than 1l of liposuction at the same time as abdominoplasty the procedure must be performed at an AHCA certified outpatient facility or a hospital. This is one of numerous reasons we constructed our surgical facility to fulfill AHCA standards and licensure. During the surgery a trained surgeon also has safe methods to directly excise certain areas of fat in addition to volumes of greater than 1litre of liposuction for the best possible results with alltypes of tummy tuck.

Tummy Tuck with Lipo

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As the other surgeons have explained the safety of combining liposuction with tummy tuck depends on blood supply, In order to perform liposuction and abdominoplasty safely your surgeon must be aware of the blood supply to avoid potentially disatrous complications with healing and skin loss.
Another very important consideration that most plastic surgeons may not tell you, is that it is illegal in the state of Florida to perform more than 1 litre of liposuction at the same time as an abdominoplasty in their office based surgical facilities. In order to perform more than 1l of liposuction at the same time as abdominoplasty the procedure must be performed at an AHCA certified outpatient facility or a hospital. This is one of numerous reasons we constructed our surgical facility to fulfill AHCA standards and licensure. During the surgery a trained surgeon also has safe methods to directly excise certain areas of fat in addition to volumes of greater than 1litre of liposuction for the best possible results with alltypes of tummy tuck.

I wanted to know why is it that some doctors say no to lipo of the stomach with tummy tuck and some say it's OK? I'm confused

Thank you for your question. The safety of "tummy tucks" combined with liposuction has been debated for years in plastic surgery. The main concern is preserving the blood supply to the abdominal skin that is left behind. There is evidence that aggressive liposuction can damage the blood supply and lead to delayed wound healing and other complications. There is also evidence that conservative liposuction in certain areas can be safely combined with a "tummy tuck". Safety is the number one goal of any elective procedure so I recommend consultation with a plastic surgeon experienced in "tummy tucks" and liposuction for specific discuss about your options and the associated complication rate. Hope this help and good luck.

I wanted to know why is it that some doctors say no to lipo of the stomach with tummy tuck and some say it's OK? I'm confused

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thank you for your question. The safety of "tummy tucks" combined with liposuction has been debated for years in plastic surgery. The main concern is preserving the blood supply to the abdominal skin that is left behind. There is evidence that aggressive liposuction can damage the blood supply and lead to delayed wound healing and other complications. There is also evidence that conservative liposuction in certain areas can be safely combined with a "tummy tuck". Safety is the number one goal of any elective procedure so I recommend consultation with a plastic surgeon experienced in "tummy tucks" and liposuction for specific discuss about your options and the associated complication rate. Hope this help and good luck.

TT liposuction?

There are two forms of tummy tuck, the mini and the full; you may have liposuction of your entire belly with a mini tummy tuck but not with a full tummy tuck. This has to do with maintaining blood supply to your belly skin during your surgery. You can have lipo of your lower flanks with either surgery. Please contact our office if you need more clarification.

TT liposuction?

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There are two forms of tummy tuck, the mini and the full; you may have liposuction of your entire belly with a mini tummy tuck but not with a full tummy tuck. This has to do with maintaining blood supply to your belly skin during your surgery. You can have lipo of your lower flanks with either surgery. Please contact our office if you need more clarification.

Liposuction in conjunction with tummy tuck

A tummy tuck (abdominoplasty) removes excess abdominal skin and fat. This procedure cuts the primary blood supply to the remaining anterior abdominal skin which is then stretched tight for wound closure.  The double-whammy of cut blood vessels and tight closure causes the skin to struggle for survival based on the secondary, peripheral blood supply.  Adding liposuction to the trunk causes increased swelling and inflammation which can hinder recovery of the already-traumatized skin.  That is why I do not perform liposuction of the abdomen and flanks in conjunction with a tummy tuck.

Liposuction in conjunction with tummy tuck

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A tummy tuck (abdominoplasty) removes excess abdominal skin and fat. This procedure cuts the primary blood supply to the remaining anterior abdominal skin which is then stretched tight for wound closure.  The double-whammy of cut blood vessels and tight closure causes the skin to struggle for survival based on the secondary, peripheral blood supply.  Adding liposuction to the trunk causes increased swelling and inflammation which can hinder recovery of the already-traumatized skin.  That is why I do not perform liposuction of the abdomen and flanks in conjunction with a tummy tuck.

Tummy tuck and lipo

I routinely perform liposuction and tummy tuck at the same time and have had no problems with this approach.  Many surgeons agree with me and I have actually had less healing problems when I started using more suction than I did beforehand.

Tummy tuck and lipo

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I routinely perform liposuction and tummy tuck at the same time and have had no problems with this approach.  Many surgeons agree with me and I have actually had less healing problems when I started using more suction than I did beforehand.

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.