Tummy tuck, liposuction and hysterectomy

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 liposuction because of the added risks of fluid collection under the skin, VTE and wound healing problems.

Aggressive liposuction with tummy tuck is dangerous.  A full tummy tuck with liposuction at the same time will certainly put you at a high risk for fluid under the tummy tuck skin (seroma). A full tummy tuck with aggressive liposuction at the same time will also certainly put you at an unacceptably high risk for a potentially fatal pulmonary embolism (PE), venous thromboembolic event (VTE). The literature is complete with this information. The science is the science. This is a risky combination.

The incidence of seroma formation is about 16.0 percent in the abdominoplasty-alone group and 31.2 percent in the abdominoplasty with liposuction group.

The combination of abdominoplasty and liposuction procedures can still overwhelm the body's ability to resist these shear forces by the fact that more surface area is available to “shear” and thus produce seroma fluid. Not so much as an additive effect but synergistically, such that the seroma fluid from the flanks flows into the adjacent abdominal space and resists the ability of the upper abdominal flap to close over the abdominal wall. Patients must be counseled about their risk for seroma formation and treatments aimed at resolving them including frequent postoperative visits for needle drainage and the rare case requiring operative drainage in the face of a persistent seroma.

Dear skategirl,   Cosmetic surgery is purely elective (you do not need it , but rather you want it) and as such, complication rate should be reduced to a minimum.    In a recent article the the plastic surgery journal that was based on data from cosmetic surgery only insurance company, it was revealed that combining tummy tuck with other surgery, increases the severe complication rate 2-3 times in comparison to tummy tuck alone. Combination of tummy tuck and liposuction increases the complication rate X 10  !  In Florida, it is illegal to perform tummy tuck with liposuction of over 1000 cc (small amount) after state investigation of many complication , including death, revealed it to be mostly due to the combination surgery of tummy tuck and liposuction.   So, theory and reality are 2 different things. I would not recommend to combined the surgeries for your safety. The best sequence of surgeries , in my opinion, will be hysterectomy first, followed by tummy tuck 2-3 months later and if needed , liposuction 6-8 weeks later (only about 10% of my tummy tuck patients request liposuction, due to the significant weight loss that occurs due to the abdominal muscle tightening that reduces the amount of food that you can eat and your sense of hunger.)   Always, consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery, to make sure that they are numerous, consistent and attractive with flat stomach, tight and youthful skin, nice belly button, good body posture and low scar.                            Best of luck,                                                  Dr Widder 

Although online consultants cannot provide you with specific advise regarding the “safety” and suitability of this combination surgery for you,  the 2 operations can certainly be done safely for the appropriately selected patient.  Best to be as close to possible to your long-term stable weight prior to proceeding. Make sure you have chosen your surgeons carefully. Best wishes.