TT After Vaser Lipo? (photo)

I have had 3 Vaser Lipo surgeries that did absolutely nothing for me. I look exactly the same as I did before the surgeries. I am 45, have four children and have had a hysterectomy. I am 5'8 140 and considering getting a full TT. I want the results to be permanent having not had a flat belly in 25 years. What are the possibilities of a perfectly contoured abdomen after a full TT surgery?

Doctor Answers 4

Vaser and Tummy Tuck

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When considering abdominal contour surgery, assessment must be made regarding skin excess, soft tissue fullness (fatty tissue) and muscle separation (diastasis).  For Vaser to be effective, there must be limited diastasis, good skin quality with minimal excess, and enough fatty tissue that removal will make a significant differnence.  Very few women are candidates for lipo alone after 4 pregnancies.  Most have excessive skin and muscle separation. 
Additionally you likely have an abdominal incision already from your hysterectomy.  Healing of this scar is a reasonable barometer of how you might heal after a TT.  Post operatively in your photos, you have excess lower skin, irregular skin contour in the upper and lower abdomen, as well as an obvious diastasis.  All of these issues can be effectively corrected with a TT, a procdure you likely should have had in the first place.

Tummy tuck after liposuction

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It is certainly reasonable to have a tummy tuck after liposuction. The tummy tuck will take care of tightening the abdominal muscles and flattening the stomach region in patients with abdominal weakness.  Good luck with your selection of a surgeon.

TT After Vaser Lipo?

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Unfortunately you are an example of choosing a technology, VASER, to "try" to correct excess abdominal skin. In fact you state you had "3" VASER invasions! Yes I believe a full TT with MR can help you obtain a better appearing abdominal wall. 

Tummy Tuck After Vaser Lipo

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Vaser is a very powerful tool in surgical body shaping.  However, it is not going to replace a need for tummy tuck in most patients.  With more advanced techniques of superficial vaser treatment we are able to better sculpt the skin and stimulate additional tightening.  However, I do not think that the degree of skin tightening is very reliable.

That is why I like to perform vaser lipo and tummy tuck at the same time.  Properly performed vaser liposelection can thin out the skin flap before tightening it with tummy tuck surgery.  Also, based on your abdominal shape, especially if you are not planning on having more children, you may consider muscle tightening (plication) as a part of your TT surgery.  And finally, I would suggest extending liposuction to flanks and back to further improve your shape and elongate the appearance of your waist.

The challenging part is what you call a perfectly contoured abdomen.  It is possible to tighten the muscles and improve definition of the underneath structures with Hi Def Lipo type procedures but I do not think that that type of aggressive procedures can be performed simultaneously. 

I think a formal TT with muscle tighening and a conservative muscle defining liposelection would be my choice.  I would not be comfortable doing more then that especially in view of 2 previous Vasers.

Boris Volshteyn, MD, MS
East Brunswick Plastic Surgeon

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