Partial abdominoplasty or liposuction?

I recently had a consult with a plastic surgeon who told me that liposuction would remove the fat and the results would be flattering, but wouldn't completely flatten the area and might leave a little skin. A partial abdominoplasty would definitely flatten and tighten my lower abs. My biggest concern is the recovery from this procedure, specifically the pain and functional limitations. Please let me know what you would recommend and also what your patient experiences are with recovery.

Doctor Answers 8

Partial abdominoplasty or Mini abdominoplasty vs. liposuction

I agree with what your plastic surgeon has told you.

Liposuction alone will remove the fat and cause some skin tightening depending on the type of liposuction used (laser, Vaser, or traditional.) It will not get rid of a large amount of excess skin, and it will not help with muscle tightening. It is best for excess of fat, but not skin. It does not address the muscle separations that occur during pregnancy.

Abdominoplasties- full or partial - remove the excess skin and tighten the abdominal wall. It will flatten and tighten the abdomen much more than liposuction alone. The choice to decide whether you need a full or partial depends on your weight, excess skin, and body type. This should be discussed with your board-certified plastic surgeon during a consultation.

Finally, pain and functional limitations differ depend on the procedure done. The more abdominal wall work, i.e. muscle tightening, the more post- operative pain patients will have. Intra operative pain injection or post operative pain pumps can help with pain control. Although abdominal surgery is initially painful, the pain improves daily and is controlled by pain medications. Most people are walking the night of the procedure and doing light exercise by one week. Every surgeon has their own post-operative regiment that should be followed.

Philadelphia Plastic Surgeon
5.0 out of 5 stars 39 reviews

Partial Tummy Tuck and Liposuction

First, you look quite thin in the picture. It is hard for me to imagine that your problem would be solved with liposuction alone.

Second, The value of a mini-abdominoplasty is in both tightening the muscles in the lower and/or upper abdomen and in removing excess skin so that things are pulled tight and the results of the muscle tightening are more obvious.

Recovery from a mini-abdominoplasty depends upon how extensively the muscle needs to be tightened and how tight the skin is pulled after the excess is removed. If a full muscle tightening is done, I would ask you to refrain from heavy lifting for six weeks. That seems like a long time, I admit, but in the grand scheme of your life and how long you would enjoy the result, six weeks is not that long. I often add liposuction in the upper abdomen and the flanks to further improve the result but that decision is very specific to the person and our exam.

I have changed my practice over the last year to do two things differently that make the recovery much more tolerable for our patients. 1. I use a kind of long lasting local anesthesia called Exparel at the time of the surgery. This is put in while you are asleep and makes the muscles essentially numb for three days. These first three days are the hardest to tolerate and I have found this simple change to improve patient comfort dramatically. 2. I have stopped using drains and converted to what is known as progressive tension suturing. People hate drains, and by taking a little extra time in the operation to eliminate the space that would otherwise need to be drained, they can safely be avoided.

These two things have made the process dramatically better, especially in the first week and the results are still great.

I have attached a link to a patient who was also thin but with a bulge in the lower abdomen before an abdominoplasty and who ended up with a flat abdomen and a better shape afterwards. She had a full abdominoplasty but may have had more extra skin than you do.

Jeremy Pyle, MD
Raleigh-Durham Plastic Surgeon
4.9 out of 5 stars 109 reviews

Fat or Skin?

The answer to your question depends largely on what you're trying to address. If it's just subcutaneous fat you'd like to remove, liposuction can absolutely be sufficient. Laser-assisted liposuction can tighten the skin in addition to removing fat, but not to the degree that abdominoplasty can. If you're concerned about a combination of skin and fat, abdominoplasty can effectively address both those things, as well as tighten your abdominal muscles.
As you know, the recovery process following an abdominoplasty is more involved than following liposuction. If you have a physically demanding job, you'll need to take plenty of time off. If you have small children at home, you'll probably want to hire a babysitter or enlist the help of a friend or family member for a couple of weeks, because bending and heavy lifting are not advised. However, if you work from home or have a sedentary office job, you'll be able to return to your duties within a couple of weeks. My patients tell me that the pain is manageable with prescription painkillers, and they're able to switch to over-the-counter medications after only a couple of days. Consider this level of downtime when making your decision. Good luck!

Thomas McNemar, MD, FACS
Stockton Plastic Surgeon
4.9 out of 5 stars 16 reviews

Mini Tummy Tuck Will Tighten Your Abdomen

Thank you for your question. You look very thin and fit and I do not see much excess fat beneath your skin.

I could be more certain to based on a personal examination, however I doubt that liposuction even laser liposuction is going to give you a significantly tighter abdomen. A mini tummy tuck will tighten and flatten your abdomen and if liposuction is needed it can be done at the same time.

Be certain to consult a plastic surgeon who is certified by the American Board of Plastic Surgery and experienced in tummy tuck and liposuction procedures.

Liposuction or partial tummy tuck

Thank you for asking about whether to have liposuction or a partial tummy tuck.

  • Although the photo is dark, you look young and trim,
  • Yet your lower abdomen protrudes,
  • This is typical of looseness of the lower rectus muscle,
  • It is corrected with a mini-tummy tuck - a short incision to tighten muscle,
  • liposuction removes excess fat,if necessary, at the same time.
  • I suspect your plastic surgeon is correct but if in doubt, get a second plastic surgery opinion. Best wishes.

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

Tummy tuck?

Thanks for your question. Unfortunately your photo is too dark to evaluate. Lipo has a much shorter recovery than a tummy tuck. Best of luck.

Tummy Tuck or Liposuction of Abdomen?

Thank you for the question and picture but the picture quality is quite dark; consider sending additional views to receive better advice.

On average, patients who undergo tummy tuck surgery will experience more discomfort and have a longer recovery period compared to patients who undergo liposuction surgery. Of utmost importance however it is undergoing the appropriate procedure for your specific situation; this can only be determined after a careful history, physical examination, and a full communication of your goals.

Be careful with your decision-making; it is not uncommon to see patients in the office who have undergone a “lesser” procedure only to require additional surgery to achieve the results they were initially looking for.

I hope this, and the attached link, helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Partial abdominoplasty or liposuction?

More pictures or an exam will be necessary to determine the correct procedure. In general the muscle tightening of a tummy tuck can produce more pain. However, the most important thing is that the correct procedure is performed for your anatomy.

Liposuction results are highly surgeon dependent. Find a plastic surgeon with ELITE credentials who performs hundreds of liposuction procedures each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

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.