36, 3 kids. Should I get lipo or a tummy tuck to avoid loose skin? (Photos)

Question

Hi, I’m 36 years old and had 3 kids. I’m about 185pds and 5”5. I mostly just want to remove the fat in my abdomen And have less downtime but scared I may have loose skin , should I get tummy tuck or lipo?

Daniel Barrett, MD · Answer

Dear lace55,

based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. Flanks liposuction would give you a better shape. I would suggest you to consult a board-certified plastic surgeon because only after a thorough examination you will get more information and recommendations.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Luis Macias, MD, FACS · Answer

Hi! This is a great question and one I get often during surgical consultations! The best option really depends on the amount of skin laxity, abdominal fat, and whether there is any abdominal muscle separation after pregnancy.
For someone who has had three children, I often find that a combination of liposuction and a tummy tuck can provide the most comprehensive result. Liposuction can remove unwanted fat, while a tummy tuck addresses excess skin and, when needed, repairs diastasis recti (which is the separation of the abdominal muscles) that can contribute to abdominal bulging after pregnancy.
If you have good skin elasticity and minimal loose skin, liposuction alone may be an option and generally has less downtime. However, if you already have significant skin laxity, liposuction alone can sometimes leave you with more noticeable loose or redundant skin because the skin isn’t being removed.
A tummy tuck does involve a slightly longer recovery than liposuction alone, but it also addresses the skin and abdominal wall, rather than just the fat. Ultimately, I would recommend an in person exam because it’s important to assess your skin quality, pinchable fat, and abdominal wall before deciding which approach would give you the best result you’re looking for.

Sean Yuan, MD, FACS · Answer

If you plan to have more children, I would generally recommend postponing a tummy tuck. Liposuction with Renuvion or BodyTite may be an option if your skin laxity is mild, but these treatments cannot remove significant excess skin.If you have finished having children and have substantial loose skin with prominent stretch marks, a full tummy tuck is usually the better option. An in-person examination can help determine which approach best fits your anatomy and goals.

Yasemin Aydinli, MD · Answer

I understand the wish for less downtime, but I have to be direct with you: liposuction is not an option for your abdomen. In your photos the skin of the lower abdomen is already sagging, and after three pregnancies the abdominal muscles are almost certainly separated as well. Liposuction only works when the skin is tight and would leave your skin looser and more wrinkled than it is now, which is exactly the result you are afraid of. What your abdomen needs is a full tummy tuck, which removes the excess skin, repairs the muscle wall and, combined with liposuction of the flanks, gives a flat contour. At about 185 lbs, losing some weight before surgery will improve both the result and the safety. On recovery, let me reassure you: the tummy tuck incision itself is not the painful part, what patients feel afterwards is mostly the liposuctioned areas. My patients consistently tell me it is nothing like the pain of a caesarean section and is much milder, because in a tummy tuck the muscle and the deep layers are not cut. The restrictions after surgery are the same as after liposuction, and the compression garment is worn for the same length of time. The only difference is that you walk slightly bent forward for about a week, and after that it is no longer needed.

Don W. Griffin, MD · Answer

Thank you for your question. Based on your presented photos, liposuction alone will not give you the best result. Your photos show a combination of fat excess and skin excess with likely diastasis of the abdominal muscles. Your best option would be a full tummy tuck or abdominoplasty with diastasis repair and liposuction of the central abdomen and flanks to create a 360 degree improvement in your trunk.

Gary M. Horndeski, MD · Answer

Liposuction only removes fat, not skin.  You have excess skin and would benefit from a tummy tuck.

Best Wishes,

Gary Horndeski, M.D.

Drew Davis, MD · Answer

Since avoiding loose skin is the main goal, a tummy tuck is usually the better fit. Liposuction removes fat but does not remove skin. After three pregnancies, the skin of the lower abdomen has often been stretched past the point where it can tighten on its own. Taking fat out from under that skin can end up leaving it looser and more wrinkled. 
Pregnancy also commonly causes diastasis recti, a separation of the abdominal muscles. This can cause a lower belly that pushes forward no matter how much fat is removed. Liposuction cannot fix this, while a tummy tuck can tighten the muscles and flatten the abdomen at the same time.
A full tummy tuck is often paired with liposuction of the waist and flanks for better shaping. Recovery is more involved than lipo alone, but you will likely be more satisfied with your final result. A board-certified plastic surgeon can confirm the plan with an in-person exam.

Manuel Diaz, MD · Answer

Hello. Based on your photos and your history of three pregnancies, it appears you would be a better candidate for a tummy tuck (abdominoplasty) than for liposuction alone. There is visible excess and laxity of the skin in the lower abdomen, and the abdominal projection could also indicate diastasis recti (separation of the abdominal muscles).
A tummy tuck would allow us to remove excess skin and repair separated or weakened abdominal muscles, resulting in a flatter, firmer abdominal wall. Liposuction alone would remove fat but would not correct muscle separation or eliminate loose skin; in fact, it could even accentuate the laxity.
In your case, I would consider combining the tummy tuck with liposuction of the abdomen, waist, and flanks to further refine your contours and achieve better definition.
An in-person consultation would be necessary to assess the degree of muscle separation, skin laxity, and fat distribution, and to determine the safest surgical plan for you.

Camille Cash, MD · Answer

When considering between a tummy tuck or liposuction you need to consider if skin laxity.  Based on the photos you currently have loose skin.  Liposuction alone won't correct this and could make it worse.  You do appear to be a good candidate for a tummy tuck.  This would remove the excess subcutaneous fat and skin and correct abdominal wall laxity.  Sometimes liposuction is added for additional contouring.  The result is a tighter, flatter tummy.  I've included a video that I hope you find helpful.

Mats Hagstrom, MD (license on probation) · Answer

Your shorts which are on the tight side are obstructing the view to make a good assessment regarding the degree of skin laxity that you have
It looks like you have a dependent fold even if it’s not that big.
The best procedure would be a full tummy tuck, especially if youwant a tight abdomen.
Liposuction will help to some degree but will not correct your skin laxity. Skin laxity is probably the number one reason patients are unhappy with Liposuction results.
It’s also really important to find a surgeon who has sufficient skill.
Liposuction scale, various substantially among plastic surgeons, even though with good reputations may not be all that good at Liposuction.
Look for plastic surgeonswho offer both procedures and have extensive Liposuction experience.
Bring pictures of yourself to use as a reference during consultations(without the tight shorts).
During consultations ask providers to open up their portfolios and show you before, and after pictures of previous patients who had similar abdominal characteristics. That’s 
 best way to understand what your results are likely to look like in the hands of each provider. An experienced provider should not have any finding you previous examples of patients who had similar body characteristics. Best, 
Mats Hagstrom MD

36, 3 kids. Should I get lipo or a tummy tuck to avoid loose skin? (Photos)

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