Will cutting out fat during tummy tuck give results equal to having liposuction?

Question

I am getting a tummy tuck with muscle repair in September. The dr I am using does not do liposuction. He said he cuts out the fat. Is that going to give my flanks the same reduction as if I had liposuction of the flanks?

James E. Chappell, MD · Answer

Great question.  During abdominoplasty many surgeons (hopefully you are seeing a BC PS) will not do liposuction of the flap of skin created during the procedure, but may cut out some of the deeper fat.  Liposuction of the flap can lead to flap healing complications (usually in a full abdominoplasty, not a mini).  Liposuction of the flanks is generally safe, even done at the time of abdominoplasty.  I defer to your surgeon's opinion since they know you best.  Always feel free to get a second opinion if you are unsure.  Best of luck to you.

R. Brannon Claytor, MD, FACS · Answer

Patients who have rectus diastasis and are planning to have a tummy tuck often are looking for a more sculpted and thin waist.Historically, it was a challenge to combine liposuction with a tummy tuck operation. However, with more up-to-date and refined surgical techniques combining liposuction with a tummy tuck operation, it is not only safe it is also more effective at contouring and shaping the waistline. In advanced surgical hands the drainless tummy tuck operation can result in sculpted abdomen with no drains being necessary in the postoperative period. Performing liposuction avails the surgeon the ability to do discontinuous undermining which allows the upper abdominal flap to be advanced as a composite flap for closure. The main significant alteration in the surgery is maintaining nerves and blood vessels to the abdominal flap with the liposuction. Therefore, liposuction can actually accomplish a more complete abdominal re-rejuvenation than simple tummy tuck alone. As you plan your surgical treatment I certainly hope that your are incorporating a board certified plastic surgeon and feel comfortable discussing these points and others with your surgeon and getting an answer that is to your satisfaction.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your
question. I usually recommend liposuction in combination with a tummy tuck.  This can be done
through a low and short incision, all completely below the bikini line.  The belly button can be designed to look
natural and have no scars on the exterior.  
Your muscles can also be plicated resulting in a flat abdomen.  Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.  The most important
aspect is to find a surgeon you are comfortable with. I recommend that you seek
consultation with a qualified board-certified plastic surgeon who can evaluate
you in person.
Best wishes and good luck.
Richard G. Reish, M.D. FACS
Harvard-trained plastic surgeon

Camille Cash, MD · Answer

While it is common to include some liposuction with a tummy tuck, it is not always needed or desired.  Contouring of the abdomen is done with a tummy tuck and can somewhat address the hip area.  If you are finding you want additional sculpting you can elect to have it done at a later time.  I encourage you to speak in more detail with your surgeon about your goals for surgery and what you can expect in terms of results.

Steven Wallach, MD · Answer

You can have suctioning of the flanks as well during a tummy tuck. I do that most of the time. Not sure why yours will not do so.  Good luck.

Douglas Taranow, DO, FACOS · Answer

Loralie,I cannot understand what your surgeon is talking about.  Unless he takes the abdominoplasty incision all the way around to the back, he cannot come close to the results seen from liposuction of the flanks/lower back along with the tummy tuck.Dr T

Tom J. Pousti, MD · Answer

Thank you for the question.
Generally speaking, liposuction is a tool that is often used during the time of tummy tuck surgery. Different plastic surgeons utilize this tool differently; some are more “aggressive” than others. In my practice, I frequently utilize this tool to treat adipose tissue of the flanks and pubic areas during tummy tuck procedures.

Care must be taken during tummy tuck surgery to avoid excessive "trauma" to the blood supply of the abdominal wall flap;  for example, if too much liposuction surgery is performed at the time of  tummy tuck surgery, it may be a cause of compromise of blood flow and resulting wound healing problems...

I would suggest you spend additional time discussing your goals, plans, and expectations directly with your plastic surgeon, in front of a full length mirror.  Working together you will come up with the best plan to achieve the desired outcome.  It is very important that you are both be on the same page when it comes to goals/expectations…
 
Best wishes.

Bernabe Vazquez, MD · Answer

There may be some confusion in the way you understand what your surgeon is planning. It has recently become popular to thin out the remaining tissue of any deep fat as we think this does not have a good blood supply and could lead to wound healing problems. This however will not substitute for the liposuction that should in my opinion always be done to improve contour. Cutting out the fat cannot and should not be as extensive as liposuction and therefore cannot produce the same result.

Salem Samra, MD, FACS · Answer

The fat removed in a tummy tuck is in the lower front part of the abdomen. It does not address the fat accumulated in the flanks. This could be addressed separately with liposuction. Hope that helps and good luck!

Robert L. Kraft, MD, FACS · Answer

Some liposuction can be performed during an abdominoplasty and it is common to do so. What should not be done is to thin out the flap and diminish its integrity.  Without photos, it’s impossible to comment in more detail. Excision of tissue will be beneficial but it is possible that you may need a later procedure if the flanks continue to bulge after the tummy tuck.

Will cutting out fat during tummy tuck give results equal to having liposuction?

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