How Can a Physician Tell the Difference Between Fat and Loose Skin for a Tummy Tuck?

Doctor Answers 11

Skin and fat

The difference between skin and fat should not be difficult to determine if you surgeon is a board certified Plastic Surgeon. 

Kennewick Plastic Surgeon
5.0 out of 5 stars 4 reviews

Body Contouring Evaluation

Most patients seeking tummy tuck have a combination of loose skin and fat. However, patients who are candidates for body contouring tend to fall on a continuum between liposuction and tummy tuck based on the skin quality, the amount of subcutaneous fat, the elasticity of the skin, and amount of intra-abdominal fat. Each surgeon will utilize his or her own preferences, experience, and expertise to determine what the optimal surgical plan should be. Therefore, you should consult with 3 board certified plastic surgeons to understand your options, and choose the surgeon/surgical plan that best meets your needs/objectives.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 31 reviews

Evaluation of the abdomen for body contouring

When evaluating an abdomen several factors must be examined
  1. Skin
  2. Subcutaneous fat
  3. Anterior abdominal wall laxity
  4. Intra-abdominal fat or visceral fat
If your skin has multiple stretch marks then liposuction may not be the best option. There are modifications of an abdominoplasty but in your particular case a standard abdominoplasty would be the best choice. This will flatten the abdominal bulge, contour the abdomen with liposuction of the trunk, flanks and posterior hips, and tighten the skin. The trade off is the scar. This is an individual decision for your to make after you weigh the risks and benefits. If you want to have a flat abdomen the trade off is the scar that can be hidden by your bathing suit or underwear. With proper planning the scar can be managed. Proactive scar care is vital to obtain an aesthetic result.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 14 reviews

Tummy Tuck

There's always a combination of fat and loose skin in any patient thinking about a tummy tuck.  The better question is,"is my skin so loose enough that it needs to be tightened, or is it elastic enough to bounce back after liposuction alone?"  An experienced plastic surgeon should be able to examine you and tell you which procedure would be best for you.

Robert K. Sigal, MD
Reston Plastic Surgeon
4.0 out of 5 stars 16 reviews

Extra skin or extra fat?

To determine if the patient has extra skin or extra fat is done by simply pinching loose skin.  Skin itself is relatively thin (1-5mm) so anything over that is fat volume.

During a tummy tuck the skin and fat are removed together in the area between the belly button and the pubic area.  If you have extra skin then you can grab it and pinch it with your hands.  Only in very thin patient is this skin only, everybody else has excess fat as well

Martin Jugenburg, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 337 reviews

Skin v fat

It is not difficult to tell the difference between skin and fat.  I think the more important point is that there is a layer of superficial fat which should  not be removed with liposuction or you will develop contour abnormalities.  On the other hand, the skin and this superficial layer of fat are removed together in a tummy tuck.  Hope this helps.

Tummy tuck

It is not difficult to tell the difference between the two.  Even a photo can distinguish between the two.  Skin laxity is a good sign that a tummy tuck is necessary.

Shahin Javaheri, MD
San Francisco Plastic Surgeon
4.0 out of 5 stars 3 reviews

How to determine if a tummy tuck or liposuction is the appropriate choice to treat your abdomen

A well trained board certified plastic surgeon would examine you and then should easily be able to determine whether the issue regarding your abdomen is related to too much fat, lax and excess skin or a combination of both. Relevant recommendations can then be made. With excess fat alone (but not massive), liposuction could be considered whereas with solely excess loose skin a tummy tuck would be the appropriate choice. 

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 26 reviews

Tummy tuck v. Liposuction

Many patients come to my office wondering if they have too much fat or too much skin and are often confused by which procedure is right for them.  In general a quick examination is all it takes for an experirence PS to know if you have too much fat or skin or both.  Take the time to sit down with a PS in your area and discuss your questions.

Delio Ortegon, MD
San Antonio Plastic Surgeon
4.0 out of 5 stars 21 reviews

Fat vs. Loose Skin and Tummy Tucks

An experienced plastic surgeon can determine the difference between fat and loose skin in about 5 seconds via physical examination. It is done by feel, and how much can be pinched, when compared to areas of the body that don't normally have as much fat. It can take much longer to convince a patient that loose skin is loose skin, but the determination is the most important detail in deciding how to get a pleasing result.

We all want good results, and we all want to do the smallest procedure which will give good results. For the tummy, this boils down to liposuction vs. a tummy tuck. When skin is tight and fullness is from fat, liposuction works well. It is a quicker procedure with a faster recover. When skin is loose; however, liposuction can be a disaster. It can cause irregular folds in the skin that, while less full, looks less than attractive.

The advantage of the tummy tuck is the ability to tighten, as well as remove. The abdominal muscles and the skin can both be tightened with a tummy tuck. It is a longer, more expensive procedure that has a longer recovery, but it is also doing a lot more than liposuction can. The downside that most patients worry about is the scar. A well placed scar beats loose skin, especially liposuctioned loose skin, hands down.

If you have had liposuction of the abdomen and the skin is loose and irregular, you may stil be a candidate for improvement with a tummy tuck.

Joseph Mele, MD
Walnut Creek Plastic Surgeon
4.5 out of 5 stars 11 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.