Tummy tuck and liposuction - Can they be performed at the same time?

Question

I am planning to have a tummy tuck done later this year. My surgeon told me that they do not perform liposuction on the upper flap. They said that liposuction can be done later down the line. Is this coming practice or just a more conservative approach? I see some surgeons offer liposuction to the abdomen at the time of tummy tuck possibly using newer, liposuction tech technologies. I would much rather not undergo a second procedure. It is quite costly and the downtime is not desirable. Also liposuction may require general anesthesia again, which I would prefer to avoid.

Gary M. Horndeski, MD · Answer

A tummy tuck and liposuction can be done at the same time. However, you cannot liposuct the upper part of the tummy tuck flap because it may interfere with the blood supply and the flap may die. The surgeon can liposuct other areas of the body or the flanks, if necessary.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Paul M. Parker, MD, FACS · Answer

If the patient has sufficient fat in the abdomen to be treated with liposuction, I will liposuction that fat at the same time as the tummy tuck. As long as the liposuction is done properly, the patient will heal very well and the recovery time is no different than a tummy tuck performed without liposuction. Combining these procedures will give a better result than if no liposuction were done. It is also more efficient, allowing liposuction and the tummy tuck to be done at one procedure.

Moises Salama, MD · Answer

Thanks for your question. Yes, liposuction and a tummy tuck can be combined. However, every case is unique. I cannot provide a proper recommendation without pictures. That said, I suggest having a consult with a board certified plastic surgeon. Take care, Dr. Salama, board certified plastic surgeon.

Jacob Carlson, MD · Answer

Liposuction can be performed during a tummy tuck, but your surgeon’s recommendation to avoid aggressive liposuction of the central upper abdomen is a thoughtful and common approach.
During a tummy tuck, the blood supply to the central abdominal skin is partially interrupted. For the incision to heal well, that remaining blood supply needs to be preserved. If too much liposuction is done in that area at the same time, it can compromise healing and increase the risk of wound problems and poor scarring.
I do perform limited liposuction to the upper abdomen during a tummy tuck, but it is usually conservative compared to the flanks or lower abdomen. More aggressive contouring can be done later if needed, once healing is complete.
Your surgeon’s guidance is not outdated. It reflects a safety-focused approach to protect your incision, healing, and final scar quality.

Justin Yovino, MD, FACS · Answer

Loop of the flanks, waist, hips, love handles, and back is totally fine with tummy tucks. I avoid lipo of the upper abdomen bc of risks of healing. It’s best to do that area either before or after the tummy tucks.

Scott C. Lindsay, DO · Answer

Thanks for your question! We often do liposuction to the love handles or braline with a tummy tuck but doing the upper abdomen can compromise the blood supply. The best way to ensure you won't need that additional liposuction is a little bit of weight loss. Good luck!

Elisa Stein, MD · Answer

Momof2dds,
Liposuction is often combined with tummy tuck surgery. That said, most surgeons are very cautious about performing liposuction on the upper abdominal skin because that is where the blood flow to the skin flap we are pulling down in a tummy tuck comes from. Rather, liposuction of the sides of the abdomen (flanks), hips, thighs... other areas would be performed simultaneously.
Dr Stein

Brian K. Reedy, MD · Answer

Yes, it’s a relatively common and more conservative approach, though it's not universal. Some surgeons are more cautious about combining full abdominoplasty (tummy tuck) with liposuction to the upper abdominal flap (the area above the belly button that’s lifted during the tuck) because of, concerns about blood supply.

The upper flap is lifted off the abdominal wall and pulled down during a full tummy tuck. This dissection can compromise blood flow to the flap.

Adding liposuction on top of this (which also disrupts blood vessels) increases the risk of tissue necrosis, wound healing issues, or delayed recovery.

So, your surgeon is likely prioritizing safety and predictable healing, especially if they’ve seen complications before or just prefer to err on the side of caution.

Yucel Sarialtin, MD · Answer

Hello,
Thank you for your question.
Your surgeon’s approach of avoiding liposuction on the upper abdominal flap during tummy tuck is a more conservative and traditional method aimed at preserving blood supply and reducing complications. Some surgeons now combine advanced liposuction techniques with tummy tuck in a single procedure, but this depends on individual patient factors and surgeon expertise. While combining both can enhance contouring and reduce the need for a second surgery, it may increase operative time and risks. It’s important to weigh the benefits against potential complications, anesthesia concerns, and recovery. Discussing your priorities and risks thoroughly with your surgeon will help decide the safest and most effective plan tailored to you.

Jeffrey M. Darrow, MD · Answer

It is common place to combine liposuction with a tummy tuck. Originally tummy tucks involved a surgical separation of the abdominal skin flap from the underlying fascia/muscle.  This divided ALL of the blood vessels which normally run between the fascia/muscle of the abdomen and the abdominal skin flap.  This decreased the blood flow to the abdominal skin flap and people avoided doing liposuction of the abdominal skin flap because the trauma of the liposuction would injure the blood vessels in the skin flap and result  in inadequate blood supply to keep the abdominal skin flap alive.  It is now well known liposuction of the entire abdomen can be done, then an  abdominoplasty can be done as long as the abdominal skin flap is not surgically separated from the fascia/muscle. The liposuction allows the abdominal skin flap to move freely, but while it thins the tissues to improve the contour, it leaves intact the blood vessels running between the fascia/muscle and the skin flap and leaves the skin flap with a better blood supply.  This would allow you to have a single operation with thinning of your tissues by liposuction and resection of excess skin by a tummy tuck and have a single recovery. Your cost would also be lower. Best wishes.

Robert M. Wald, Jr., MD · Answer

You can definetely do a tummy tuck and upper abdominal liposuction at the same time. Every doctor is different and their views on surgical procedures is based on their experience. I believe most surgeons would do both at the same time. Safety is the key to any procedure and discuss this with your surgeon.