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

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.

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.

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.

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.

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.

Some plastic surgeons will not liposuction the upper flap in any situation. This is perhaps the safest approach to assuring the best possible blood flow of the lower flap. We do know that in many circumstances the blood flow of the lower flap can be excellent with liposuction, which may be modified to the particular situation. I think it is prudent to not to any liposuction in smokers and probably past smokers and anyone with significant scars. Therefore, it depends on the surgeon and the circumstances of a given patient.

Thank you for your question. As a Total Definer plastic surgeon, I liposuction the whole abdomen with my tummy tucks. It is a myth that one cannot liposuction the upper abdomen. The surgeons who still believe that, should read the aesthetic plastic surgery literature, upgrade their techniques and improve their techniques. I routinely do VASER liposuction 360 degrees with my tummy tucks to create youthful, athletic bodies with an hourglass figure. See a board certified plastic surgeon with extensive experience in advance body sculpting techniques for an in person consultation/evaluation. Although there's nothing wrong what your surgeon suggested to you, this is accomplished in one surgery. Other reasons why one might choose to do it this way is because their BMI is high (not a good candidate for a tummy tuck anyways) or they have limited funds they want to invest into themselves. See other surgeons for consultation. Good luck.

The short answer is it depends. I routinely perform liposuction in my tummy tucks, as do many surgeons. However, this is generally more focused to the flanks and lower back. Central abdominal liposuction is often for contouring/shadowing. If patients have excessive fat deposits of the upper/central abdomen I generally counsel them that while modest amounts of liposuction can be done at the time of the tummy tuck, they are likely to have persisting fullness after the tummy tuck. This is because too aggressive of this liposuction combined with a tummy tuck can significantly increase the risk of wound healing complications. While most patients would prefer to avoid 2 procedures, the trade off of trying to be too aggressive in a single operation and ending up with a wound can be even more problematic.
Sean M Fisher, MD Aesthetic Plastic SurgeonSeattle, WA

Thank you for your question. Liposuction and tummy tuck are procedures that many surgeons perform in combination. However, there are caveats and many surgeons are more aggressive with liposuction along the sides and flanks of the abdomen while doing very little to nothing in the upper portion of the abdomen when combined with tummy tuck for safety reasons and to prevent wound healing problems. A discussion with a board-certified plastic surgeon will help explain their reasoning behind it, and always remember that safety is paramount for this operation. Good luck on your journey!

It is common and considered safe to combine a tummy tuck with liposuction but there are limits. Liposuction of the upper abdomen is generally avoided at the time of a tummy tuck due to blood flow concerns. Disruption of the blood flow can lead to wound healing problems and necrosis. Liposuction of the hips and flanks is not affected and can safely be combined with a tummy tuck.