Tummy Tuck vs. Lipo - thoughts? (Photo)

A tummy tuck combined with flank liposuction is often considered the best option for individuals looking to achieve a more sculpted and toned midsection. The tummy tuck addresses excess skin, particularly in the lower abdomen, which liposuction alone cannot resolve. It also tightens and strengthens the abdominal muscles, especially if there has been muscle separation (diastasis recti) due to pregnancy or weight changes. Flank liposuction helps to remove stubborn fat deposits from the sides and back, which often create the appearance of "love handles." When combined, these two procedures provide comprehensive abdominal contouring, as the tummy tuck smooths out the abdominal area, while liposuction refines the waist and back. This combination ensures a more balanced, hourglass shape, with both the skin and fat addressed for a dramatic, long-lasting transformation. Additionally, this dual approach minimizes the risk of loose skin after fat removal, which can sometimes occur with liposuction alone.
It is important to consult with an experienced plastic surgeon who can customize your surgical plan and determine the best technique for you based on your individual anatomy and goals.
Krishna Vyas, MD, PhD, MHSHarvard, Hopkins, & Mayo Clinic Trained Aesthetic Plastic SurgeonNew York, New York

Hello, littlebowpeepboob, thank you for your history and questions regarding whether you need a tummy tuck or lipo. Most plastic surgeons would agree that you need an abdominoplasty or tummy tuck. You have too much excess abdominal skin for a successful tummy liposuction. Even if you use state-of-the-art VASER liposuction with radiofrequency (RF) for maximum skin contraction, you will still probably be left with tummy wrinkles and hanging skin. Therefore, you would be a much better candidate for an abdominoplasty or tummy tuck. During an abdominoplasty or tummy tuck, an incision is made underneath your abdominal skin fold, and tissue dissection is carried up to the rib cage. Your rectus abdominis muscles are plicated. The skin and fat from the top of the pubic region to the bottom of the belly button are removed. The belly button is reconstructed. The pubic region is raised and reduced. You could do additional liposuction in the upper abdomen and the flank region to maximize your abdominoplasty. However, if you only have tummy liposuction, you will be left with excess abdominal skin. I hope this helps you to clarify what surgery will be best for you. Again, most certified plastic surgeons would suggest undergoing abdominoplasty or tummy tuck and not just lipo of the abdomen. Good luck. Most plastic surgeons offer free virtual or in-office physical consultations. Therefore, explore what other plastic surgeons have to say. If you have any more questions regarding tummy tucks, abdominoplasties, or abdominal liposuction, contact an experienced plastic surgeon. Since the tummy tuck surgery is a big procedure, please seek an experienced, board-certified plastic surgeon with significant experience in performing tummy tucks. Do your research. If you cannot find an experienced tummy tuck plastic surgeon in your neighborhood, consider traveling out of state. Sincerely, Dr. Katzen, MD, MBA, FACS, FICS. ( Plastic Surgeon, President of the American Society of Bariatric Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

Dear littlebopeepboob,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

The answer to your question would depend on your postoperative expectations. I will include a video in hopes that it helps to answer some of your questions. Best of luck to you!

According to your photographs, you have excess skin, especially in your lower abdomen, and excess fat around your abdomen. You can achieve a very good result with liposuction and tummy tuck. If only liposuction is performed, there is a high probability that you will go for a tummy tuck in the future due to the excess skin.
Best Wishes
Erman AK M.D.

Hello; your abdominal skin quality is poor. Your upper abdominal skin is very loose. Your belly button; took a horizontal shape. There is sagging in the lower abdomen zone. You have fat; in both your lower and upper abdomen fields. In this case, if related fat is removed from your abdominal area; wrinkles will appear on the upper abdomen; the belly button will take on the appearance of a "sad belly button" and your lower abdominal skin, will sag more. This cannot be prevented from devices; such as "Renuvion J Plasma or Bodytite". The best option for you is "Lipoabdominoplasty". Thus, you will get rid of from both your excess fats and sagging abdominal skin. Mini Tummy Tuck, is not a good option; because, it does not provide for a solution way; for the looseness in your upper abdominal skin area.

You appear to have loose skin in the mid section. For this reason, a tummy tuck would probably be more suitable for you.

Given the fact you presumably do not have muscle laxity or diastasis, you are a great candidate for liposuction with a mini-tuck. I would also consider umbilical transposition to address any skin laxity above your umbilicus. All done with oral sedation and local tumescent anesthesia, no drains, reasonable down time. Thank you!

Hello, thank you for your recent question and photos. Liposuction would reduce your fullness but could leave you with loose skin. Your home run result would be to do a tummy tuck with liposuction to your waist, post hips and braline. This would tighten all the loose skin and bring in your waist. However, if you plan on having kids in the future I recommend to either do just liposuction or only a tummy tuck to remove lose skin no diastasis repair. Best of luck!

You already have horizontal creases in your frontal view and excess hanging skin. Liposuction would make the situation worse. You would benefit from a tummy tuck. If you are not planning future pregnancies, I recommend abdominoplasty with mesh reinforcement. The mesh creates a more hourglass figure by compressing the abdominal wall resulting in early satiety and helps maintain a reduced weight.

Best Wishes,

Gary Horndeski, M.D.