Is a smooth tummy tuck worth it?

Question

Very excited to hear about this new operation. Because no muscle repair is done, aggressive lipo can be done followed by a much smaller scar above the bikini line. Down time is only one week. Is it too good to be true? I've seen it on several T.V, shows. I was going to have a full TT, but may wait for the procedure to come to Canada. Thoughts?

Richard H. Tholen, MD, FACS · Answer

Your understanding of the promotional hype is accurate. Unfortunately, not doing a muscle repair has nothing to do with blood supply to the abdominal skin and "permitting" aggressive liposuction. Let's be clear about what is what. "Smooth Tuck" is a marketing term that is applied to a specific combination of liposuction with a "no umbilical transposition or incision" and "no muscle tightening" short-incision mini tummy tuck. Some patients may undergo umbilical "float" when more skin is removed. But in no Smooth Tuck case is the amount of skin removed similar to the greater degree of skin removal and tightening accomplished with a full tummy tuck. Less skin removal = less improvement = less concern about circulation = opportunity to call this "something new and improved!"

	Basically this operation is aggressive abdominal and flank (hip rolls, or love handles) liposuction. This liposuction empties out the overlying skin, which is too loose or inelastic to shrink down appropriately for the degree of fat removed, so a (small) chunk of skin is removed to take-up some of the slack. Review of the "Smooth Tuck" before and after photographs on this plastic surgeon's website clearly show obese patients that have pretty dramatic liposuction results for which a variable degree of skin removal has been made necessary by that liposuction. I find it a bit disingenuous that EVERY patient's "AFTER" photograph shows the patient in underwear or elastic panty that completely covers whatever skin incision and/or residual irregularity or skin laxity remains. And, as with all of our patient photography, the ones shown generally represent the "best" examples, not the "average" results.

	To be sure, these results seem pretty good, even in clothing, but at the quoted price of $10000, which is supposedly "a bit less expensive than a standard tummy tuck," most plastic surgeons will be able to perform a full and complete tummy tuck, which should yield better results for most of these kinds of patients.

	Neglecting the muscle repair, which is such an important part of tightening and flattening the stretched abdominal wall, and removing only the lower bit of excess skin (similar to a panniculectomy) rather than making an incision around the belly button to release and allow breastbone-to-pubic bone skin tightening is really falling short of the potential improvement available, and it costs the same or more than a full tummy tuck.

	As to the claim of "less downtime," each patient still has an incision to heal, and major liposuction to recover from. This recovery takes the same time regardless of the "name" attached to the procedure! The only additional restriction that I would have my tummy tuck patients observe is "No sit-ups or crunches" for 6 weeks after surgery. Otherwise, any tummy tuck patient will recover just as fast (or slow) as the Smooth Tuck procedure patients.

	I say these things not to condemn the plastic surgeon who is doing this procedure, and is enough of a "marketer" to name and obtain media exposure for what any board-certified plastic surgeon already does each and every week with their patients. Unfortunately, you, and probably many others, are ready to avoid what is the appropriate procedure and experienced advice, in order to "wait" until this "new operation" (NOT) comes to Canada. Here's the sad news: this procedure has already been in Canada and the US for many years; it just hasn't had this name and it hasn't been promoted as being able to replace tummy tucks with a faster, better, and quicker-recovery (did I forget to say "more expensive") operation. Fads and hype names will continue to come and go.  See an experienced ABPS-certified plastic surgeon for good advice--get several opinions if something seems out of line or "too good to be true!"

	Or maybe I really should start marketing the Dr. Tholen "PowerLift!"

Jonathan Saunders, MD · Answer

You are right. too good to be true. a good tummy tuck involves skin , fat and muscle.  if all three are not addressed, you will be losing something in the long run. operations seen on tv as a general rule should be looked at with some skepticism

Mathew C. Mosher, MD · Answer

The term "Smooth Tuck" was recently discussed on "The Doctors" and other talk shows. The surgeon suggested that he developed this procedure which is at best an exaggeration. Essentially this modified abdominoplasty or "tummy tuck" improves the torso shape by performing circumferential liposuction in combination with a vertical tightening of the skin without a repair of the underlying muscle laxity. This option has been considered and when appropriate offered to patients for decades by Plastic Surgeons. However, most patients seeking rejuvenation of their abdomen do have muscular laxity or diastasis that when repaired this step improves the results from a "tummy tuck". The recovery is easier when the muscles are not tightened but the incision length is the same length and in the same location. If you have a thick fat layer then liposuction can be considered at the time of your "tummy tuck" or done as a first of two procedures to maximize your safety and your final results. A  "mini tummy tuck" usually refers to the removal of the excess skin and fat layer in the lower abdomen only.

	If you are significantly overweight or have medical problems that make you a poor candidate for elective surgery then any surgery should be postponed until your health is optimized. This variant of combining liposuction with a modified abdominoplasty can be a good option for selected patients but should not be viewed as a "safer" alternative to traditional abdominoplasty with or without liposuction. Speak with your Plastic Surgeon about what procedure or procedures will give you the results you are looking for.

	Dr. Mosher

Richard Baxter, MD · Answer

Regardless of the terms used, if the muscles are separated (called a diastasis) then they should be repaired with a tummy tuck for a good result. There is nothing about not doing muscle repair that enables more fat to be removed. t is a good idea to see more than one plastic surgeon experienced in abdominoplasty before deciding.

Craig S. Rock, MD, FACS · Answer

The smooth tuck is essentially a traditional mini tummy tuck, increasing the volume of fat liposuctioned.  It is marketed as good for patients "too obese" for a traditional tummy tuck.  If you require tightening of the abdominal fascia ("muscle repair") based on your current appearance, skipping this step will have a negative impact on your surgical result.  I would recommend consulting with a Board-Certified Plastic Surgeon to determine which procedure is appropriate for you.

	Good luck

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Is a smooth tummy tuck worth it?

Answers (9)

Answer: Muscle repair usually necessary for good tummy tuck results

Answer: Muscle repair usually necessary for good tummy tuck results

Answer: Smooth tuck vs. Tummy tuck

Answer: Smooth tuck vs. Tummy tuck

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Our mission is to create a world where every investment in modern beauty is Worth It.