I'm considering a tummy tuck. The Dr I have seen for a consultation does not do preform Lipo at those of tummy tuck? (Photos)

I'm worried about this back roll or muffin top I keep heating about . I'm not expecting to be a bikini model after surgery but I don't want it to look weirder that it did before.

Doctor Answers 15

Abdominoplasty and Liposuction


There has been much ado about the safety of combining an abdominoplasty with any other procedure, including liposuction. There is very good data to show that doing so does not change your risk of complications or danger. I can understand some of my colleagues not wanting to perform extensive liposuction on multiple areas, which would substantially increase operative time, but performing liposuction on the hip/waist area has almost become part of the abdominoplasty for many of us who specialize in body contouring. Your photos indicate you are in great shape, and that liposuction would give you a nice improvement. I think you need to find another surgeon who is an ABPS certified/ASAPS member that does this regularly. Additionally, find a surgeon who embraces these points: 1. The long incision needs to be very low, at the thigh/abdomen border laterally, and no more than 2 cm above your labial commissure at the pubis. If the hole where the belly button was attached can not be excised with the extra skin, then vertical closure of the hole is far superior to placing the big incision too high. 2. Removing the deep fat of the abdominal flap, which will improve circulation to the skin and optimize definition. 3. The use of progressive tension sutures (PTS) for optimization of flap tension and elimination of the need for drains. Best of luck!

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 90 reviews

I'm considering a tummy tuck. The Dr I have seen for a consultation does not do preform Lipo at those of tummy tuck?

If the patient does suffer from fat collections there are areas of the trunk and back that can safely be liposuctioned at the time of a tummy tuck but other areas would possibly risk circulatory compromise and major complications.  The hip rolls or "grab handles" are an area that can safely be liposuctioned and usually contribute to the muffin top that women complain about.  The upper mid back region under the bra strap is an area that should be avoided at the time of a tummy tuck for safety issues.  I hope that this helps you.  Good luck with your procedure and enjoy the results since you do appear to be an excellent candidate for tummy tuck.  There is more information in the video linked to above that you will find useful.

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 31 reviews

Tummy Tuck and Liposuction

Liposuction is a commonly performed compliment to the TT procedure and safely done thousands of times a year throughout the country. I'm sure your surgeon has a good reason for his/her choice so you need to decide if you want to stay with that surgeon or get another consultation elsewhere. Perhaps the surgeon simply thought you didn't need liposuction.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

Liposuction at the time of a tummy tuck

Most experienced plastic surgeons will perform liposuction of selective areas like the flanks at the same time as a tummy tuck in the appropriate patient.

Keep in mind that following advice from a surgeon on this or any other website who proposes to tell you what to do without seeing photos and more importantly without examining you, physically feeling your tissue, assessing your desired outcome, taking a full medical history and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest that you get a second opinion from a surgeon certified by the American Board of American Plastic Surgery and one who is ideally a member of The American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

Tummy Tuck w/Liposuction?

Thank you for your question and photos. Although we often combine liposuction and abdominoplasty, there are cases in which this approach is not indicated. In patients that have excessive skin/soft tissue laxity, liposuction may actually worsen the problem by removing 'supportive' fat. Your posterior photo appears to show that you have very little fat excess, but significant skin/soft tissue laxity common with large volume weight loss. This is only corrected well by excision, often with an extended abdominoplasty procedure. It would take an in-person exam to be certain, but I believe that this is the case. I would discuss this option with your plastic surgeon, and obtain additional consultations if needed to obtain more information. 

Michael F. Bohley, MD
Portland Plastic Surgeon
4.9 out of 5 stars 18 reviews

Tummy tuck

Hi, thanks for sharing your concern with us! I defitnly recommend you to get a tummy tuck, Back and waist liposuction and BBL, this procedure is very common in aesthetic procedures, but first all the medical evaluation and laboratory exams need to be done and well. with this procedure you will get beautiful results.

The reason of you can't get a liposuction In your abdomen is that you have a lot of extra skin in your abdomen, and your abdominal muscle needs to be repaired.

Have a nice Day! :)

Jean Paul Giudicelli Saba, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 15 reviews

Safety of liposuction with tummy tuck

Safety is of primary concern when performing operations such as tummy tucks and liposuction. These are medically unnecessary procedures that are only being performed to enhance your appearance. Thus one cannot justify performing these types of procedures if there are major risks. Many factors enter into risks for complications including underlying health, age, time required for the surgery, type of anesthesia, and extent of the surgeries. Your surgeon will take these all into consideration to determine what is safe for you. In most cases limited liposuction can be safely performed in conjunction with a tummy tuck but all doctors are guided by the principle of "first do no harm."

Wayne I. Yamahata, MD
Sacramento Plastic Surgeon
4.9 out of 5 stars 47 reviews

I'm considering a tummy tuck. The Dr I have seen for a consultation does not do preform Lipo at those of tummy tuck?

Liposuction of the abdomen, hip handles and mons pubis area performed appropriately at the time of a tummy tuck is performed frequently by well trained experienced plastic surgeons.

Fred Suess, MD (retired)
San Francisco Plastic Surgeon
4.5 out of 5 stars 8 reviews

Your tummy tuck doesn't require liposuction

but you could benefit from having liposuction of your flanks along with your tummy tuck.  And this is safely done with studies to support combining procedures.  Ask your surgeon if he will do this and if not, there are plenty of other surgery within driving distance that will gladly accommodate your request to help achieve the best outcome possible.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

I'm considering a tummy tuck. The Dr I have seen for a consultation does not do preform Lipo at those of tummy tuck?

Thank you for the question.

Generally speaking, liposuction is a tool that is often used during the time of tummy tuck surgery. Different plastic surgeons utilize this tool differently; some are more “aggressive” than others. In my practice, I frequently utilize this tool to treat adipose tissue of the flanks and pubic areas during the tummy tuck procedures.

In your case specifically, whether or not you should undergo liposuction surgery will depend mainly on your goals;  if you are concerned about adipose tissue of the flank or back areas, best to have the liposuctioning performed. 

 I would suggest you spend additional time discussing your goals, plans, and expectations directly with your plastic surgeon (and/or seek second opinion consultations), in front of a full length mirror.  Working together you will come up with the best plan to achieve the desired outcome.

  I hope this, and the attached link, helps.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,498 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.