My Surgeon Told Me To Get My TT and Lipo Separately, Is This Normal?

My surgeon says he won't be performing liposution while he is doing my tt, he says I can have lipo later, is that normal.

Doctor Answers 14

Liposuction - Can It Be Performed at the Same Time as a Tummy Tuck (TT)?

Hi bell65 in Australia,

There are several different issues here but the over-riding factor is that excessive liposuction of the central flap of the tummy tuck (ie, the tissue that remains behind and is pulled tight) risks compromising the blood supply to that tissue.  That can lead to wound infections, tissue necrosis, secondary wound healing and all sorts of complications that can range from minor to nearly debilitating.  So, in general, a procedure or habits (such as tobacco smoking) or medical conditions (such as diabetes) that can impair blood flow increase the risks of a tummy tuck.  I typically avoid lipo in that region, or will do just a small amount of direct fat removal.

Lipo of other regions (such as outer thighs, or hips, but not anything that provides blood supply to the flap) can be performed safely.  I almost always wind up doing lipo on one or more areas aside from the tummy tuck (TT) specifically.

There is also a limit to the amount of fat (and surgery) that can be performed safely at any one time, and a lot of that assumes that you're in generally good medical health.  That amount of fat varies but is often limited to about 5000 cc's (or 5 liters) of fat, though it should really be different amounts based on the patient's overall size (or BMI, or something equivalent).  This, too, is something that you'll need to discuss carefully and specifically with your own surgeon (ie someone who can see and examine you in person and can take all of these factors into consideration).

So - can it be done at the same time?  Yes...depending on exactly what you're talking about.

I hope that this helps, and good luck,

Dr. E

New York Plastic Surgeon
5.0 out of 5 stars 125 reviews

Liposuction combined with tummy tuck

Liposuction can be combined with a tummy tuck at times.  Liposuction should not be performed in the central abdominal area at the same time as a tummy tuck due to the risk of skin necrosis.  Liposuction of the flanks or lower extremities is frequently combined with tummy tuck in carefully selected patients.

Andrew P. Giacobbe, MD
Buffalo Plastic Surgeon
4.9 out of 5 stars 23 reviews

Separating procedures

Here in Florida, there's actually a legal requirement:  if you are performing a tummy tuck in an office-based facility, you can not legally perform more than 1 liter of liposuction at the same time.   

So, if patients have more than a liter of fat to be removed, they can either pay significantly more to have their surgery done at the hospital, or break it up into two operations.  Neither option is particularly appealing to patients.

That being said, I routinely do some (less than 1 liter) liposuction of the waist ("love-handle" area) at the time of tummy tuck, for patients that would benefit.  It helps to give a beautiful hour-glass contour!

Thomas Fiala, MD
Orlando Plastic Surgeon
4.9 out of 5 stars 79 reviews

Can You have Liposuction and Tummy Tuck together?

  This is a difficult question to answer without seeing you in person, as your plastic surgeon did.  He may be concerned over the amount of liposuction that you may need in order to get really good results.  Performing too much liposuction at the time of a Tummy Tuck procedure can damage vital blood vessels which can impair healing and results of the tummy tuck.  We often perform liposuction at the same time as a tummy tuck procedure in order to improve the results of the contouring procedure.  However, too much is not always better and you will have to trust you plastic surgeon.   As always, you should always go to a board certified plastic surgeon and if you don't feel comfortable with your surgeon, then get another opinion.  Hope this helps- Erez Sternberg, MD.

Erez Sternberg, MD
Jacksonville Plastic Surgeon
4.9 out of 5 stars 32 reviews

Simultaneous liposuction and tummy tuck.

It is possible to combine liposuction and a tummy tuck most of the time.  This is determined by how much liposuction needs to be performed and where.

The best advice is to consult with another or several other plastic surgeons to make sure you feel comfortable with your surgeon's plan.

Richard H. Fryer, MD
Salt Lake City Plastic Surgeon
4.9 out of 5 stars 271 reviews

Depends where you are going to have the liposuction

I almost alwayscombine  liposuction with an abdominoplasty (TT) but not on the abdominoplasty flap.  If you have liposuctioning done on the abdominoplasty flap you may comprimise the circulation to the incision.  Liposuctioning on the sides - gives a well shaped waist line

Hilton Becker, MD
Boca Raton Plastic Surgeon
4.6 out of 5 stars 15 reviews

Tummy Tuck and Liposuction in ONE or TWO Procedures

A tummy Tuck involves:
- undermining of the tummy skin as much as is needed
- correction of tummy muscle laxity and separation AND
- removal of the excess skin

The blood supply to the REMAINING Tummy Skin is the most important predictor of proper healing. If enough damage was done to the blood supply or to an already damaged blood supply (as may be seen in smokers, people with certain diseases such as Lupus or Scleroderma etc), the balance may be tipped to skin death and wound separation.

 As long as the tummy skin undermining is minimal AND the blood supply to the skin is minimally compromised by liposuction, liposuction MAY be safe to do in some Tummy Tuck cases (Mini Tummy tucks, certain Brazilian Tummy Tuck methods where there is no undermining of skin more than a few fingers on either side of the midline etc). However, in cases of severe skin laxity when a lot of undermining needs to be done (and the blood supply is compromised) performing aggressive liposuction (with FURTHER damage to the skin blood supply) may assure major complications.

Performing Liposuction of the Tummy Tuck undermined areas in another later procedure is always a safe alternative and needs to be considered.

Dr. Peter A Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 108 reviews

Liposuction with Tummy Tuck

Most surgeons have been taught to not do Liposuction of the abdomen with Abdominoplasty because of fear of reducing the blood supply to the abdominal flap. If the blood supply is compromised, the risk of wound healing problems markedly increases. However, new techniques that preserve the blood supply better have allowed liposuction of the abdomen at the time of Tummy Tuck. As of now, there few surgeons comfortable with these techniques, If the surgeon you have talked to gets good results and you are otherwise comfortable with him or her, then you are probably much safer listening to the advice given. 

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 6 reviews

Liposuction and tummy tuck at the same time

Most plastic surgeons do some liposuction at the same time as a tummy tuck.

However, doing large volume liposuction at the same time as a tummy tuck increases the risk of complications, including blood clots.

It is a judgment call based on the amount of liposuction needed, the patient's physiology, their health, and the acceptable risk vs. the anticipated results.  That's where experience comes in.

It sounds as if your surgeon is suggesting a very safe course.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 177 reviews

Liposuction and Tummy tucks: See Video Below

Generally speaking it is not wise to lift and lipo the same areas. It is too much trauma. However, varying degrees of liposuction of non-lifted (undermined areas) can be accomplished. This determines the type of tummy tuck which is performed. I have broken these down into four types to illustrate the differences and the areas of liposuction and call them the micro, mini, midi and maxi (Four M's)

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 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.