Tummy Tuck After Umbilical Hernia Repair with or Without Lipo? Second Opinion For Second Hernia. (photo)

I had an umbilical hernia repaired last year and I now have another hernia right above the previous one. I have decided to have a full tummy tuck with the hernia repair. I’ve consulted with a few plastic surgeons and I am confused because some recommend lipo with the tuck and others said I don’t need it. Advice?

Doctor Answers 7

Liposuction with tummy tuck?

There is only so much one can tell from a photograph.  You appear to have a well-healed hernia incision and some roundness or protruberance of your abdomen.  There does not appear to be any significant loose or sagging skin, and I don't see a hernia.

A good physical exam would determine the presence of a hernia, whether there is a significant diastasis recti (separation of the sit-up muscles), and whether there is a significant amount of subcutaneous tissue or fat. 

Umbilical hernia can certainly be performed in conjuction with a tummy tuck.  Your abdominal muscles can be tightened which will flatten your abdomen.  If there is significant abdominal fat (which is often the case in the midline of the upper abdomen), then conservative liposuction would also be called for. 

The exact plan for the surgery needs to be determined after a good exam and consultation with a board-certified Plastic Surgeon.

Cleveland Plastic Surgeon
4.6 out of 5 stars 18 reviews

Liposuction and tummy tuck and hernia repair

Thank for your question and the photos. I have to say that even with these good photos, clinical examination is required to answer you questions. There is some fullness of the waist and this can be determined more accurately with clinical exam using pinch test. If that is the case then liposuction will improve your outcome. As for the umbilical hernia, again physical exam will help to determine that and if present, it can be treated at the same time. 

Moneer Jaibaji, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 15 reviews

Lipo vs No Lipo

Nothing takes the place of a good physical exam.  Based on your description and photos I would recommend that you have your hernia readdressed first.  Then if you are a candidate for abdominoplasty then that procedure can be performed and based on your current photos I would not perform liposuction.  

Dr. ES

Lipo with tummy tuck? Is it necessary?

You are confused because you rightly understand that if lipo is recommended as "part-of" a tummy tuck it makes no sense to turn fatty tissue into "swiss cheese" by removing some of the fat via liposuction, and then surgically excising it! I doubt, however, that this is what any of your plastic surgical consultants is recommending.

Some might recommend liposuction for the upper abdomen, as this area sometimes remains a bit "poochy" even after a good tummy tuck with muscle repair (which will  repair your additional hernia, and reinforce your previous umbilical hernia repair). Some plastic surgeons may recommend avoiding liposuction of this area to minimize the potential for damaging the blood supply to the lower abdominal skin, whereas other may safely perform some specific flap-thinning maneuvers during the tummy tuck. Ask details and reasoning for more understanding.

Other plastic surgeons may be recommending liposuction of the hips or flank areas to further improve on your abdominal contour and overall results. Again, circulation can be a concern for some areas, and skill, precision, and experience are needed to obtain good outcomes when this is advised. Others may simply recommend tummy tuck alone, decreasing complexity, risk, and cost. (And perhaps results)

There are plenty of opinions out there, as there are many different skill and experience levels among surgeons. Also, remember "need" is relative; most surgeons try to balance best outcomes with risk, time, and cost, just as you should. Make sure you are seeing American Board of Plastic Surgery-certified plastic surgeons, not someone who is "board-certified" in a specialty that has little or nothing to do with plastic surgery, or a "bogus board" that is not a member of the ABMS (American Board of Medical Specialties). Best wishes!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

Tummy tuck with or without liposuction

The way your question is phrased we can't tell if the liposuction is considered a second procedure, or a part of the tummy tuck. Many of us do use liposuction as a tool during tummy tuck to smooth out the hip or waist, or to smooth the transition over the hip, all included with the tummy tuck procedure. Is is needed? More for some than others though it is a simple step to an improved result when needed. Additional charges are a red flag.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews

Liposuction with Tummy Tuck?

Thank you for the question and pictures.

I would not let the different recommendations regarding liposuction surgery confuse and/or stress you. Liposuctioning is just a tool that can be used to improve the contour of the flanks and/or mid abdominal wall area. It is a tool that is commonly used during a variety of body contouring surgery including tummy tuck surgery.

I would suggest that you select your plastic surgeon carefully and allow him/her to use whatever tools necessary to achieve the best results possible.  Make sure you communicate your goals and “trouble areas” clearly.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Full Tummy Tuck Without Liposuction

The role of liposuction in tummy tucks is largely for reshaping the waistline outside of the effects of the tummy tuck. Based on your photos, I see little benefit to lateral waistline or flank liposuction in your case. In a limited tummy tuck, it can also be used for upper abdominal fat reduction. Given that your are going to have a full tummy tuck, a good choice to have the most assured method of permanent hernia repair, liposuction would not be a useful part of your abdominal reshaping. 

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 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.