Tummy Tuck Consultation?

The doctor said he doesn't perform liposuction on the abdomen with tummy tuck because it results in severe skin damage. He said he thins out the fat layer and by pulling the skin, the end result would look the same as having liposuction done as well. If I do an extended tummy tuck, can doctor lift my hips so the sides of my butt would look higher? By just tighten the muscles and pull the skin, would I still get a defined waist at the end with no lipo? (5'2"/135)

Doctor Answers 13

With Body Contouring, You Have Options!

Traditionally, liposuction was not combined with skin removal procedures such as tummy tucks because of concerns about the blood supply to the skin.  This has changed recently.  Limited liposuction of the flanks has been routinely used with tummy tucks by most surgeons for sometime, but recently more extensive liposuction has been safely performed as part of a lipo-abdominoplasty.  It benefits patients by contouring the entire trunk and improving waist definition if there is excess fat.  A extended tummy tuck or circumferential body lift is another alternative that removes more skin and fat simultaneously.  This procedure is helpful in lifting the outer thighs and buttocks while defining the waist in patients with loose skin.  Unfortunately the scar will be longer, but easily hidden under underwear if placed appropriately.  Both procedures are very safe and effective in the hands of an experienced surgeon in a healthy patient.  Be sure to ask to see before and after photos for both procedures and to discuss the pros and cons of each procedure in someone of your height and weight.

Fairfax Plastic Surgeon
4.6 out of 5 stars 54 reviews

Body lift versus tummy tuck


Thank you for the question.  I perform liposuction in the majority of the tummy tuck patients since I feel like this allows the tummy tuck results to blend into the surrounding areas.  Its not always necessary but it is helpful.  If desire your hips and buttock to be pulled up at the same time you will need to entertain the idea of a lower body lift which is a tummy tuck but the incision continues all the way around the waist allowing elevation of the hips and buttocks.

All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 162 reviews

Combining liposuction with a tummy tuck can work for you

I frequently combine liposuction of the hips/flanks/love handles with a tummy tuck.  Liposuction of the neck, breasts, arms, and thighs can also be done safely with a tummy tuck.  In order to make your buttocks higher, I would recommend a body lift or circumfirential tummy tuck.  I frequently use this approach to flatten the belly, to provide a much more narrow waist, and to perform a buttock lift.  It's hard to tell you the best procedures to meet your aesthetic goals without photos or seeing you in person, but I am located in Baltimore which is pretty close to you. Thank for your question!  Dr. Schreiber, Baltimore Plastic Surgeon

Jeffrey E. Schreiber, MD, FACS
Baltimore Plastic Surgeon
5.0 out of 5 stars 202 reviews

Tummy tuck

Dear MD2012,

    Tummy tuck and liposuction are 2 completly different procedures. Liposuction only thins the skin and tummy tuck,  if done correctly , tightens the skin and muscles and narrows the waist. With tummy tuck procedure , there is high likelyhood that you will lose weight due to the muscle tightening which increases the intra abdominal pressure. This reduces hunger and limits the amount of food that you can eat. In my practice I do not perform liposuction at the time of tummy tuck due to the increase risk of damage to the circulation of the skin that can result in skin loss or wound healing problems.  If my patients request additional thining of the skin, liposuction is performed 6-8 weeks later. Cosmetic surgery is purely elective and  additional risk should be avoided. Be sure to consult with an experienced board certified plastic surgeon and check their before and after results.

                          Best of luck,

                                                   Dr Widder

Shlomo Widder, MD
McLean Plastic Surgeon
4.8 out of 5 stars 124 reviews

Tummy tuck and liposuction

Thank you for an excellent question. In the past, it was thought that liposuction and tummy tucks should not be done at the same time. This was due to a fear of lessening the blood flow to the abdominal skin and compromising the healing. This has changed over the last several years. 

Tummy tucks are now done routinely with liposuction, and there are several studies that show its safety. The addition of liposuction allows better contouring of the flanks and love handles. It is difficult to get this type of result with a tummy tuck alone, though you should discuss this with your plastic surgeon.

If an extended tummy tuck is done, or perhaps a circumferential body lift, the buttocks can be lifted. The trade-off will be a longer scar. Tightening the muscles will help with waistline definition, but liposuction will further the result in many cases.

Best of luck with your tummy tuck

Jeff Rockmore

Jeffrey Rockmore, MD
Albany Plastic Surgeon
4.9 out of 5 stars 67 reviews

Tummy tuck with liposuction

We have routinely performed liposuction on the sides flanks during a tummy tuck to help contour entire abdomen.  It is unsafe to liposuction the superior area if abdomen during this surgery .  Good luck 

Sanjay Lalla, MD, FACS
West Orange Plastic Surgeon
4.8 out of 5 stars 48 reviews

Liposuction At The Same Time As A Tummy Tuck

Dear MD2012,  To liposuction or to not liposuction with an abdominoplasty really depends on two things; the needs of the patient and the comfort level of the surgeon.  When I was in training, it was considered dangerous to liposuction at the same time as a tummy tuck.  But, things change and many studies demonstrate the safety of performing the two procedures together if you remember where the blood supply is coming from to support the flap.  Today, I almost always perform some liposuction with a tummy tuck to shape and contour the abdomen and waistline.  I have done this for years without any significant injuries to the abdominal healing.  If the patient has significant fullness in the upper abdomen, there is no amount of stretching and pulling that will adequately thin the abdominal flap to obtain the desired result.

Even with the most aggressive extended abdominoplasty, I do not envision much lift to your buttocks.  This usually requires a lateral thigh/ buttock lift which requires a different positioning of the patient on the OR table.  

These are great questions and something to discuss with your plastic surgeon during your consultation.  Hope this helps. 

Herluf G. Lund, Jr, MD
Saint Louis Plastic Surgeon
4.7 out of 5 stars 83 reviews

Liposuction is often routine during tummy tuck

It is true that the skin flap can be thinned from underneath, though many find liposuction during tummy tuck, especially over the hip and flank very safe and effective. The definition you see in the waist might depend on the amount and direction of the skin laxity and your surgeon will give you the best advice.

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

Liposuction of the tummy skin in abdominoplasty

Thank you for your question. During a full abdominoplasty loose skin and fat is elevated off the abdominal wall and pulled down snugly. Elevating the skin changes its blood supply and diminishes it. While some doctors do liposuction this elevated skin during abdominoplasty  liposuction at the same time can further diiminish the blood supply and lead to healing problems or tissue loss in the lower abdomen. 

In my own practice I routinely liposuction hips and love handles with tummy tuck surgery. I find that these areas do not diminish the blood supply to the frontal abdomal skin and help to countour the waist. I rarely liposuction the frontal abdominal skin at the same time as the tummy tuck to perserve the blood supply.  In most patients when the skin is pulled tight additional liposuction is not necessary. In patients who might benifit from frontal abdomen liposuction I feel it is safer once the tummy tuck has healed. In mini tummy tuck I do liposuction the frontal abdomen at the same time because much less skin is elevated

You will need to be examined to determine if your waist contour would benefit from extended abdominoplasy,Belt lipoectomy (tummy tuck all the way around), frontal flank or circumferential liposuction-- all are reasonable options for an appropriate candidate.

Adam Tattelbaum, MD
Washington DC Plastic Surgeon
5.0 out of 5 stars 104 reviews

Liposuction And Tummy Tuck - Will The Results Be As Good If They Are Not Done Together?

Most Board Certified plastic surgeons do liposuction of the flank or muffin tops at the same time as an abdominoplasty (tummy tuck).  There was a landmark paper written by some excellent Brazilian plastic surgeons discussing a combination surgery known as a lipoabdominoplasty.  One of the authors was my good friend and former student, Presper Dahier, M.D. of San Paulo, Brazil.

Each plastic surgeon has his or her comfort zone and experience with reference to liposuction at the same time as an abdominoplasty.  The plastic surgeon you consulted with obviously feels that fat thinning is equivalent to liposuction.  Here again is one of those situations where you have to pick the plastic surgeon on the quality of his or her results, board certification, and how much your trust him/her, then allow the surgeon to use the technique they feel most comfortable with.

With reference to the lifting of the sides of the buttocks by an extended tummy tuck, this rarely happens.  The extended tummy tuck is really a way of getting rid of dog ears, and at the most posterior portion of the incision, the surgeon is more interested in a smooth line and not elevation of any tissue.  To get an elevation of your buttocks and lateral thigh, you need the back half of a lower body lift.  This gives you a circumferential scar, but a great lift of the buttocks and lateral thighs. 

Finally, with reference to a defined waistline, this is best done with liposuction of the love handles (muffin tops) which I perform from a mid back incision.  I doubt seriously muscle tightening and skin pulls will give you the same degree of definition of the waist. 

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.