Is tummy tuck with flank liposuction dangerous? Better to do separately? (photos)

Liposuction is unnecessary to create the look you are trying to achieve,and.....its dangerous to combine the procedures.  You seriously need to rethink the current plan.  The literature represents the science.  The people that do these procedures together either do not read the literature, which is inexcusable, or read it and don't care that the danger to the patient is real, which is inexcusable.
In addition, there are technical reasons why both should not be done at the same time.

Abdominoplasty treats the skin excess and muscle weakness of the abdomen, as well as any fat that is between the belly button and the pubic hairline. Liposuction treats only fat. It can be used to thin out the abdomen, but the skin must be in good condition with no excess, and there should not be muscle weakness. I do not like to combine abdominoplasty with liposuction because of the added risks of fluid collection under the skin, blood clots (potentially fatal) and wound healing problems.

Aggressive liposuction with tummy tuck is dangerous.  A full tummy tuck with liposuction at the same time will certainly put you at a high risk for fluid under the tummy tuck skin (seroma). A full tummy tuck with aggressive liposuction at the same time will also certainly put you at an unacceptably high risk for a potentially fatal pulmonary embolism (PE), venous thromboembolic event (VTE). The literature is complete with this information. The science is the science. This is a risky combination.

Study outcomes in the Plastic Surgery Literature (Fluid Collection Risk):

Results: One hundred twenty-five patients underwent abdominoplasty with flank liposuctionand 75 patients underwent abdominoplasty alone. The incidence of seroma formation was 16.0 percent in the abdominoplasty-alone group and 31.2 percent in the abdominoplasty with liposuction group (p < 0.05).

The combination of abdominoplasty and liposuction procedures can still overwhelm the body's ability to resist these shear forces by the fact that more surface area is available to “shear” and thus produce seroma fluid. Not so much as an additive effect but synergistically, such that the seroma fluid from the flanks flows into the adjacent abdominal space and resists the ability of the upper abdominal flap to close over the abdominal wall. Patients must be counseled about their risk for seroma formation and treatments aimed at resolving them including frequent postoperative visits for needle drainage and the rare case requiring operative drainage in the face of a persistent seroma.

In another study (Blood Clot Risk)

Conclusions:

The amount of fat removed during plastic surgery is a factor influencing the occurrence of pulmonary embolism in patients undergoing abdominoplasty/flank liposuction, and the duration of surgery is a concomitant factor.

This combination of liposuction of the flanks and abdominoplasty

All risk no benefit.

See Journal Link below to read the studies yourself.

These two procedures are commonly done together to get a good sculpted result. You might consider getting a couple more consultations with board certified plastic surgeons. Good luck.

I usually do both procedures together. I would ask your doctor his reasoning for this Its hard to give an answer without seeing medical history.If you feel that doctor doesn't do it I would get a second opinion to see why it can't be done.

Every State has its own statutory regulations when it comes to having liposuction at the same time as a major operation such as Abdominoplasty. For example, in Florida 1000cc of fat can be removed at the same time as Abdominoplasty. This is created for patient's safety. There are higher incidents of complications when a Tummy tuck is  accompanied by large volume of liposuction

This is an older notion that has been disproved.  As a matter of fact, I feel that doing liposuction at the time of tummy tuck gives a much better affect than doing the procedure separately.  Find a surgeon that has a lot of experience with this, and you will do great.  Good luck!

HI,Thanks for your question. I always do tummy tuck and flank liposuction at the same time. Otherwise a patient will look asymmetric post-operatively with a flat abdomen but persistent love handles. It really does not add much extra time or risk to the procedure. I suggest that you discuss the procedure with another surgeon who has more experience performing abdominoplasty. Please make sure that he is board certified and can show you multiple before and after examples of his work.All my best,Daniel A. Medalie, MD

thank you for sharing your question and photos.
If your health conditions allow it, there is no risk in performing a liposuction along with the tummy tuck. You are a perfect candidate to perform liposuction on your entire back and flanks.
good luck!

There may be specific concerns in your case but as a general rule combining a tummy tuck with lipo to adjacent areas is commonly done and safe.

Thank you for your question and photos. Doing liposuction of the flanks during a TT is not only not dangerous, but it is not adequate in your case based on these photos. Your BMI is 29. If you were my patient, I would do VASER Hi Def Lipo of your whole back (upper, lower, bra rolls, lower back fat pad, full abdomen, upper anterior and lateral chest wall and pubic liposuction) with your abdominoplasty. If your surgeon thinks it is dangerous to do liposuction and a TT together, I would suggest you have liposuction 360 degrees first and do the TT later. Much better result and with a much shorter abdominoplasty scar.See a board certified plastic surgeon experienced in advanced body sculpting techniques for an in person consultation/evaluation. Good luck.

Dear C,    Thanks for posting your pictures. From observing your pictures you are a great candidate for tummy tuck surgery. Tummy tuck is one of the best investment in yourself. It will increase your confidence, your self esteem , your sense of femininity and will make shopping fun...   Tummy tuck will give your flat stomach, tight and youthful looking skin, nice belly button, narrower waists, improved body posture and most likely, you will lose significant weight due to the abdominal muscles tightening that will reduce the amount of food that you can eat and your sense of hunger.   Congratulation on your wisdom, understanding the significant increased risks of severe complication when combining the procedures. Cosmetic surgery should have minimal complication because it is purely elective. Do not let expedience jeopardize  your health and surgical outcome.   Only about 10% of my tummy tuck patients request liposuction, because most of them lose weight and they are quite happy with the final outcome. If patients desire liposuction, I recommend to wait 2-3 months, in order for their body weight to stabilize.   You have to realize that not all results are the same, because experience, technical skills and aesthetic eye are critical for good outcome. So, do your due diligence carefully and choose your surgeon wisely.   Always, consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery, to make sure that they are numerous, consistent and attractive with the above mentioned features and low single scar.                               Best of luck,                                                Dr Widder