Posterior flank lipo or no lipo with my tummy tuck? (Photo)

Question

I'm scheduled to have a tummy tuck in 2 months, and i can't make up my mind whether to add a posterior flank lipo. It will cost about a 1/3 more in order to add the lipo. My kind doctor and husband are leaving the decision totally up to me. Would I see 33% better results by adding it? Or would it be just a waste? Please help me make up my mind!! TIA!!

J. Timothy Katzen, MD, FACS · Answer

I would highly suggest you have this posterior flank liposuction. I think you’ll be sad if you do not have this area liposuction. This will enhance and define the hourglass figure. The tummy tuck and love handle liposuction are commonly paired to maximize the results. Therefore, in my opinion, there is no question. Do the posterior Lipo. Good luck. I hope this helps to answer your question about whether to do posterior flank liposuction. 
Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

William Andrade, MD · Answer

Hello, most of my patients who choose to have liposuction with their tummy tuck are satisfied with the outcome, but as with your surgeon, I always advise that the degree of improvement is modest.   Also, some types of liposuction are combined with modalities (like laser, radiofrequency, ultrasound energy etc) to help tighten the skin a little, and others do not.   The methods that tighten the skin have additional risks and are often more expensive.  Your surgeon can the pros/cons/risks of their particular liposuction modality before deciding whether to include it with your tummy tuck.

Leila Kasrai, MD, FRCSC · Answer

Has your surgeon told you what the improvement is predicted to be with this added? If they have, then would you be happy with the predicted improvement? If yes, then it may be a good idea to add it. If no, then don’t. Although you’ll be paying 1/3 more, consider how much benefit it would be to add this rather than rating it as “33%”.

Jason Hess, MD · Answer

I do not think liposuction would provide a 33% improvement in your case.  However it seems a substantial added expense depending on the cost of the abdominoplasty.  I find that most patients benefit from a combination of liposuction and abdominoplasty.  In my practice, I perform liposuction on 85 to 90% of my tummy tuck patients.  Best of luck with your upcoming procedure.  Irregardless of whether you choose liposuction or not, tummy tuck is one of the highest satisfaction of procedures and plastic surgery.

Daniel Barrett, MD · Answer

Dear tjtj20,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

I would suggest that you do the liposuction of your flanks. Once you see your tight flat abdomen, you will notice your flanks even more.

Cagil Meric Erenoglu, MD · Answer

Hi,tjtj20! Thank you for your question.
Flank liposuction looks like to enhance your postoperative results. So it is better to focus on an integral result instead of seperating it into parts.

Camille Cash, MD · Answer

Liposuction can help to enhance your curves and tighten your look.  It's hard to say what percentage improvement you'll get overall.  It would be more cost effective for you to have it done now versus having the tummy tuck alone and then later on return to have the liposuction.

Douglas Taranow, DO, FACOS · Answer

Absolutely, have the liposuction performed at the same time as your abdominoplasty.  You will be much more shapely and experience one recovery.

Mats Hagstrom, MD (license on probation) · Answer

To me a talented plastic surgeon will view the impact of a tummy tuck on the entire torso and will design the procedure accordingly. this means if someone has skin laxity that extends to the side or the back then the tummy tuck needs to be extended to take this into consideration. if the love handles have excessive fat that will not match the improvement on the front of the abdomen from the tummy tuck then the love handles need liposuction and it needs to be done correctly to look good. In my opinion it’s not so much if you should have Liposuction or not but who should be doing aunt and what will it look like.
To get control and access to shape that area properly patients need to be turned on their side or face down. trying to sculpt that area properly with patients laying on their back is not going to deliver the type of results that are possible.
This has to be part of the discussion. Is the surgeon going to turn you under anesthesia to properly treat that area and what do their results look like when reviewing before and after pictures. When reviewing results for tummy tuck outcomes patients shouldn’t look at the backside of the patients and request to see before and after pictures from all angles. If surgeons don’t take pictures of tummy tuck results showing the backside then at least they should do that for Liposuction results. An experienced surgeon should have no difficulty showing you a minimum of 50 sets of before and after pictures for any procedure you’re interested in. this means an experienced surgeon should easily be able to show you pictures of patients who had tummy tucks with and without liposuction since the provider is letting patients make the decision.
The provider should be able to show you with samples of previous work exactly what the difference will be of having Liposuction and not having Liposuction. personally if someone has fat or skin laxity in the adjacent area it seems appropriate to incorporate or the plan to surgery so that adjacent areas blend into the area being treated. this is simply just being a good surgeon who has the ability to step back and see the forest not just the trees.
Picking the right plastic surgeon is always the most important variable and should be taken seriously.
Before choosing this provider how many surgeons did you interview?
If I was getting a cosmetic surgical procedure I think I would recommend patient start by having a minimum of five in person consultations and continue having more of them until I felt very certain I was in the hands of the most talented and experienced provider.
The results from this procedure is permanent and irreversible.
Judge tummy tuck results by who gets the most natural looking bellybutton. That tends to be the most difficult part of the procedure and surgeons who consistently get the best looking belly buttons tend to get all the other aspects of the procedure correct as well. Other aspects of quality work include very low set scars that follow anatomic contours naturally. as mentioned previously quality work also means the patient’s torso looks good from all angles. i’ve seen far too many surgeons spend 15 minutes doing quick dirty liposuction with patients laying on their back and charging thousands of dollars for it and in the end the liposuction didn’t look good or the patient could barely tell that anything was done. proper body contouring using liposuction costing thousands of dollars needs to be done as a quality procedure and this means the patient needs to be turned in the correct position to get the results needed. in my opinion you can’t do that laying on your back. 
I am in agreement that surgeons should let patience have a big Part in deciding what and how procedures should be done but good surgeons well as a steer patients towards what is going to look good and what is the best way to do the procedure.
Part in deciding what and how procedures should be done but good surgeons well as a steer patients towards what is going to look good and what is the best way to do the procedure. For the last 10 years I’ve been specializing exclusively on liposuction and fat transfer procedures. For the first 15 years of practice I did general plastic surgery with lots and lots and lots of tummy tucks. The way of you liposuction today is quite different than how I did it many years ago. today I view the torso as a single anatomic unit and either do liposuction of the entire torso or don’t do it in order for patients to not have unnatural transition zone between treated and untreated areas.
I do all my procedures with patients awake using local anesthesia with mild sedation. The main advantage for this when it comes to body contouring as I can have my patients hold many different anatomic positions allowing me to perfectly contour their body. except for the front of the abdomen almost all the work is done with patients laying on their side. This is not really feasible in conjunction with a tummy tuck and under general anesthesia.
It doesn’t mean you need to have two procedures but you should make absolutely sure you’ve picked the best provider when it comes to both tummy tucks and Liposuction if you’re going to have both.
Perhaps a bit complicated and over the top but I take the subject seriously because the impact of permanently changing your body if it isn’t done correctly has implications that are potentially severe.
Best,
Mats Hagstrom MD