Tummy Tuck Surgery

What is usually involved with tummy tuck surgery? I have been told that most docs do some liposuction to even out things.

Doctor Answers 14

Tummy Tuck Procedure

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After you are under general anesthesia, a horizontal incision is made within or at the pubic hairline towards the hip bones. The incision is placed within the swimsuit lines. The more excess skin that exists, the longer the incision. Through this incision, the muscles can be tightened by pulling them together to achieve a flatter abdomen. The skin is pulled downward, the excess skin excised, and sutured into position. Skin with stretch marks may be completely or partially excised. Liposuction is used to improve the abdominal contour. A large amount of tissue is excised and a smaller incision is made around the belly button, allowing the tissue above the belly button to be pulled downward and removed. The belly button position is unchanged; it heals slightly altered. The abdomen is closed with multiple layers of sutures and a compression garment is placed around the abdominal area. Liposuction is typically necessary to give the best aesthetic results.

San Francisco Plastic Surgeon
4.8 out of 5 stars 81 reviews

Tummy Tuck surgery

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Surgeons may perform surgery in different ways. Yes, normally, liposuction of the abdominal area is part of the tummy tuck procedure. I have attached a video of a tummy tuck procedure. If performed correctly, the excess skin and adipose tissue should be removed and the abdominal muscles (that have most likely stretched out) should be put back together.

Liposuction AND Tummy Tuck (Abdominoplasty)

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Liposuction has but one goal remove fat - it does NOT tighten skin nor can it repair stretched out muscles.

A well-done full Tummy Tuck (Abdominoplasty) will "take in" the looseness and stretched out muscles of the abdominal wall and thereby it will flatten the tummy and do away with the "pooch". It will narrow the waist are lift a sagging Mons pubis and COULD lift sagging anterior thighs smoothing away cellulite dimpling.

Proper healing in Plastic Surgery is always a contest and balance between TENSION and BLOOD FLOW. Too much tension, added to other factors, reduces blood flow through the area resulting in tissue death and wound separation. For this reason, all efforts are to maintain and prevent decreases in blood flow and blood vessel injuries.

While liposuction is often used with Tummy Tucks to contour the hips and buttocks only a minority of surgeons would liposuction the skin flap that was lifted off the anterior muscles to allow their repair. Doing so risks injuring the limited blood supply in this flap resulting in flap death and or wound separation. Those who do liposuction this flap do very limited lifting / undermining, limited muscle repairs and limited liposuctioning. As a result of all these limited procedures, this combined operation (on the front) can benefit very few women.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Tummy Tuck Surgery - Normal components

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Dear Silversage,

I do not consider liposuction as part of a routine tummy tuck. A tummy tuck allows the surgeon to directly remove excess abdominal skin and fat, and also tighten the abdominal wall. These two actions have several effects:

Tightening the abdominal wall

  • This pulls in the abdomen (seen best on side view pictures) and corrects any bulge or diastasis that resulted from having children.
  • If you happen to have a significant distance from your lower ribs to your pelvis (common if you are tall), then the mid-line tightening will also cause notable bowing of the musculature along the flank region, and this will improve your hour-glass figure.

Skin removal

  • For most patients, between 30-50% of the abdominal skin can be removed.
  • This gets rid of any stretch marks that had been present on that skin.
  • The remaining skin has to be stretched out to cover the whole abdomen, and this intrinsically makes it thinner.
  • A new belly button is created.
  • With "standard" scar length tummy tucks, the rotational component of aligning the scars helps pull in the waist line (improving the hour glass shape as well).
  • Longer scar lengths (extended abdominoplasty) has the benefit of an anterior thigh lift.

I do sometimes perform liposuction in conjunction with a tummy tuck (most often the flanks or "love handles"), but I consider this an additional procedure - it adds a significant amount of time to the operation because you need to be flipped prone for the liposuction component.

Please look over my video about tummy tucks - it visually reviews many of these points.


Tummy tuck overview

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Abdominoplasty involves removing excess fat and skin, and correcting muscle separation if necessary. Lipoabdominoplasty is good to get excess fat that can't be reached with regular excision techniques. It is great to give your body a better contour.  

Tummy Tuck Details

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The tummy tuck (Abdominoplasty) procedure is designed to reverse the predictable changes that occur after pregnancy and/or weight gain and eventual loss. These changes include sagging skin (or skin with a loss of elasticity), excess tummy fat, and abdominal muscle separation.


Therefore, a standard tummy tuck procedure addresses these 3 anatomic changes and usually involves:

  •    Removal of excess abdominal skin
  •    Removal of excess abdominal fat
  •   Tightening of the abdominal wall muscles


Liposuction performed on the abdominal and or hip area at the same time that a tummy tuck is performed can be associated with interference of the blood supply to the tummy skin, can lead to prolonged healing, and can lead to contour abnormalities.

Optimizing results with tummy tucks

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Modern techniques can help us combine liposuction with tummy tuck surgery safely and effectively, leading to more optimal results.

Mario Loomis, MD
Middletown Plastic Surgeon
4.5 out of 5 stars 8 reviews

Tummy Tuck Procedure -

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Tummy tuck (also called abdominoplasty) is a very popular cosmetic surgery procedure. A tummy tuck can be an effective tool for shaping and sculpting the body for better body appearance and improved self esteem.

Sometimes no amount of diet and exercise can create a flat tummy. Tummy tuck plastic surgery actually tightens abdominal muscles and removes excess fat and skin from the stomach area to create a tighter, slimmer, smoother belly. A  tummy tuck can be combined with other procedures such as liposuction of your waists or flanks (i.e. love handles) to fine tune your result

Patients choose abdominoplasty cosmetic surgery for a number of reasons, including:

Excess abdominal skin following weight loss
Weight gain (beer belly or spare tire) from a sedentary lifestyle
Abdominal fat that is resistant to diet and exercise
Stretched stomach muscles from pregnancy
Desire for a thinner profile
Desire to look younger and fitter
Desire to fit into clothes better

I recommend you visit with an ASPS member plastic surgeon to further explore your options and to find out if you are a candidate for this procedure

Liposuction and Tummy Tuck Combined

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The use of liposuction with an abdominoplasty or tummy tuck is not necessarily the standard. When the skin flap is elevated off of the abdominal wall there is a significant disruption of the blood supply. Therefore, liposuction of the abdominal flap must be done cautiously and only of the upper part of the flap. Liposuction of the inferior and inferior central part of the flap has a very high potential of leading to tissue necrosis, wound breakdown and significant contour irregularity as you are only removing fat from the upper abdomen.

However, I often add liposuction of the posterior flanks to really shrink the size of the waist. This leads to a great outcome and a definite decrease in clothing size.

Liposuction with tummy tyck

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More than 90% of the time I perform a tummy tuck, I routinely perform liposuction.  The area in which I most commonly perform liposuction are the flanks.  I do not routinely perform liposuction of the skin lifted off the abdominal wall; in some patients, this can lead to an increased risk of healing.

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.