Is it true that fat under the muscles in the abdomen can not be lipoed? (photos)

When I first got my tummy tuck/ Lipo my upper tummy was flat, Then within 2-3 mths my upper stomach just blew up and my doctor could not explain it. It stayed up. Went to another doctor and he refuses to operate, that it's nothing he can do for fat under he muscle.

Doctor Answers 15

Is it true that fat under the muscles in the abdomen can not be lipoed?

You are correct that visceral fat within the belly cavity cannot be liposuctioned and is best treated by diet and weight loss.

Turkey Plastic Surgeon
4.9 out of 5 stars 89 reviews

Is it true that fat under the muscles in the abdomen can not be lipoed?

It is true that fat under the muscle can not be removed by liposuction, but that is not likely your problem. If you abdomen was flat after your abdominoplasty and then, abruptly enlarged, it is likely that the muscle tightening (plication) suture pulled through or loosened.  This can be repaired by reoperation. You should wait at least 6 months after the first operation before proceeding with a second procedure.  Best wishes.

Janet Woodyard, MD
Baltimore Plastic Surgeon
5.0 out of 5 stars 16 reviews

Upper abdominal fullness following tummy tuck

Thank you for your question.  If your abdomen was flat following your abdominoplasty and then abruptly protruded 2-3 months following surgery, I suspect that the muscle tightening (rectus plication) may have come undone.  If that's the case, repair would require reopening the abdominoplasty incision to tighten the muscles once again.  To be sure, discuss with your surgeon or seek a second opinion with one or more board certified plastic surgeons.  Best wishes!

Fat under muscles

Thank you for your question. Yes fat under the muscles called visceral fat and lipo can not be done in this area.

Visceral Fat Facts--Tummy Tuck Revision with VASER HI DEF

Visceral fat can't be liposuctioned, however I recommend a formal consultation with a body contouring expert to determine if this is the case or not. It may be that you need a tummy tuck revision which in addition to Hi Def liposuction with ThermiRF and/or ultrasound and fat grafting to give you the flattest, most contoured results. See an expert in hi-def physique. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 176 reviews

Tummy tuck - upper abdomen 'blew up' after 2-3 months

Thank you for asking about your tummy tuck.

  • First of all, I'm sorry this happened. It's quite discouraging.
  • Whatever the explanation, it will help to lose some weight if that is possible.
  • I see four possible explanations for what happened - 
  • First, you were too heavy for a muscle repair, and pressure from internal fat disrupted the repair. This cannot be corrected until you lose weight or the same thing will happen again. This seems most likely.
  • Or you may have excess fat in the middle upper abdomen under the skin. This can be removed with liposuction - this seems unlikely if two surgeons have examined you and told you that this is not the problem.
  • But it is possible you were not too heavy for a muscle repair - but upper muscle sutures didn't hold. This could be corrected with additional surgery.
  • Finally it is possible that your muscle repair is fine but excess fat under the muscle is pushing the muscle outward, causing a bulge. You are correct - this cannot be removed surgically but requires weight loss.
  • If it isn't clear which is the situation, ultrasound study should show what is going on. 

Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

Is it true that fat under the muscles in the abdomen can not be lipoed?

Assuming that you have not gained significant weight since your surgery there are a couple of possible explanations.  You are correct that visceral fat within the belly cavity cannot be liposuctioned and is best treated by diet and weight loss.  In your case however it is more likely that either a running suture was used to tighten the "muscle" of your upper stomach and broke, or excessive lower stomach tightening was performed causing bulging of your upper stomach wall.  The former is more likely than the latter in my opinion and may require revision of your surgical procedure.  This is speculation without a face-to-face examination so meet with ABPS board-certified plastic surgeons in your area to get informed opinions.  Best wishes,

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 30 reviews

Looks more like a failure of the muscle repair

yes its true that you cannot liposuction visceral fat ie fat under the muscle.  But from your photos and your history, it appears that you may have broken some of the sutures used to repair the muscles.   You would need an in person exam to further confirm this scenario.  But if this is the case you would benefit by some weight loss and re-operation.  This is a fairly uncommon complication but can happen, especially if one does not follow the lifting restrictions post a tummy tuck.  

Reps B. Sundin, MD
Washington DC Plastic Surgeon
5.0 out of 5 stars 26 reviews


Thank you for the photos and question and though an examination is needed if the fat is behind the abdominal wall then it can only be lost with weight loss.  If,however, this is due to loss of sutures from your abdominal repair at the time of your abdominoplasty then further surgery may help but a work up is need.

Dr. Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 60 reviews

VIsceral fat

VIsceral fat is not amenable to liposuction.  However, the primary issue is whether your hernia repair has failed in the upper abdomen.  

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.