37, four kids. Do I need just a BBL or a tummy tuck too? (Photos)

Question

I have had four kids, and I am 37. I don’t have any stretch marks and not horrible diastasis recti but I do have a small bit of apron belly! Recommendations? Thanks!

Jacob Carlson, MD · Answer

I think you have a couple different options, and it really boils down to how dramatic of results you want to achieve. Liposuction +/- a skin tightening procedure does a really nice job of removing the excess subcutaneous fatty tissue. If you are just wanted to address the "apron belly" that you described, that would certainly be a reasonable option. Liposuction to the abdomen would address that; and if you wanted to do address excess subcutaneous tissue in areas like the flanks or back, you could consider Liposuction 360.
There are a few differences between Liposuction versus a Tummy tuck. With respect to incisions, obviously a tummy tuck incision is going to be significantly longer than the incisions for liposuction. Most surgeons try to place a tummy tuck scar in a place where it can be easily concealed by your undergarments or pants. In a tummy tuck, the excess skin is physically cut out, so overall the skin of the abdomen is going to be 'tighter' than with liposuction alone. Another significant difference between a tummy tuck and liposuction is that, with a tummy tuck, a surgeon is able to perform plication or muscle wall repair. You mentioned that you do not have significant diastasis (which is great), but plication can also be performed to tighten the abdominal wall muscles. In the vast majority of cases, plication is going to give a patient a flatter stomach from the side view than liposuction alone will do. Liposuction will remove the fat in an area, but it doesn't do anything to tighten the muscles. For a lot of patients, it is usually diastasis or laxity of the abdominal muscles that is giving them the protrusion of the abdomen and not so much the excess fat.

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