Liposuction with tummy tuck? Is it safe?
Liposuction performed at the time of abdominoplasty can decrease the blood supply to the remaining abdominal skin if performed in the upper abdomen. In the flanks, this is less likely to affect the healing of the lower abdomen.
Personally, I do not think it is worth the risk of having healing problems, and would recommend liposuction of the abdomen be performed first, at a separate procedure than the abdominoplasty, if it is warranted. (Roxanne Sylora, MD, Orlando Plastic Surgeon)
Liposuction performed cautiously can be combined with a tummy tuck. As with any surgical procedure the surgeon must adhere to good surgical principles and technique to minimize complications. (Earl Stephenson, Jr., MD, DDS, Atlanta Plastic Surgeon)
Extensive liposuction of the upper abdomen combined with tummy tuck can cause serious complications.
Based upon your photograph you will need an extensive liposuction in the area above your belly button.Understand the during a tummy tuck the blood vessels that supply your upper abdomen are detached as the tummy skin is elevated off of the muscles.This means that the blood vessels from your sides and flanks are necessary to keep the skin of your upper abdomen of life when it is pulled down tight after removing the lower loose abdominal skin.
In addition the blood vessels within the skin of your upper abdomen should not be damaged so that blood supply keep your skin alive. Aggressive liposuction of the upper abdomen during the course of a full tummy tuck can damage to blood vessels of the upper abdominal skin and result in necrosis or death of the skin of the remaining abdomen where it is reattached to your lower abdomen. Based on photographs I personally would not do extensive liposuction in combination with a tummy tuck for fear of causing wound healing problems and possibly skin death and the lower abdomen.
In my opinion based on your photographs I would suggest either very significant weight loss before a full tummy tuck or having a liposuction now to reduce the excess fat and wait 6 months for a full tummy tuck. (Brooke R. Seckel, MD, FACS, Boston Plastic Surgeon)
Is lipo on my upper abdomen and flanks safe with a tummy tuck?
In my over the internet opinion if having as full TT than NO upper abdominal liposuction should be done – possible lower skin necrosis due to the vascular blood supply issue. I would do flank and hip, back lipo. If having a mini TT than the upper abdominal lipo is OK. (Darryl J. Blinski, MD, Miami Plastic Surgeon)
Liposuction with tummy tuck combination hotly debated
You will not find a definitive answer on this website because there isn’t one in the plastic surgery community. Every few years this issue is brought up again by someone who publishes a study including several hundred cases on either side of the question and the authors try to justify their position (for or against).
Inherently, it does make sense to avoid liposuction of the upper tummy at the time of abdominoplasty in my mind. Hoever, there is a lot of evidence that it is safe. Furthermore, many surgeons practice what they call “discontinuous undermining” of the abdominal flap which in theory does make it safe to perform liposuction of the upper tummy. Now, allow ME to pose a question to YOU: If you had a tummy tuck and liposuction of the upper abdomen at the same time, then ended up with a complication, how would you feel? I have a very strong “NO REGRETS” policy, so I don’t do both at the same time. I suction the flanks all the time – and it helps create a better waistline, but the upper tummy? Nope. I leave that alone until a later date. So I can sleep at night! (Thomas P. Sterry, MD, New York Plastic Surgeon)
You seem to be a very good candidate for a lateral tension abdominoplasty tummy tuck procedure. During this procedure blood vessels are preserved in the upper abdomen where liposuction is safe to be performed in the same operative setting. Please see a board certified plastic surgeon to undergo (Kevin Tehrani, MD, FACS, New York Plastic Surgeon)
Lipo to the flanks and a mild lipo to the upper abdomen are safe as long as the abdominal perforating arteries are not cut. This can be achieved either by doing a very narrow “tunnel” in the upper half of the tummy tuck dissection (this “tunnel” would be the space needed to do the muscle suturing) in order to avoid cutting those arteries or by doing a Lipo-abdominoplasty which is a variant of a Tummy Tuck characterized for preserving these vessels. I also perform (practically always) a Lipectomy, which is the removal of the fat with the scalpel. It is executed when the abdominal flap is already dissected and it let’s the surgeon do some fat thinning without risking the abdominal blood supply.
In my opinion, doing a Tummy Tuck without treating at least the flanks as well with liposuction, is an incomplete procedure thus an incomplete outcome. About your case: By looking at your photos, you seem to be an excellent candidate for a Tummy Tuck with Liposuction.
Your abdominal region has plenty of fat and skin that could be greatly enhanced with these procedures. An important thing about your case is that you have plenty of skin, so make sure you know your scar can be positioned very low.
Make sure you see some cases of the surgeon (even though each case is different) you choose in order to make sure he/she is accustomed to placing a very low scar. Remember this surgery is not for getting only a flat tummy when using clothes, but to have a good looking one when using a bikini or even naked.
The liposuction would be the cherry on top, which would help the surgeon sculpt your body and give you an even more feminine silhouette. Hope I cleared your doubts about the TT and Lipo question. If you wish to discuss your case further more, feel free to contact me. (Luis A. Fernandez Goico, MD, Dominican Republic Plastic Surgeon)
Tummy tuck with lipo?
A few points I would like to make first:
1. If a surgeon is going to give an opinion by photos alone, which in and of itself is sub-optimal, I cannot get a good sense what procedure is optimal for you by the photos that you sent.
One would need photos that show the entire abdomen from the front and the sides. Please understand that photos do not substitute for a proper physical examination.
2. In previous years I was afraid to do lipo with an abdominoplasty for fear of compromising the circulation to the abdomen. This has since been disproven, depending upon the technique and technology the surgeon uses.
3. For the last couple of years, I combine agressive VASER liposuction of the upper and lower abdomen, flanks, lower back and often include inner and outer thighs, upper arms and mid/upper back with almost all of my abdominoplasties. Many times I then transfer the fat removed to the hips and buttocks. The VASER emulsified the fat without destroying the fat cells so they are viable to transfer to other areas. The VASER is tissue specific for fat and does not damage nerves or blood vessels. The fat removed usually has either no or a minimal tinge of red indicating how little blood vessel damage and blood loss there is with this technique. Therefore, in experienced hands it is safe and can be used extensively on the torso at the same time as an abdominoplasty.
I NEVER operate on smokers. Breast augmentation with or without a lift is sometimes included as well in these procedures using a “One Day recovery breast augmentation” technique. Lipoabdominoplasty is done without drains and Exparel is used to reduce post op discomfort – narcotic use after surgery is often less than half dozen tablets.
4. I do agree with the other surgeon, sometimes direct fat excision from the lower abdominal flap, which can be done as well with a lipoabdominoplasty, may be necessary to give the lower abdomen the best possible contour.
The question to ask yourself is: do I want to just tighten my abdomen and remove some extra skin, or, do I want to rejuvenate my entire torso? The procedure takes longer than an abdominoplasty alone but the resultant contours in my opinion justify the additional efforts. Recovery is not much more than from an abdominoplasty alone. (Mark D. Epstein, MD, Stony Brook Plastic Surgeon)
Both suggestions have there merit and are a function of the comfort of the surgeon performing them and what might give the best result with the least risk Dr Corbin (Frederic H. Corbin, MD, Brea Plastic Surgeon)
Liposuction of abdomen with a tummy tuck
Liposuction of the abdomen during a tummy tuck has become quite a controversial issue. This is due to the fact that there are differing techniques of tummy tucks, and the areas of liposuction are varied.most definitely the agreement for most conservative surgeons is that the area below the new “belly button” is at risk and probably should NOT be liposuctioned.
In my hands I find the flanks are safe for liposuction, and should be done in most patients, to reduce the “dog ears”. The upper abdomen is an area that is not without risks but I often remove that bulge, especially with obese patients. (John Sampson, MD, Jackson Plastic Surgeon)
In general, suctioning the upper abdomen with the flanks, done conservatively, when doing an abdominoplasty, is a reasonable and safe approach. I think what Dr. Singer wrote, is very wise: “Keep in mind, that following the advice from a surgeon on this or any other website who proposes to tell you what to do based on two dimensional photos without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure may not be in your best interest.”
If you smoke, that changes everything. If you have diabetes or poor glucose tolerance (pre-diabetes) the same applies. A full examination with a complete medical history as well as an assessment of your desires and the likely outcome is essential. But doing the surgery as a two stage process is also a careful and safety oriented approach. There may be justification for that route. (Benjamin Gelfant, MD, Vancouver Plastic Surgeon)
In my practice I often do conservative d liposuction with a tummy tuck and this would be a great procedure for you. Direct excision of fat is also very useful and is safer then liposuction. From your pictures I would anticipate a very nice result. (Gregory Lynam, MD, Richmond Plastic Surgeon)
I would suggest a tummy tuck with flank liposuction as your first procedure. If the upper abdomen bulge is still a concern, you could return for a second procedure to liposuction your upper abdomen. I do not recommend extensive liposuction of the abdomen at the time of tummy tuck due to the compromised blood flow when lifting the flap for a tummy tuck. (Christopher J. Morea, MD, Raleigh-Durham Plastic Surgeon)