Risk of Necrosis
Have lipo or Smartlipo 6 months prior to abdominoplasty does not increase risk of tummy tuck necrosis during the surgery.
If you post pictures, we may be able to give you advice on your suitability for surgery.
Your situation is not unlike many people. No matter how much we explain about the difference between lipo and tummy tuck and the need to fix diastasis during the tummy tuck, many patients do not fully understand this until after they see that the lipo removes the fat but does not repair the separated muscles.
To fully correct the roundness to the abdomen, the muscle repair really is necessary. (David Shafer, MD, New York Plastic Surgeon)
Smart Lipo is a propriety procedure. It has been marketed well and has been done mostly in an office setting by many practitioners who are not Plastic Surgeons and do not have the training to perform Abdominoplasty. I believe this has led to many cases like yours.
I know of no large peer reviewed study that gives an answer to your question. Although there is FDA approval of the Smart Lipo device there have been few studies in the Plastic Surgery literature to compare results to standard liposuction. For some time there was heated debate about performing liposuction at the time of abdominoplasty because of concerns about blood supply as well as a few other issues.
I now routinely perform standard tumescent liposuction with my abdominoplasty because I have integrated it into my technique. I know of no studies that have looked at the risk after Smart Lipo (Thomas R. Walek, MD, Providence Plastic Surgeon)
Your situation is becoming increasingly common, with people being convinced that laser lipo is an alternative to abdominoplasty and then needing one anyway. Because of the scarring from the laser, it can be a lot more difficult or not at all depending on each case. On average the chance of problems with healing is probably higher but your plastic surgeon will be able to make some adjustments in technique to minimize them. (Richard Baxter, MD, Seattle Plastic Surgeon)
By waiting a year like will the risk of problems because of the Smart Lipo is minimal. In your case you run no higher risk of tummy tuck necrosis versus someone who has never had Smart Lipo.
Ordinarily liposuction will remove fat while the damage to surrounding blood vessels is modest. Smart lipo however uses heat energy to destroy the fatty tissue and cause resorption of the fat. This does have the potential of disrupting circulation to the skin, at least temporarily. The skin circulation will repair itself, and though there are not reports of skin loss with tummy tuck after, I would suggest a wait of six to twelve months to allow the tissues to fully recover. Can’t hurt to play it safe. (Peter E. Johnson, MD, Chicago Plastic Surgeon)
You can safely have a tummy tuck after liposuction
Liposuction of any sort can damage the blood supply to the overlying skin. However over time healing occurs and blood supply is restored. While your risk of complications are slightly higher than those of someone who has not had liposuction, you should be fine if you wait long enough.
It is my opinion that there is no cookbook answer about what is enough time between operations. Tissues are well healed when they are soft and supple again and no longer feel “woody” and stiff as they did right after the surgery. This can take up to a year, but that is very individual. As always make sure you choose a surgeon certified by the American Board of Plastic Surgery (Elizabeth Slass Lee, MD, Bay Area Plastic Surgeon)
A tummy tuck can safely be performed one year after liposuction. This should also include repair of the diastasis. (Dana Khuthaila, MD, FACS, New York Plastic Surgeon)
I don’t feel that you will have a significant increase in wound healing problems 12 monthe after your Smartlipo. Smoking would be much more hazardous and much more likely to result in tummy tuck necrosis. I certainly agree with the others in that you would have been much better off (including financially), if you had undergone the tummy tuck initially. (John Whitt, MD, Louisville Plastic Surgeon)
At about 1 year after your liposuction it should be okay top have a tummy tuck. It just may be a bit tougher because of residual scar tissue from the liposuction. (Steven Wallach, MD, Manhattan Plastic Surgeon)