Liposuction or Tummy Tuck?

An issue that comes up often in evaluating the belly is the decision between liposuction and tummy tuck. I am all for using the smallest hammer possible to make the abdominal wall look good. A smaller procedure usually means a faster recovery, less risk and less expense.

Liposuction is an excellent procedure for removing localized disproportionate fat. It makes use of small, usually hidden, incisions and allows the body to be contoured with minimal changes to the skin. It works best in patients with discreet pockets of fat who have good skin tone.

Loose skin is an indication for a tummy tuck. While liposuction can remove fat, a tummy tuck can remove fat but additionally tightens the skin and the abdominal wall. Removing the excess with a low abdominal incision tightens skin. This also removes previous low abdominal scars and stretch marks on the lower abdomen. Placing sutures into the tough lining in front of the anterior abdominal wall muscles tightens the abdominal wall, like an internal corset.

Which procedure is the correct one for you depends on many factors, and the decision is best made during consultation with a Board Certified Plastic Surgeon. For some people a compromise between the two procedures, or a mini tummy tuck may suffice.

In general the following rules usually apply. If your skin tone is good (tight) and there is a localized area of fat on the abdominal wall, liposuction can often help. If your skin is redundant (folding over) and the underlying muscles are lax (commonly from weight loss or pregnancy), then a tummy tuck will provide superior correction.

Additional notes: Pain pumps can help decrease postoperative discomfort, and speed recovery for tummy tucks. Liposuction, tummy tucks (abdominoplasty) and mini tummy tucks all work better if you are near your ideal weight and a non-smoker. Smokers have a greatly increased risk of wound healing problems when matched with their non-smoking counterparts.

By: Joseph Mele MD, FACS