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Adam G. Tattlebaum M.D.

Tummy Tuck vs Liposuction: Which is right for me?

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Tummy Tuck or Liposuction?

Do I need a Tummy Tuck or Liposuction

Patients are often confused about the difference between a tummy tuck and liposuction. Both improve the appearance of the abdomen, but which is right for me.

Think of liposuction as the operation to consider if you have good tight skin. Liposuction can diminish areas of bulging fat but it does not remove any skin. It works best when the overlying skin is tight because the skin will shrink once the fat is removed.

Think of tummy tuck if your skin is loose which is usually the case after childbearing. A tummy tuck will remove BOTH skin and fat, so it is a skin tightener and fat remover at the same time. Tummy tucks also allow muscle tightening. In childbearing the abdominal wall stretches, a tummy tuck can allow muscle repair that liposuction cannot.

In consultation, I will evaluate your goals and your individual starting point. Depending upon the quality of the skin I may recommend tummy tuck, liposuction, or sometimes a combination. 

Tummy Tuck

While most women do not want a tummy tuck, it is still the gold standard for the removal of both skin and fat. In most postpartum women the issue is loose skin so it is often the best option in this population. When these patients come to my office wanting liposuction I explain that liposuction makes the loose skin looser, not tighter and that’s when they realize I’m about to embark upon a discussion of the thing they hoped I would not bring up…. the dreaded tummy tuck. Nobody really wants it, they are hoping that I will have a laser or lotion that will shrink up the loose skin, but unfortunately, a tummy tuck is still the most predictable option for the loose postpartum belly.

To be a candidate for a tummy tuck, other than having a loose stomach, or having excessive skin in the area, you must be healthy and be at a reasonable weight before the surgery. The heavier the patient is, the riskier. It is also important to consider that tummy tuck surgery will not make you “thin”, and that you should have realistic goals before your surgery. While tummy tucks do indeed remove some fat and skin, weight loss may not be as great as you think. However, the results of a tummy tuck are usually long-lasting. The extra skin will not come back unless your weight fluctuates again.

Liposuction

Liposuction is one of the most common surgeries performed worldwide. Though it is indeed one of the most popular procedures individuals opt for, it is ironically the least understood.

Liposuction in its simplest form is the insertion of a small metal tube that is connected to a vacuum suction device. The tube is essentially passed back and forth while sucking the fat out from underneath the skin.  There are different types of liposuction devices that can be used depending upon the surgeon’s preference. Each plastic surgeon uses his or her judgment to decide which device and which size tube or “cannula” should be used for the surgery. A larger and more aggressive cannula, or tube, is needed when areas have a high amount of fat such as the flanks, while a smaller cannula is more fitting for areas such as the chin or neck. 

Liposuction is good for removing fat, but will not remove excess skin. In the example of pregnant women, liposuction will not satisfy if the patient has excessive or flabby skin, even if the fat is removed. However, if you want to get rid of small fat deposits around your stomach, buttocks, thighs, or hips, where the skin is often tighter then liposuction is an appropriate fat-reduction plastic surgery. This procedure will remove fat pockets from the targeted areas and reduce the “love handles” or bulges while improving the overall contour in patients with good skin elasticity. However, it isn’t a weight-loss tool. There is a vast difference between body contouring and losing weight. Liposuction works best for diet-resistant areas where the skin is tight and likely to shrink back when the fat is taken away. 

Recovery after liposuction can vary but because it is a superficial operation most patients recover quickly. You may experience some oozing at the site of your incisions and swelling at the site of your fat removal, most surgeons recommend a compression garment to help. It takes about six months for patients to see final results as the body heals and swelling diminishes. While results are permanent, patients must then maintain a healthy diet and lifestyle as fat that remains after liposuction can enlarge if a patient’s diet is not healthy.

Tummy Tuck with Liposuction 

I commonly perform liposuction of the flank or love handle area as part of my tummy tuck for appropriate candidates (not everyone needs it). I feel that contouring this area makes the tummy tuck look better. Because of this, anything I can reach on the flanks with the patient face up is part of the tummy tuck.

Some patients carry their flank fullness all the way around above the buttocks. For these patients, I may recommend what I call “Posterior flank” or “360” liposuction. This is an area that I cannot reach from the front. In these patients, we start surgery face down with the posterior flank liposuction. This is considered an additional site of liposuction. Sometimes fullness of the back rolls is addressed as well.

Hip and flank liposuction does not interfere with the blood supply to the abdominal skin that we pull down during a tummy tuck. Some surgeons will liposuction the upper tummy tuck skin to thin it. I think this is risky and often unnecessary. Lifting and pulling on the skin changes and stresses its blood supply, liposuctioning this area at the same time is a double stress and can lead to healing problems. If I have a patient with fatty fullness in the upper abdomen we discuss staged upper abdominal liposuction after the abdomen has healed. It is much safer.

During the Consultation

Dr. Tattelbaum has been listed as one of the top plastic surgeons in Washingtonian and Bethesda magazines. As discussed, one of the most common concerns that many patients have is determining which procedure may be right for them. This is particularly common among those who wish to reduce excess fat or skin around the midsection. As we have seen, each procedure offers certain benefits, and each one may be a better fit for some patients than it would be for others. 

The best way that patients might decide which of the two procedures matches their circumstances is to discuss the matter with Dr. Tattelbaum. He can offer insights and information regarding the advantages that each procedure offers. Patients may also wish to explore how the procedures are implemented, as well as their specific goals and needs, to determine the best technique for them.

Schedule a Tummy Tuck Consultation 

Dr. Adam G. Tattelbaum, MDPC, is a double-board certified plastic surgeon. He enjoys the process of teaching his patients as much as he loves performing surgeries. If you are considering surgery and would like to know more about undergoing a tummy tuck or liposuction procedure call Dr.Tattelbaum’s office at (301)-804-6832 or contact us online.

April 4, 2022 7:15 am
Categories: Blog

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