The question of Liposuction vs. Tummy Tuck is one I get every week. In fact, this week the discussion of the differences between Liposuction and Full Abdominoplasty and Mini Tummy Tucks was had at least ten times.
I have discussed the topic several times here on the San Francisco Plastic Surgery Blog, but it’s been a while and it seems like now is a good time to review the differences between Liposuction, Tummy Tucks and Mini Abdominoplasties. They are not interchangeable, and each has specific indications, advantages and limitations.
Liposuction
Liposuction Indications: Liposuction specifically and exclusively removes fat. It is designed to sculpt the body by removing localized pockets of disproportionate fat. It does so very well.
The most effective method is Tumescent Liposuction. The procedure involves injecting the tumescent fluid, a balanced salt solution with a local anesthetic and epinephrine added. The fluid allows for compression of the small blood vessels and less bruising. The anesthetic helps with post-operative pain, and the epinephrine helps to reduce bruising. Adding additional energy to the liposuction, like lasers and ultrasound, have been tried. They can cause burns, and have not demonstrated a significant advantage over tumescent liposuction alone.
Liposuction of the abdominal wall removes disproportionate fat and smoothes the belly.
Liposuction Advantages: The main advantages of Liposuction are: small scars, the ability to remove significant amounts of fat in a directed manner, relatively less expense when compared to procedures that remove (actually tighten) the skin less and less recovery time and discomfort. To be fair to the Tummy Tuck, the reduced recovery time and expense is because Liposuction is doing less; however, if less is what you need, Liposuction is a better option.
Liposuction Limitations: Liposuction requires smooth, tight and elastic skin over the area of fat removal. This allows the skin to tighten and the best possible results. Despite what you may see advertised, lasers, ultrasound, radio frequency, heat, cold, microwaves and other added modalities to not significantly shrink loose skin. Removing the fat from under loose skin will reduce girth, but this rarely looks better when the skin folds irregularly. The loss of support that occurs when the stuffing (the extra fat) is removed is the problem. When the skin is already folding, a Tummy Tuck is the better option.
Tummy Tuck (Abdominoplasty)
Tummy Tuck Indications: Loose abdominal skin, loose abdominal muscles and disproportionate fat of the lower abdominal wall are all indications for Abdominoplasty. Unlike Liposuction, a Tummy Tuck can tighten the muscle behind the fat and tighten the skin in front of the fat. This is especially useful after weight loss or pregnancy, the two main reasons Tummy Tucks are performed.
The Tummy Tuck, or Abdominoplasty, removes fat like liposuction, but is also tightens the abdominal wall muscle and skin in one procedure.
Tummy Tuck Advantages: The open Tummy Tuck procedure allows for direct visualization of the abdominal wall muscles. When the rectus abdominus muscles are loose or separated (Diastasis Recti), the tough case of the muscle can be tightened like an internal corset to flatten the abdominal foundation and maximize the results of your Abdominoplasty. Likewise, the skin over the abdominal wall is tightened by removing any excess from the lower belly.
Tummy Tuck Limitations: Tummy Tucks do not work as well if you store your fat behind the abdominal muscles. It is best if this fat is lost, we’re talking diet and exercise, prior to surgical intervention. Trying to tighten the abdominal muscles when the belly is stuffed with fat is like trying to close a suitcase when it is stuffed full of clothes. Additionally, it can be hard to contour the upper abdomen when there is disproportionate fat in this area, or when the upper abdominal skin is very loose. Additional treatment, like staged liposuction or a Fleur-De-Lis Tummy Tuck, respectively, may provide better results.
Mini Abdominoplasty (Mini Tummy Tuck)
Mini Abdominoplasty Indications: A Mini Abdominoplasty is best when any skin or muscle laxity is confined to the region beneath the belly button. The Mini Tummy Tuck has some of the advantages and disadvantages of both Liposuction and Full Tummy Tucks.
The Mini Tummy Tuck combines aspects of Liposuction and Abdominoplasty to repair abdominal laxity that Liposuction can’t when a Tummy Tuck is too much.
Mini Abdominoplasty Advantages: The Mini Tummy Tuck’s recovery is closer to that of Liposuction, but it can do more than Liposuction alone. The procedure tightens the skin below the belly button by removing skin, like a Tummy Tuck, since less skin needs to be removed in patients who qualify for the mini procedure, the scar is shorter. Since less muscle is tightened, only below the belly button, there is less post-operative discomfort and a speedier recovery.
Mini Abdominoplasty Limitations: Since less skin is removed with the Mini Tummy Tuck, it cannot tighten the skin as much as a Full Tummy Tuck. Since the belly button and its surrounding skin are left attached, the mini procedure cannot tighten the upper abdominal wall. A “Floating Belly Button” technique can be used when just a little tightening is needed above the belly button, but an in-person consultation is needed to make the determination. Since less muscle is tightened, bulges in the upper abdomen cannot be addressed with this procedure.
Abdominal Rejuvenation
Instead of trying to figure out which procedure is best for your belly on your own, schedule an in-person consultation with a Board Certified Plastic Surgeon like Joseph A. Mele, MD. Your Plastic Surgeon should be familiar with all the above Abdominal Rejuvenation procedures and many more. This allows them to evaluate your abdomen first, and then pick the procedure that will work best for your specific needs. To schedule a personalized consultation about your Cosmetic Plastic Surgery, give me a call at (925) 943-6353, and learn all your options.
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