Tummy tuck without Liposuction
A full tummy tuck (abdominoplasty) improves the appearance of the abdomen following pregnancy or weight loss by addressing excessive skin, excessive fat, and abdominal wall laxity:
- Excessive skin: all skin from the umbilicus (belly button) to the pubic area is removed. The remaining upper abdominal skin is advanced downward and tightened.
- Abdominal wall laxity: the entire abdominal wall is tightened (typically 4 to 5 inches) by permanent stitches into the fascia (fibrous tissues between the rectus abdominis muscles).
- Excessive fat: all fat below the navel is removed, corresponding to the area of skin removal.
The big question: What do you do with the excessive abdominal fat above the navel? The answer is not as obvious as it seems. Many plastic surgeons are reluctant to perform liposuction of the upper abdomen during a tummy tuck for fear of problems with reduced blood flow to the tissues. Specifically, they are concerned that if you elevate and advance the tissues, suctioning them at the same time may create too much trauma.
The problem: If you don’t liposuction the upper abdominal tissues, your abdomen may still protrude excessively after surgery, potentially requiring a second surgery for abdominal liposuction at a later date.
The solution: I routinely perform liposuction of the abdominal wall during tummy tucks. The key is to be conservative with the amount of suction performed, so that the procedures can be combined safely. Fat removal must be done conservatively to preserve blood supply to the abdominal skin and remaining fat. Even greater care must be taken with diabetics (who must be well-controlled) and smokers (who must be off cigarettes), as both of these groups are at greater risk for blood flow compromise.
Judicious liposuction during tummy tuck can improve the cosmetic surgical results while preserving patient safety.
Dr. Friedman is the Founder and Director of the West Plano Plastic Surgery Center on the campus of Presbyterian Hospital of Plano. He also serves the Fairview, Lucas, and Wylie communities.