Liposuction Versus Tummy Tuck – Options After Childbirth
Liposuction will only address the subcutaneous fat and has no effect on the skin or underlying muscle. With childbirth, the abdominal muscles have been stretched apart (rectus diastasis) causing a loss of shape in your waiste.
Pregnancy can also cause permanent stretch marks which cannot be removed with diet, exercise, or liposuction.
Also, if there is an overhang of skin/fat at the waiste line then this extra skin will continue to be there after liposuction.
If you have minimal muscle damage, miminal skin/fat overhang, and minimal stretch marks then liposuction can be a good alternative.
The downside to the tummy tuck is the lower abdominal scar and longer recovery time.
Make sure you look at before and after photos of patients who look like you do before surgery and get a good idea of what these procedures actually look like. Make sure your doctor shows you the tummy tuck scar and what it looks like at all phases in the healing process. (John L. Burns Jr., MD, Dallas Plastic Surgeon)
A tummy tuck works on 3 different areas; the skin (tightening), the fat (removal)and the muscle (tightening). Liposuction focuses mostly just on the fat (removal).
If there is loose skin that has been stretched from pregnancy, which is commonly the case, fat removal only( liposuction) may make the skin only more loose.
Therefore, a tummy tuck may be more beneficial by removing and tightening the skin like it was before pregnancy and tightening the muscles (kind of like an “internal corset”). (Brian Joseph, MD, Orlando Plastic Surgeon)
Liposuction is the removal fat from the layer of tissue between the skin and muscle.
Fat can be removed from just about anywhere on the body. An adult has a finite number of fat cells and once they are removed, the remaining fat cells may increase in size but do not replicate.
In patients under the age of 40-45, the skin will shrink down once that volume is removed. The amount of shrinkage is affected by such things as prior surgeries, stretch marks,amount of fat being removed, and previous significant weight gain shifts.
Abdominoplasty visit procedure where redundant, lax skin and underlying fatty tissue are removed and the underlying muscle layer tightened. Length of the incision and extent of muscle tightening determines whether one undergoes a mini , standard or extended abdominoplasty.
When I examine a patient during the initial consultation, I try to find out if they are at their target weight. By that I mean that many patients are in the process of dieting and Ike urged them to continue with dieting and exercise until they get to a stable weight and maintain it wait for three months.
At that point we will schedule the surgery. This allows for a better chance to optimize the result Most of the abdominoplasties I perform include liposuctioning,to improve the contour particularly in the upper abdomen and along the flanks.
In summary, excess fat with minimal skin laxity is treated with liposuction and excess skin is treated with abdominoplasty (Joseph M. Perlman, MD, Houston Plastic Surgeon)
The problems of pregnancy include:
- Excess skin and stretch marks.
- New Areas of fat in the lower abdomen, hips and thighs.
- Misshapen belly button
- Stretching and widening of the muscles – diastasis recti/ventral hernia/ umbilical hernia.
Liposuction will treat #2/ Full Tummy Tuck will treat #1, #2, #3, and #4 — but you will have scars around the belly button and a long horizontal scar below the bikini line.
Mini-Tummy Tuck will address #2, #4 and #1 below the belly button.
There is no scar around the belly button and the horizontal scar is not as wide. (Robert M. Freund, MD, New York Plastic Surgeon)
There is NO physical way you could have carried baby without having your midline six pack muscles (rectus abdominis) split apart and PERMANENTLY be pushed aside. This happened to allow your uterus to grow forward.
Regardless of HOW MANY exercises you engaged in and regardless of HOW FREQUENTLY you did so, the stretching of your abdomen is permanent (Sort of like the stretching I may put on your favorite blouse if I wore it for 9 months or so…)
An Abdominoplasty (Tummy Tuck) would narrow your waist, flatten your tummy, remove saggy skin from the lower tummy (especially the one with stretch marks between your belly button and privates), lift a sagging Mons pubis and may lift the anterior thighs smoothing cellulite (IF a Lockwood procedure is done).
LIPOSUCTION DOES NOT SHRINK SKIN. It only removes fat. If you have fat deposits on the back / hips or thighs, that fat can be vacuumed by liposuction at the same time as the Tummy Tuck. (Peter A. Aldea, MD, Memphis Plastic Surgeon)
Abdominoplasty or Tummy Tuck adresses the skin laxity or the excess skin of the abdomen.
It also tightens the stomach muscles that loosen with each pregnancy. Liposuction removes excess fatty deposit in the abdomen or any other area of concern.
To have a good result on liposuction you must have good skin elasticity otherwise your skin will become wavey and irrigular. In some cases you need both a liposuction and a tightening of the skin. (Samir Shureih, MD, Baltimore Plastic Surgeon)
It depends on what you look like. Generally, if there is extra tissue that hangs over at the pubic area then Abdominoplasty is remommended. If you just want to lose volume then Liposuction will help but will not tighten the skin at all.
If you have a protuberent abdomen then a diastasis repair will be needed which is done with an abdominoplasty not liposuction. (Sharon Theresa McLaughlin MD, Long Island City Plastic Surgeon)
Identify your “dislikes” then choose the correct procedure
Pregnancy really challenges a woman’s abdomen, potentially stretching the abdominal wall, deforming the belly button, layering extra fat in inconvenient places and creating stretch marks. Many women who consult on which procedure to restore their bellies are not clear on what each procedure does.
Liposuction may suffice if the patient has small areas of fat (around the belly button, for example), but whose abdominal muscles are still tight and the skin fairly tight. It’s really well suited for pre-pregnancy women, whose skin will accomodate well, once the excess fat is removed.
Tummy tucks can improve a woman’s self-esteem by reshaping the abdominal wall, belly button and removing the excess skin. The trade offs are a long scar, which spans from hip to hip as well the risk of surgery and convalescent time.
It is a powerful operation, which should only need to be done once, in a woman’s life. Make a list of the features you dislike about your tummy and then consult with an experienced PS to help you with the correct decision. (Lavinia K. Chong, MD, Orange County Plastic Surgeon)
Usually, due to post-pregnancy changes (stretch marks, laxity/excess skin, bulging, and separation of six-pack muscles), a tummy tuck is needed. Liposuction can be used as an adjuctive procedure for instance to contour the waist to elimate those pesky love handles. (C. Bob Basu, MD, FACS, Houston Plastic Surgeon)
There are key differences between liposuction and tummy tuck. Liposuction involves using a small cannula to remove fat. No skin is removed and any looseness of underlying muscles is not addressed. To get a good result after liposuction, it’s imperative that a patient doesn’t have a large amount of loose skin and doesn’t have signs of irreversible skin injury, such as stretch marks.
Most women who have had child need a tummy tuck. This involves removes extra skin, tightening the abdominal wall muscles and removing fat.
The only way to know with certainty which procedure is best for you is evaluation with a board-certified plastic surgeon. (Sam Jejurikar, MD, Dallas Plastic Surgeon)
The difference between tummy tuck and liposuction
Liposuction is indicated for patients who are at or close to ideal weight and have excess fat under the abdominal skin with normal skin tone. Liposuction will remove majority of the fat cells. The skin, having normal elasticity, will retract down with time.
With pregnancy, the skin typically stretches and looses its elasticity. Stretch marks may also form. The growth of the baby will also stretch the fascia between the abdominal muscles (“six pack” muscles) causing the inside of the abdomen to push out where the weakness is.
This results in a “belly beer” abdomen. In this instance, the only solution is a tummy tuck. The tummy tuck will remove the loose skin and stretch marks up to the belly button, and corrects the weakness between the muscles.
I have seen patients who have normal skin tone and no stretch marks after pregnancy, who have a “beer belly” due to weakness of the muscles. In this case, liposuction will flatten the abdomen to some degree.
However, if the patient wants to have a flat abdomen, a tummy tuck will be required to tighten the muscles. (Michael A. Jazayeri, MD, Santa Ana Plastic Surgeon)
Many patients need both a tummy tuck and liposuction, but for different reasons. A tummy tuck will remove the extra skin that may have become stretched out (including the many of the stretch marks — if you are so “lucky”), and liposuction is great for debulking areas that may have become a little “thicker”.
Typically, the lower tummy needs to have skin removed, but it may also benefit from some muscle tightening. This is what a tummy tuck can do. On the other hand, liposuction is terrific for removing the fatty deposits in the flank or spare tire region.
I have found that many women are more impressed by the way their tummies look after the liposuction in this area than they were after a tummy tuck. (Thomas P. Sterry, MD, New York Plastic Surgeon)
A tummy tuck is indicated in patients who have loose, saggy skin with or without stretch marks. Usually this is the result of pregnancy or weight fluctuations throughout a patient’s life.
These patients may also have a weakness of the abdominal wall (the lower portion typically) which will require tightening with stitches at the time of the tummy tuck surgery.
Liposuction is indicated for patients who have good skin tone and elasticity with minimal to no stretch marks. Also these patients should not be severly obese but have localized areas of fatty tissue that is resistant to diet and exercise.
The success of liposuction depends on the quality of the overlying skin. Usually younger patients (<45 yrs) have better outcomes with this procedure due to their increased elasticity compared to older patients. Some patients also may benefit from limited liposuction of their sides(flanks) at the same time as a tummy tuck to improve their overall contour. (William Bruno, MD, Beverly Hills Plastic Surgeon)
The correct procedure depends upon your tissues and anatomy. Liposuction removes excess fat under the skin. We then rely on the skin elasticity to tighten the skin over the area of liposuction. A tummy tuck removes excess skin, excess fat and tightens the underlying muscles.
If your abdominal problem is limited to excess subcutaneous fat and of you have good skin quality, liposuction may be appropriate. However, if you have had child, you may have excess skin as well as fatty tissue and the abdominal muscles may be “stretched out”.
In this case a tummy tuck would provide a much better result than liposuction. Seek a consultation with a board certified plastic surgeon who performs both of these procedures. Your surgeon can then assess your particular case and make the best recommendation for you. (James H. Schmidt, MD (retired), Sarasota Plastic Surgeon)
After pregnancy, most women have a number of changes to the abdomen. The majority of these changes occur below the belly button. There has been localized stretching of the skin and of the muscle layer of the abdomen, resulting in stretch marks most of which are usually located between the pubic area and the belly button and also stretching of the tough layer called the fascia over the abdominal muscle layer.
This localized stretching results and to very common appearance is of the abdomen after pregnancy one of which is fullness of the lower abdomen from the stretching of the muscle layer and the other is stretch marks of the skin.
In addition, most women will have some excess fat in the region of the abdomen and hip areas. An abdominoplasty or tummy tuck addresses each of the problem areas of the abdomen that occurs after pregnancy.
The excess skin is removed and with the most if not all of the stretch marks. The weakness of the abdominal muscle/fascia layer is tightened with stitches in order to restore a flatter contour to the abdomen and to accentuate the waist.
In addition, in my practice, liposuction is performed with an abdominoplasty and probably 90-95% of cases to improve the appearance of the hips or to create better definition in the area above the belly button.
In contrast, liposuction alone will only remove the excess fat. It will do nothing to address the stretching of the muscle/fascia layer so there will be persistent protruding of the lower abdomen. In addition, you will need to rely on skin contraction alone to adapt to the new contour after liposuction and this lower abdominal skin, which has been stretched with pregnancy does not have the ability in many cases to contract at all and certainly it will not contract to the same degree to which it can be tightened with an abdominoplasty.
In general, after two pregnancies, most women will do better with abdominoplasty than liposuction alone; however, you do need to consider your age and the appearance of your skin and the appearance of the lower abdomen in order to make the final decision. (Ralph R. Garramone, MD, Fort Myers Plastic Surgeon)
A tummy tuck addresses three areas – skin, fat and muscle. Liposuction only addresses the fat and relies on your skin to shrink independently after the surgery and does not address the muscle at all.
For liposuction you should have good skin tone and no looseness to the muscle covering or fascia of your abdominal muscle called the rectus abdominus muscle. In general – a tummy tuck is indicated for patients after pregnancy or extreme weight fluctuations such as after gastric bypass.
Liposuction is typcially indicated for patients who just have a localized area of fatty deposit that is resistant to diet and exercise. A comprehensive consultation including a complete exam is the best way to determine your needs. (Bahram Ghaderi, MD, Chicago Plastic Surgeon)
The question is “Thinner” versus “Tighter.”
If your tissues are already tight or you don’t want them any tighter, then liposuction may be for you. For women after multiple pregnancies, a tummy tuck is far more often the best answer as it tightens that which childbirth has loosened.
Patients have to be willing to have the surgery though as it is a bigger deal than simple liposuction. (John P. Di Saia, MD, Orange Plastic Surgeon)