Should I Get Liposuction Or Tummy Tuck After Pregnancy?

A common question asked by many mothers…will I need a tummy tuck, or will liposuction be enough. In general, the abdomen, or Tummy, goes through significant changes during pregnancy.

The muscles and fascia (muscle covering) streches out, the skin also streches.

Even the belly button goes through some changes. If one develops stretch marks…that causes the skin to become loose and it’s hard to regain it’s tone.

Tummy tuck targets all these things. Liposuction treats the fat under the skin. The skin tend to retract depending on the patient’s age and quality of the skin. If there are significant streach marks, it’s less likely to do so. (Rafi S. Bidros, MD, FACS, Houston Plastic Surgeon)

An appropriate candidate for a tummy tuck is an individual who has excess skin with poor elasticity. Additional benefits of an abdominoplasty is the repair,or tightening, of the stomach muscles.

Liposuction is an excellent procedure for an individual who has good skin tone.

No hanging skin and good muscle tone. The best candidate for liposuction is someone who has localized fat deposits.

In my experience most women who have had multiple pregnancies require either an abdominoplasty or a mini abdominoplasty, to resect some skin and repair the muscles so the lower abdomen wont “pooch”.

This can be combined with liposuction to thin contour the waist and the upper abdomen. The best thing is to have a consultation with an experienced surgeon and see what is your best treatment options. (Irvin M. Wiesman, MD, Chicago Plastic Surgeon)

Most commonly tummy tuck (abdominoplasty) is the right choice after pregnancy because it removes both the extra skin, stretch marks down low on the abdomen and bulging of the abdominal muscle wall created by the pregnancies.

If you have had only one pregnancy and/or the amount of abdominal wall bulging is small, then liposuction may be all you need. There are really three different components to the changes seen in the abdomen after pregnancy:

1. Excess Skin: Often women complain of loose skin and associated stretch marks especially down low below the belly button
2. Excess Fat: Also usually down low below the belly button. Some women have this and some don’t. Often women think they have a lot of fat when most of the bulging may be from the abdominal wall bulging/stretching created by the pregnancy
3. Abdominal wall bulging: This is related to the stretching of the facial wall of the abdomen during pregnancy and separation of the abdominal muscles which often occurs.

Amazingly it almost returns to normal after pregnancy but not quite. So some bulging is left behind. Each pregnancy makes this a little worse. This can’t really be improved with sit-ups or crunches as my patients often ask.

Abdominoplasty corrects all three of these and gives very dramatic results. It is a bigger operation with a longer recovery and a long scar. In spite of this most women are very happy with the results because they can get back to a much flatter abdominal appearance and get rid of fat, skin and stretch marks all at the same time.

On the other hand liposuction may work well if the skin is in reasonably good shape and is not very loose or thin. Women who have had only one child may be good candidates for liposuction since they may have only a small amount of component #3, abdominal wall bulging.

Finally, there is a smaller version of a tummy tuck called a mini-abdominoplasty if you fall in between (have too much extra skin down low to do liposuction alone but not enough abdominal wall bulging or extra skin above the umbilicus to warrant a full tummy tuck. (David L. Mobley, MD, FACS, Sarasota Plastic Surgeon)

One quick question to ask: Is there significant skin excess of changes? Many mothers consider improvement in their abdomen after pregnancy.

Pregnancy stretches and inflates the abdomen and often the skin is not able to recoil as it had once stretched.

The one question I try to answer and ask my patients to consider are they concerned with excess fat only OR are there stretch marks and excess skin that they hope to have corrected.

For most women who have had children considering improvement to their abdominal contour and look, the tummy tuck with or without liposuction is generally the appropriate choice because it address the loose skin and stretch marks as well as corrects the muscles that have been displaced away from the middle. (Ankit Desai, MD, Jacksonville Plastic Surgeon)

The answer is in the skin

Liposuction is a procedure where fat is vacuumed from under the skin to change body contour. Tummy tuck is the surgical removal of excess skin and fat from the stomach along with tightening of the muscles on the abdominal wall.

Liposuction is often used in conjunction with a tummy tuck. A person who has had pregnancies is likely to have some laxity of the muscles as well as skin and these are better addresses with abdominoplasty with or without liposuction than with liposuction alone. (Barry Stuart Handler, MD, San Diego Plastic Surgeon)

You need to ask if it is an issue of fat or fat plus skin. Fat only or fat and a little extra skin can typically be addressed by liposuction.

Vaser liposuction which involves heat plus sound waves provides a component of skin tightening. If there is fat and significant skin, you will need some version of a tummy tuck either mini or full.

If you have stretch marks, your skin is less elastic and liposuction will provide less skin tightening and you are more likely to fall into the category of a tummy tuck. (Roger J. Friedman, MD, Bethesda Plastic Surgeon)

To determine which option would benefit you the most an examination is needed. However, a general rule would be that if there is excess skin or stretch marks then a tummy tuck is better. Otherwise, a small collection of extra fat may be best approached with liposuction only.

Typical post-pregnancy patients will benefit from a combination of the two procedures.(Michael L. Spann, MD, Little Rock Plastic Surgeon)

If you are done having children, then it is a good time to have a consultation to see whether lipo, tummy tuck, or a combination of both would give you the best results. Liposuction will remove excess unwanted fatty tissue, but will not tighten the skin or eliminate strech marks.

Tummy tuck will get rid of excess fat from the waist down, and tighten the skin and eliminate strech marks that are below the belly button. So each individual person should be examined to see what will be the right surgery!. (Amy T. Bandy, DO, FACS, Newport Beach Plastic Surgeon)

Best to be examined for Lipo or Tummy Tuck

It depends on how much loose skin you have and the status of your abdominal muscles. After children chances are the muscles are a bit loose. It is best to be examined by a plastic surgeon, share your questions and concerns, and come up with a plan that meets your goals and expectations. (Farzad R. Nahai, MD, Atlanta Plastic Surgeon)

Liposuction of abdomen first before consideration of tummy tuck as it may not be necessary

Vast majority of patients who underwent liposuction, either via tumescent technique or traditional plastic surgery under general anesthesia, should do well without need for tummy tuck, or abdominoplasty. After liposuction, there is a ‘plane of scar tissue’ between the skin and the muscle, hopefully with less fat pads in between.

With appropriate compression garment application, most laxed skin of the abdomen should retract and tighten nicely. Unless you have super-laxed skin on the abdomen, you want to avoid unnecessary tummy tuck as there are risks of infection, scar tissue, even small bowel obstruction from scar tissues.

Make sure tummy tuck is not sold to you just have another procedure done while you are under general anesthesia.(William Ting, MD, Bay Area Dermatologic Surgeon)

Lipo is for fat removal, Tummy Tuck is for fat and skin

When you think of body contouring and choosing the right procedure, the following guideline will be helpful. Liposuction is excellent for removing excess fat and sculpting our shape but will do nothing for the skin.

In fact, it may leave you with more laxity and hanging skin once the fat is removed. Abdominoplasty (tummy tucks) will remove the loose and hanging excess skin and fat together but will not remove fat in areas where skin is not being removed.

It is very common for the two techniques to be used together. Women that have had children often have a combination of excess and loose skin from the pregnancy as well as some excess fat that could not be shed after the baby.

In most cases, a combination of liposuction and abdominoplasty will give the best result. I would recommend that you see a board certified plastic surgeon (or a few) for a consultation to determine the best choice for you. (Adam Rubinstein, MD, Miami Plastic Surgeon)

How do I get my PRe-pregnancy look back?

Whether you need liposuction or a tummy tuck will really depend on a few variables, including your current exam (how much of the problem is due to loose skin, how much excess fat is present, and whether or not your muscles have been stretched apart by the pregnancies), your goals for appearance, and your desired experience.

The only way to know for sure would be for you to visit with a Board Certified Plastic Surgeon for a consultation and examination. (Armando Soto, MD, FACS, Orlando Plastic Surgeon)

The choice between Liposuction and Tummy Tuck

On occasion there is a decision to be made as to whether a liposuction or an abdominoplasty would best solve the patient’s problem. The advantage of the liposuction is very small scars and removal of fat.

But liposuctioning an area with severe stretch marks may result in an unsightly appearance of wrinkled skin, since stretch marks are like scars and may not allow the skin to shrink properly.

For a patient who will not accept the long abdominal scar or does not wish the expense of a tummy tuck, a liposuction may be the proper compromise.

Of course liposuction does not remove stretch marks or excess skin. But one difficulty may be that when there is a lot of fat that hangs down, a liposuction may result in leaving an empty hanging skin sac.

I have had some luck in such cases by taping the skin upwards after the liposuction to get it to stick down to the underlying muscle. Also, it is important to remember that liposuction cannot be done on the upper abdomen or flanks at the same time as a tummy tuck so if those areas are a real problem, a liposuction may be preferable.

Of course, liposuction can always be undertaken later as a second operation. Thus, it is very important to have a thorough discussion with the doctor regarding the various options available to restore the abdomen to its optimal condition. (Howard T. Bellin, MD (retired), Manhattan Plastic Surgeon)