Tummy Tuck or Abdominal Smart Lipo – How to Choose
With significant weight loss or pregnancy, the skin and muscle behave like your clothing – they become loose and don’t fit correctly. You have two choices with respect to clothing: buy new clothes or have your loose clothing altered. Surgery (alteration of the skin and muscles) is the only option when the skin and muscles are loose.
To determine the best procedure for a patient, I visualize how the layers of the abdominal wall contribute to the appearance of that patient’s abdomen.
The abdominal wall layers are as follows:
- Skin Subcutaneous fat (fat between skin & abdominal muscles)
- Abdominal muscles (muscle girdle that supports the abdominal contents; this layer can loosen with pregnancy or weight gain allowing abdominal contents to protrude forward)
- Internal abdominal contents (abdominal organs and fat)
Smart Lipo only removes subcutaneous fat. Smart Lipo alone does not significantly shrink the skin and will not tighten loose muscles or decrease internal abdominal fat.
Tummy tuck removes excess skin, removes excess subcutaneous fat, and tightens the abdominal muscles. Tummy tuck will not decrease internal abdominal fat.
Only diet, exercise, and bariatric surgery can decrease the fat stored around the abdominal organs. Smart Lipo can be performed conservatively at the time of a tummy tuck to refine certain areas. Selection of the best technique will depend on the particular anatomical problem, the patient’s desired amount of improvement, the length of scar the patient will accept, and the time the patient has to devote to recovery.
For someone who has not been pregnant, has maintained a stable weight and only has increased fat under the abdominal skin, Smart Lipo *may be all that is needed.
When a patient has a large amount of subcutaneous fat, loose skin and loose muscles, aggressive abdominal Smart Lipo followed by a tummy-tuck at a later time may be the safest combination of the techniques to achieve the best results.
Smart Lipo is one technique. Sometimes Smart Lipo is all that is required, but in many instances, it is just one of several techniques employed during surgery to get the best results.
Smart Lipo under local anesthesia is not necessarily safer than Smart Lipo under general anesthesia.
There is a limit to the amount of local anesthetic that can be used safely. General anesthesia administered to healthy patients by board-certified anesthesiologists and nurse anesthetists is very safe and comfortable for the patient allowing multiple areas to be treated during one operation.
Technology assists a skillful, well-trained plastic surgeon in achieving good results but does not replace the need for surgical training and judgment. Consultation with a plastic surgeon certified by the American Board of Plastic Surgery, who has expertise in body contouring, is the best way to determine the most appropriate procedure for you.
Your plastic surgeon should be trained in both tummy tuck and Smart Lipo. Make sure that your surgeon has privileges to perform Smart Lipo and tummy tuck at local hospitals in your area even if you are having your procedure in an outpatient surgery center or an office.
Hospitals thoroughly investigate the credentials and experience of surgeons before granting surgical privileges. (Philip E. Fleming, MD, Nashville Plastic Surgeon)
There are a few guidelines to follow that can help you arrive at the best decision. First, you should be at your “best” weight and shape. “Best” means whatever reasonable weight you can achieve, with some degree of fitness.
Next, do you have hanging skin? If so, Smart Lipo will further deflate the skin, making it hang even more. Also, your skin tone has to be evaluated. If you have good skin tone, Smart Lipo may give you great results because the skin will contract easily.
If your skin tone is poor, you are better off having a tummy tuck, which includes removal of excess skin. Finally, we need to consider your abdominal muscles. If the abdominal wall is bulged out and exercise doesn’t help, only a tummy tuck will flatten those muscles. (James N. Romanelli, MD, FACS, Long Island Plastic Surgeon)
Smart Lipo removes fat without removing skin. It involves small incisions and can generally be done under a local anesthetic in the office. A full tummy tuck involves removing skin and fat from above and below the belly button.
You will have a horizontal incision from hip to hip and a small incision around the belly button. Your plastic surgeon will assess your abdominal concerns and decide which procedure is appropraite for you during your consultation. (Robert Heck, MD, FACS, Columbus Plastic Surgeon)
Smart Lipo/Tummy tuck and thier differences
Smart Lipos are done where undesireable fat are deposited in different areas of the body where overlying skin is streched out over these areas.
Abdominoplasties (Tummy Tucks) are done over the abdomen where excess skin is out bulging or hanging down in the lower part of abdomen.
Smart Lipo with or without ultrasonic devices require very tiny incisions, however tummy tucks require long incisions above the pubic hair line. The recovery time for tummy tucks are longer. Most often Smart Lipo of the upper abdomen and hip rolls could be combined to achive a better result. (Fereydoon S. Mahjouri, MD, Minneapolis Plastic Surgeon)
Nothing short of an in-person consultation will give you reliable answers but, in my Cleveland plastic surgery practice, women who have had children get the best results with a tummy tuck plus VASER Smart Lipo. This gives you the best of both worlds in almost every case: tighter skin, less fat and fewer stretch marks.
Depending on the location and volume of the stretch marks, I can sometimes eliminate all of them. The problem with Smart Lipo alone is that it won’t tighten the skin, tighten underlying belly muscles or eliminate stretch marks.
While I agree that doing the least invasive procedure first is “good” advice, a consultation with a skilled board certified plastic surgeon who does many Smart Lipo cases and many tummy tucks, will lead to the “best” advice.
The last thing you want to do is to undergo Smart Lipo only to find that you didn’t get the results you wanted/expected and in order to do so you need to undergo another procedure.
It’s best to meet with the most qualified surgeon you can find locally and take his/her advice. (Paul Vanek, MD, Cleveland Plastic Surgeon)
Large Abdomen-Smart Lipo vs Tummy Tuck
A large abdomen presents as a problem with different solutions. Smart Lipo is for removing fatty deposit areas with good skin tone and minimal excess skin. A tummy tuck or abdominoplasty is for removal of excess skin and fat of the abdomen.
In some cases a combination of both techniques may be used. (Paul Vitenas, Jr., MD, Houston Plastic Surgeon)
If you have issues with excess fat, excess skin with or without stretch marks and a bulging abdomen due to muscle diastasis following pregnancy than the only option for you would be a tummy tuck.
If both your skin and muscle are in good shape you may be a candidate for Smart Lipo only. (Renato Saltz, MD, Salt Lake City Plastic Surgeon)
Smart Lipo and abdominoplasty compliment eachother but achieve different goals
If you have a diastasis (when the paired abdominal muscles separate from the midline and the abdominal wall stretches), than one of the most important parts of an abdominoplasty is a diastasis repair where these muscles are repositioned next to eachother this returns a beautiful hourglass shape to the abdominal wall.
Smart Lipo alone would not do this but should be combined with abdominoplasty. I prefer to use Smart Lipo to do most of the dissection before starting the abdominoplasty. In this manner more blood supply is preserved, speeding recovery.
This technique is called lipoabdominoplasty and originated with plastic surgeons in Brazil. (Rian A. Maercks, MD, Miami Physician)
If your stomach muscles to be stretched as would be the skin, in these cases, even though you may have extra fat, a Smart Lipo could appear to give you even more loose skin.
A simple examination can give you these needed answers. If, however, you have had no separation of the abdominal muscles and your skin is reasonable tight, then a Smart Lipo may be just right for you.
You should do the least aggressive procedure to achieve your goals, but you do want to achieve your goals. The procedures must be taylored to the patient. Generally, when a tummy tuck (abdominoplasty) is done, Smart Lipo is performed at the same time, but a fair amount of fat is removed with an abdominoplasty as well.
In addition, in many cases stretch marks can be removed from the lower abdomen with an abdominoplasty. Your best choice is to consult a plastic surgeon who can do both procedures and does them frequently. (E. Ronald Finger, MD, Savannah Plastic Surgeon)
Although Smart Lipo and tummy tucks can both be used to deal with fat, the implications and potential results are dramatically different. Smart Lipo is ideal for contouring purposes and I almost universally combine this with my abdominoplasty (tummy tuck) procedures.
Smart Lipo alone will not address this at all. The key components of the abdominoplasty are removal of the excess skin, tightening of the muscles and re-contouring the abdominal tissues. (William F. DeLuca Jr, MD, Albany Plastic Surgeon)
Choosing Smart Lipo vs Tummy Tuck
Smart Lipo has the benefit of minimal scarring while a tummy tuck actually removes excess skin and tightens the abdomen. Thus if you have a little bit of extra fat in a little pouch but not a lot of excess skin, then perhaps a Smart Lipo would be a good option for you. (Martin Jugenburg, MD, Toronto Plastic Surgeon)