I often have patients consult for body contouring of the abdomen. A very common question patients have is whether or not they need an abdominoplasty, also known as a "Tummy Tuck", or whether liposuction alone will be enough.
Liposuction itself is a tool used to decrease the fullness under skin caused by fat. In patients with good overall skin quality and minimal excess, Liposuction can yield very nice results. (See above, in which this patient as treated with liposuction of the abdomen, flanks, and back with just Liposuction along with a breast lift with implants).
However, liposuction does have its limitations when performed alone. It does not allow for a significant amount of skin retraction, especially in areas that commonly lose elasticity such as the lower abdomen. Patient that have had significant fluctuations in weight (i.e multiple pregnancies, weight loss patients, etc) often require procedures that help remove excess skin and tighten the abdominal wall to bring the "ab muscles, better known as the the Rectus abdominis muscles, closer together.
Liposuction vs Procedures that remove skin
Take a look at the below images. The same image from above is shown in addition to the image below in which the patient had liposuction AND an excisional procedure, a Lower Body Lift. This procedure removes skin in the front of the abdomen and repairs the rectus muscles (aka tummy tuck) in addition to removing excess skin on the lower back. Notice the patient has even more dramatic contouring than the patient who had just liposuction despite starting out with more severe fullness of her abdomen.
Before and After Liposuction alone
Before and After Liposuction and Lower Body Lift with Muscle Repair
The same can be said of the same two patients from the back view. The patient who had liposuction alone has a very nice change in contour, but notice she retained some fullness due to skin excess in her love handles, while the body lift patient has minimal post operative fullness there. Both nice results, but more dramatic results with the addition of skin excision.
Before and After Liposuction alone
Before and After Liposuction and Lower Body Lift with Muscle Repair
Rectus Repair
Take a look at this patient's 3 months before and after photos following standard Tummy Tuck with minimal liposuction. She clearly has significant pre operative separation of her ab muscles, and repair of this offered her a great deal of improvement in her contour from the side profile.
Before and after Tummy Tuck and breast lift with implants, 3 months post op
Before and after Tummy Tuck and breast lift with implants, 3 months post op
The addition of a Tummy Tuck or Body Lift does have its considerations and may not be the procedures for everyone. These procedures require new incisions along the bikini line and some additional areas of healing will be required during the post operative period. Sometimes, liposuction alone can be offered to the right patients with very nice results, but it is important the patients have good understanding of all the options and limitations so that they develop realistic expectations.
Ultimately, a consultation with your Plastic Surgeon should provide you with the tools to make the best decision for you!