Web Log – June 2012 – Liposuction, Abdominoplasty, or Both?

USS Bowfin
USS Bowfin

How do I decide whether I need liposuction, abdominoplasty, or both?

First, we need to consider what each treatment accomplishes.  Liposuction primarily removes fat.  That is nice, because most of us have some fat we would like to be rid of, and the fat is removed from barely noticeable incisions.  The type of liposuction – whether it is ultrasound or laser assisted, versus traditional – makes very little difference.  The higher tech methods add some minimal skin shrinkage, but introduce other potential complications such as over resection, burns, and fluid collections.  Tummy tucks, or abdominoplasties, are open surgical procedures that have longer incisions and longer recoveries, but remove extra skin as well as fat.  They can also tighten the abdominal wall like a corset.
How do patients know which one they need?
The next step is to look in the mirror and decide what exactly is bothering you.  Is it extra skin, stretchmarks, fat, or abdominal bulge and laxity?  Then, have a consult to see if your concerns are appropriate for an operation, which methods would help the most, consider if your expectations match patient example photos, and then decide if it fits your pocket book.  A Plastic Surgeon because  can offer liposuction as well as abdominoplasty.  Non Plastic Surgeons usually only offer liposuction because they think it is an easy technique to learn while they rarely will attempt an abdominoplasty.  You might need an abdominoplasty and only be offered liposuction because the doctor does not know how to do an abdominoplasty.
How do you decide which operation a patient needs?
Most post partum patients have abdominal laxity and stretched skin and would benefit from abdominoplasty.  Stretch marks below the umbilicus indicates skin removal – no other method helps significantly.  Skin that folds over above the umbilicus or at the pubic hair line also needs an abdominoplasty – that much extra skin will never shrink adequately from liposuction.  Patients in their 40’s and older likely do not have enough elasticity in their skin to have liposuction only.  The best patients for liposuction only are 30’s or younger, have good skin quality, and have extra fat at the flanks and thighs with a modest amount on the abdomen.  Abdominoplasty patients with extra at the flanks or thighs can have liposuction added to their operation safely. Highest satisfaction rates are highest with combined procedure and lowest with liposuction only.
Wigod Plastic Surgery – Plastic Surgery for Boise, Meridian, and the greater Southeastern Idaho Region

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