What’s the difference in a Tummy Tuck and liposuction of the abdomen?

 In Abdominoplasty, Liposuction, Mommy Makeover, Tummy Tuck

Both Tummy Tuck (abdominoplasty) and liposuction of the abdomen are often components of what is commonly referred to as a Mommy-Makeover, a post-pregnancy restoration of the breast and tummy.  Both tummy and breast surgery are among the most common procedures done by plastic surgeons.

A patient consults their plastic surgeon when they cannot lose their protuberant abdomen. Many patients have lost weight and exercised diligently without achieving their goal of a flat abdomen. We see mostly when they have given up. Protuberant abdomens can come from many sources, such as weight gain or multiple pregnancies. Sometimes it is heredity or even from injuries.

The answer to the leading question is actually simple: if the problem is too much fat in the abdomen, the best treatment is a liposuction; my preference would be the traditional tumescent liposuction. If there is too much loose skin in the abdomen, then the skin must be surgically removed with an abdominoplasty. Often a patient has both excess fat and skin, and a tummy tuck and liposuction are needed for optimal results.

There is much less recovery time and the post operative period is significantly easier with a liposuction, requiring only a couple of days off work, according to the occupation. Drains are necessary with a tummy tuck and not with a liposuction. The drains are removed in 5-7 days on average. Discomfort is a minor problem for the post operative liposuction, but can be significant with the Tummy Tuck, usually requiring oral pain medication. Liposuction can be done with only local anesthesia in most cases, whereas a full tummy tuck always requires general anesthesia.

If the muscle layers of the abdominal wall have been separated, usually by pregnancy, they must be sutured together, which is called rectus muscle plication. The only way to gain exposure to accomplish this is with a tummy tuck.

Occasionally a patient simply does not want a Tummy Tuck because they don’t want the recovery time or expense. Even though they may have excessive skin, a liposuction can yield significant improvement and a happy patient in many cases.

As in most cases each patient must be assessed individually, and the limitations and expectations explained fully.

E. Ronald Finger, MD, FACS

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