Tummy Tuck or Liposuction?

Tummy Tuck or Liposuction: Which Option is Better for me?

Arguably, this is the most common question of patients who want to do something about their flabby stomach. Liposuction and Tummy Tucks often appeal to people with similar cosmetic goals. But there are some important differences.

To know if you need a Tummy Tuck or Liposuction you need to take tow determining factors to take into account. These factors are skin laxity and muscle laxity. If you suffer from skin laxity or sagging skin (which generally occurs after massive weight loss), or from muscle laxity (where the abdominal wall becomes loose after pregnancy, leading to a bulging appearance) then a Tummy Tuck is the right choice.

While some people can tolerate a small amount of excess skin in their tummy area, others feel that it is a significant issue. For this reason, some patients are advised to have liposuction first then wait at least 3-4 months to determine if they would be happy with the result. The "waiting period" will also allow the skin to shrink to the best of its ability. In general, younger patients who have avoided large weight fluctuations throughout their lives have good skin elasticity. However, liposuction can lead to scar tissue in the fat layer, which could pose some challenges during tummy tuck.

What Are Both Procedures Like?

Liposuctions and Tummy Tucks are both performed by a plastic surgeon and require incisions performed under general anaesthesia.

With Liposuction your surgeon will make small incisions around the site of your fat deposits. A thin tube (cannula) will be moved underneath your skin to loosen the fat cells. Your surgeon will use a medical vacuum to suction out the dislodged fat deposits.

With a Tummy Tuck you surgeon will make an incision all along your lower abdomen and uncover your abdominal wall. Once the muscles are exposed, your surgeon will sew the muscles in your abdominal wall together if they have become stretched out. They will then pull tight the skin over your abdomen, trim off excess skin and fat, and close the incision with sutures.

What Are the Expected Results?

Although liposuction and a tummy tuck both claim permanent results, significant weight gain after either procedure can alter this outcome.

People that have liposuction on their abdomen tend to see a flatter, more proportioned midsection once they have recovered from the procedure. These results are supposed to be permanent. But up to a year after the procedure, the fat deposits reappear, though they may show up elsewhere on your body. If you gain weight, fat will re-accumulate in your body, though not typically in the areas that were suctioned.

After a tummy tuck, the results are considered permanent. Your abdominal wall will be more stable and strong. The excess skin that has been removed won’t return unless fluctuation in weight or a subsequent pregnancy stretches out the area again.

What Are the Possible Complications?

Although there are side effects associated with any surgery, each procedure poses different risks that you should be aware of.

With liposuction, your risk of complication increases if your surgeon is working on a large area. Performing multiple procedures during the same operation can also increase your risk.

Possible risks include:

• Numbness. You may feel numbness in the affected area. Although this is often temporary, it may become permanent.

• Contour irregularities. Sometimes the fat that’s removed creates a wavy or jagged impression on the top layer of your skin. This can make the skin appear less smooth.

• Fluid accumulation. Seromas — temporary pockets of fluid — may form under the skin. Your doctor will need to drain these.

Rare risks include:

• Infection. Infections may occur at the site of your liposuction incision.

• Internal organ puncture. If the cannula penetrates too deeply, it may puncture an organ.

• Fat embolism. An embolism occurs when a loosened piece of fat breaks away, becomes trapped in a blood vessel, and travels to the lungs or brain.

Tummy Tucks have been shown to carry more complication risks than some other cosmetic procedures. Around 8% of people who have a tummy tuck need to return to the hospital because of some kind of complication. Wound complications and infections were among the most common reasons for readmission.

Other possible risks include:

• Changes in sensation. Repositioning your abdominal tissue may affect the superficial sensory nerves in this area, as well as in your upper thighs. You may feel numbness in these areas.

• Fluid accumulation. As with liposuction, temporary pockets of fluid may form under the skin. Your doctor will need to drain these.

• Tissue necrosis. In some cases, fatty tissue deep within the abdominal area may get damaged. Tissue that doesn’t heal or dies must be removed by your surgeon.

What’s the Recovery Process Like?

The recovery process is also different for each procedure.

With Liposuction your recovery process will depend on how many areas were operated on, and whether additional liposuction sessions are needed.

After the procedure, you may experience:

• swelling at the site of your fat removal

• draining and bleeding at the site of your incision

Your surgeon may recommend that you wear a compression garment to help reduce swelling and help your skin heal smoothly over your new shape.

Because liposuction is an outpatient procedure, regular activity can be resumed fairly quickly. You should be able to do anything you usually do within the next 48 hours. However, you should hold off on heavy weight lifting and extensive cardio until you’ve gotten approval from your doctor.

With a Tummy Tuck your incision will be covered in surgical dressing, which will need to be changed several times. Your surgeon will also provide you with a compression garment or “belly binder.” Within a day, you should be up and walking (with assistance) to prevent the formation of blood clots. You’ll likely be taking prescription pain relievers and antibiotics to help ease any discomfort and reduce your risk of infection. Surgical drains may also be in place for up to two weeks.

It takes six weeks for the initial recovery phase of a tummy tuck to pass, and you’ll need several follow-up appointments with your doctor to check on how your incision is healing. During this time, you should avoid any position that involves abdominal extension or bending backwards, which may pull or place too much tension on the incision. You should also hold off on any strenuous physical activity or exercise until you get your doctor’s approval.

What Level of Scarring Should I Expect From Each Procedure?

A board-certified plastic surgeon who has years of experience and training will ensure there is minimal scarring. However, no matter how great a surgeon, there will always be a scar from either liposuction or a tummy tuck.

After liposuction, patients will be left with small scars at the site of the cannula. These should fade over time.

With a tummy tuck will leave a slightly bigger scar. It will run across the lower abdomen, but should be strategically placed so it can be covered by underwear and bathing suits.