You’re considering liposuction or tummy tuck surgery. You want to know if you should have lipo or a tummy tuck. How did you find out? Liposuction is a cosmetic procedure used to remove excess fat from the body. It can aid in things like improving your body shape and contours, but it does not remove skin. Lipo does not also treat loose skin or stretch marks on the stomach.
A tummy tuck is a surgical procedure that removes excess skin, scars, and fat from the lower abdomen and waistline. It tightens and improves the appearance of the muscles in this area by removing excess tissue that causes sagging skin. A tummy tuck also helps to reduce stretch marks by removing fatty deposits beneath the skin’s surface that cause them over time, as well as giving your abdominal muscles more definition so they look more toned than before surgery!
Read on to learn more about How Do You Know If You Need A Tummy Tuck Or Liposuction, Tummy Tuck Risks Of Death and
How Do You Know If You Need A Tummy Tuck Or Liposuction
Tummy tuck or liposuction? Arguably, this is the most common question of patients who want to do something about their flabby stomach.
Plastic surgery experts have explained the key variables that determine whether tummy tuck or liposuction, or even both, can provide the “best” results.
Skin laxity
If there is a noticeable amount of sagging skin, which generally occurs after massive weight loss, tummy tuck is the right choice. This procedure uses an incision within the lower abdomen (concealed by the patient’s underwear) to remove the excess skin tissue.
However, patients with no or very minimal skin laxity can benefit from a liposuction-alone procedure in which 4-6 round incisions as small as a grain of rice are used to eliminate the fat. It is critical for the overlying skin to shrink around the new contour to achieve a smooth, natural-looking appearance.
Muscle laxity
After pregnancy and massive weight loss, the once tight abdominal wall becomes loose, leading to a bulging appearance. However, a physical evaluation is needed to determine if muscle laxity and/or fat is the underlying cause of the “problem.”
“Complete” muscle repair is only possible through standard tummy tuck in which a hip-to-hip incision is used.
Patient’s cosmetic goals
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. But some doctors feel that since the fat has already been removed, skin excision and muscle repair could be performed quicker and more efficiently.
Combo approach vs staging
After careful evaluation, some patients can actually benefit from simultaneous tummy tuck and liposuction. But if there is a need to remove large volumes of fat, the consensus is to stage each surgery to minimize the surgical trauma and bleeding.
Some doctors prefer tummy tuck after liposuction, while others perform it in reverse order. However, the ideal approach boils down to the patient’s underlying anatomies and cosmetic goals, and the surgeon’s personal experience, skills, and surgical techniques.
Tummy Tuck Risks Of Death
Abdominoplasty alone is considered a “major” surgical procedure in terms of risk and impact on normal homeostasis. Relative to other aesthetic surgical procedures, it is associated with higher rates of morbidity and morality, although with lower rates when compared with such reconstructive procedures as craniofacial surgery. According to Grazer and Goldwyn, it carries a mortality rate of 1:617 (.16 percent). about the same as that of hang gliding (1:600). A recent survey reported a rate as 1:2324 (.04 percent). The implication is that abdominoplasty has a significant and definable mortality risk associated with it; therefore, any additional procedure added to an abdominoplasty with further risk should caution the surgeon to minimize adverse outcomes before proceeding. Since not operating incurs no medical hardships, any further risks imposed by liposuction must be weighed by the physician and patient against potential gains.
Department of Plastic Surgery, Queen Mary’s Hospital, London
A 6-year retrospective series of 133 abdominoplasties was studied and type and incidence of complications are presented. From this series a group of 34 patients was re-examined between 4 and 10 1/2 years postoperatively and conclusions were made from this long-term follow-up. A high incidence of injury to the lateral cutaneous nerve of the thigh was recorded. A blood transfusion was required in 19% of the cases, the average hospitalization was 12.4 days and the complication rate ranged between 24% in those who did not attend review and 65% in those who were re-examined. Objectively judged, 55% of the patients had excellent or good results, but subjective patient satisfaction was nearly 90%.
A Safer Alternative
We recommend instead the Yoho Method “No Scalpel Tummy Tuck”, done with liposuction, which in most cases gives you a much better result with skin shrinkage and almost no scarring. If you are indeed a tummy tuck candidate, we will tell you. For more information, read “Liposuction vs. Tummy Tucks”.
Tummy Tuck Complications Years Later
Abdominoplasty—sometimes called “tummy tuck”—has a higher risk of major complications than other cosmetic plastic surgery procedures, reports a study in the November issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).
Complication risk is particularly high for the large proportion of patients undergoing abdominoplasty in combination with other procedures, according to an analysis of nationwide data by Dr. Julian Winocour of Vanderbilt University, Nashville, and colleagues. They write, “Combined procedures can significantly increase complication rates and should be considered carefully in higher-risk patients.”
Database Shows High Risk of Major Complications after Abdominoplasty
The researchers assessed abdominoplasty complication rates and risk factors using the nationwide CosmetAssure database. CosmetAssure is an insurance program providing coverage for complications related to cosmetic plastic surgery procedures, which are typically not covered by health insurance.
The study included nearly 25,000 abdominoplasties performed between 2008 and 2013, representing about 14 percent of all procedures in the database. Abdominoplasty is done to remove excess skin and tissue from the abdomen, to create a smoother, firmer abdominal profile.
Ninety-seven percent of abdominoplasty patients were women; the average age was 42 years. Sixty-five percent of patients underwent abdominoplasty combined with other cosmetic surgery procedures.
Overall, major complications occurred in four percent of patients undergoing abdominoplasty—significantly higher than the 1.4 percent rate after other cosmetic surgery procedures. (The database didn’t include less-serious complications that can be managed in the clinic). Hematomas (blood collections) were the most common major complication, followed by infections, blood clots (venous thromboembolism), and lung-related problems.
Combined procedures were a key risk factor for complications. Compared to the 3.1 percent rate with abdominoplasty alone, risk increased when abdominoplasty was combined with other procedures: up to 10.4 percent when abdominoplasty was combined with body contouring plus liposuction. After adjustment for other factors, the relative risk of major complications was 50 percent higher with combined procedures.
Other risk factors for major complications included male sex, age 55 years or older, and obesity. Risk was lower when abdominoplasty was performed in an office-based surgical suite, compared to a hospital or surgical center. Dr. Winocour comments, “Surgeons often refer patients with major illnesses, such as heart disease, to hospitals, which may be responsible for this observed trend in complications.”
Diabetes and smoking—two major surgical risk factors—were not associated with a significant increase in complications after abdominoplasty. “That likely reflected Board-certified plastic surgeons’ practice of not offering abdominoplasty to poorly controlled diabetics and recommending strict smoking cessation for at least four weeks before and after surgery,” Dr. Wincour adds.
Abdominoplasty is the sixth most common cosmetic surgical procedure performed in the United States, with more than 117,000 procedures performed in 2014, according to ASPS statistics. The number of abdominoplasties has increased in recent years—partly because of the increased number of patients undergoing body contouring surgery to remove excess skin and tissue after massive weight loss.
The study adds to previous evidence that abdominoplasty carries a higher complication rate than other cosmetic plastic surgery procedures. “Although the overall incidence of major complications is low, such complications can leave a potentially devastating cosmetic outcome and pose a significant financial burden on the patient and surgeon,” the researchers write.
They draw special attention to the risk associated with multiple procedures—especially since nearly two-thirds of patients in the database underwent other cosmetic procedures combined with abdominoplasty. Dr. Winocour and colleagues suggest that some patients at high risk of complications might be better off undergoing staged rather than combination procedures.
About Plastic and Reconstructive Surgery
For over 75 years, Plastic and Reconstructive Surgery® has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. The official journal of the American Society of Plastic Surgeons, Plastic and Reconstructive Surgery® brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair and cosmetic surgery, as well as news on medico-legal issues.
About ASPS
The American Society of Plastic Surgeons (ASPS) is the largest organization of board-certified plastic surgeons in the world. Representing more than 7,000 physician members, the society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises more than 93 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada.