As a specialist in body cosmetic surgery, one of the most common questions Dr. Zuckerman is asked by prospective patients during consultation is if an abdominoplasty (tummy tuck) is necessary to achieve desired surgical goals or if liposuction alone will suffice. The answer varies by patient, but this is an important question given a resulting abdominoplasty scar is significantly larger than the 2-3 millimeter pokehole incisions left by liposuction.
Tummy Tuck Indication #1: Previous Pregnancy
Although pregnancy affects every woman’s body differently, the majority of patients seeking contouring of their abdominal region after a pregnancy require a tummy tuck. This is for a couple of reasons: 1) liposuction cannot address excess skin or stretch marks whereas abdominoplasty can and 2) pregnancy often leaves diastasis recti, a separation of the abdominal muscles, which is only addressable via tummy tuck. However, pregnancy may also cause the body to redistribute fat to some degree, and even for those lucky moms without excess skin or stretch marks postpartum, they may be left with excess pads of fat in the abdomen. These can be quite stubborn and difficult to address via diet and exercise. For this reason, Dr. Zuckerman combines liposuction with virtually every tummy tuck he performs for patients after a previous pregnancy.
Tummy Tuck Indication #2: Massive Weight Loss
The body’s fat volume decreases upon weight loss, but the skin may not fully contract back to its original contour. Skin has a certain elasticity, and it cannot fully contract when stretched beyond its limit. Dr. Zuckerman’s weight loss patients most often have lost in excess of 100lbs and may undergo a variety of body contouring procedures including abdominoplasty, breast lift surgery (mastopexy), thigh lift surgery, arm lift surgery, and others. For a weight loss abdominoplasty in particular, Dr. Zuckerman removes excess skin surgically before pulling abdominal tissues taut. For those who have lost lesser amounts of weight and may suffer from more minor amounts of excess skin, there are some new medical technologies that use energy from a laser or radio frequency to achieve some skin tightening without full surgical intervention.
Liposuction Indication #1: Targeted Pockets of Fat Alone
Dr. Zuckerman can perform liposuction on many areas of the body as demonstrated on the Liposuction guide page under the “Am I candidate for Liposuction”. Even large volumes of liposuction up to five liters from multiple areas can be performed in a single procedure. However, Dr. Zuckerman examines each prospective patient to ensure that he feels the skin elasticity is sufficient to create a taut, smooth contour after liposuction, because multiple liters of liposuction aspirate means removing significant volume from a targeted area. Patients are not well served by liposuction if their skin then lacks the ability to fully skin contract postoperatively. Dr. Zuckerman has treated patients who underwent prior liposuction procedures with other surgeons and were left with excess skin; those patients would have been better served by undergoing abdominoplasty in the first place.
Contraindication for both Liposuction and Tummy Tuck: BMI Above 30
It is a misconception among patients that both abdominoplasty and (especially) liposuction are weight loss tools. While Dr. Zuckerman can create a dramatic change in contour using either surgical tool, neither actually helps patients lose weight beyond a few pounds of fat or tissue removed. Dr. Zuckerman counsels patients with a BMI well above 30 to lose weight through traditional diet and exercise before undergoing surgery for best results. He is happy to recommend a nutritionist to help with these efforts if requested. Patients who can maintain a stable weight are the best candidates for these procedures as significant weight gain or loss postoperatively can compromise the surgical result.
