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Can I have liposuction in my upper stomach during a tummy tuck?

Q:

I am 28 years old, 240 pounds, and 6 days pre-op from having a tummy tuck.  I have some pouches of fat under my breasts in the upper abdomen that I want to have liposuction on.  One doctor told me it was possible that I could have this done; however, another doctor said it was not possible due to the risk of skin dying.  What does this mean?  Should I get a third doctor's opinion?

A:

Yes, liposuction of the upper abdomen is sometimes done in combination with a tummy tuck. However, sometimes it is not an optimal combination as the surgeon will have to be less aggressive about liposuction and about tightening your abdominal flap during the tummy tuck in order to avoid compromising the circulation to the skin.

Fredrick A. Valauri, M.D. F.A.C.S.M.D., F.A.C.S.
New York, NY

A:

Liposuction after Abdominoplasty.

At this point you should do nothing. Some of the "pouches" you describe may remodel with time.  Instead of worrying about them, you would do better modifying your diet and losing weight.  After your weight is stable at a lower (at least 60 or more pounds) weight, you could then think about liposuction to even everything out.  By the way, now that you have had the abdominoplasty, you should be able to lose weight better.

A:

There is a little bit of debate among plastic surgeons about this very question.  Some feel that doing liposuction of the abdomen at the same time as the tummy tuck increases the overall risk of complications, such as seroma, wound healing problems, skin necrosis and so on.

Others feel that, if they modify the tummy tuck technique, then it can be done fairly safely. However, they can not undermine and pull the skin as aggressively as in the first group.

This is why you have received two different opinions! 

All the best,

Thomas G. S. Fiala, M.D. - View Other Answers by this Doctor
Altamonte Springs, FL

A:

Nm,

You've probably had your procedure by the time you get this.  I hope you fully discussed the anticipated results of your procedure as 240 pounds does not place you in the ideal candidate category.  Assuming your expectations are realistic, you could have suctioning done quite aggressively with the lipoabdominoplasty technique pioneered in South America.  You would have to accept some shortcomings such as not being able to remove the maximal amount of skin and not having the tightest muscle plication.  Regardless, with tummy tucks, it is very common to have a mound of excessive soft tissue at the upper abdomen requiring a minor office revision to correct and your "pouches" could always be addressed then in pursuit of perfection.  Hope it went well for you and that it provides you the result you anticipated.

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