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FAQ: About Tummy Tucks

1. What is a tummy tuck?

A tummy tuck (abdominoplasty) is a major surgical procedure requiring general anesthesia, and involves liposuction and excision to remove fat, plus a large excision of skin. The typical result is usually a flatter tummy with a large scar extending from the pubic area to the lower abdomen to anterior hips. Because the surgeon can directly visualize the muscles of the anterior abdominal wall during a tummy tuck, lax abdominal muscles can be surgically tightened during a tummy tuck procedure. Before the invention of liposuction, a tummy tuck was the only surgical method for removing excessive abdominal fat. In many patients (but not all) liposuction of the abdomen can often provide equivalent or better results than a tummy tuck. Because liposuction is safer and causes less scarring compared to tummy tucks, abdominal liposuction is now far more common than are tummy tucks.

2. How does abdominal liposuction differ from a "tummy tuck"?

Liposuction of the abdomen removes most of the fat found under the skin and above the abdominal muscles. When patients have good abdominal muscle tone, liposuction can provide a dramatic improvement, with a natural appearance of the abdomen, and with minimal scarring. In the vast majority of liposuction patients, the natural elasticity of abdominal skin contracts smoothly, and there is no need to surgically remove skin. Tummy tuck usually involves liposuction to remove fat plus the surgical removal of a large section of skin from the lower abdomen, together with a surgical relocation of the belly button. A tummy tuck can result in an unsightly scar that extends across the entire lower abdomen, just above the pubic area in addition to an unnatural appearance of the belly button. The recovery after liposuction is much safer, quicker and easier than the recovery after a tummy tuck.

3. What are the advantages of a tummy tuck (compared to liposuction)?

The only patients for whom a tummy tuck is superior to abdominal liposuction are the relatively few women having extreme degrees of lower abdominal skin laxity, unusually extensive stretch marks, or severely stretched abdominal muscles (as a result of pregnancy). Tummy tuck surgically removes skin with severe stretch-marks (striae-distensae). Liposuction does not remove stretch marks. A tummy tuck can produce a flatter abdominal wall by tightening the abdominal muscles. Liposuction is appropriate for patients who have abdominal muscles that have not be excessively stretched out of shape by pregnancy. A tummy tuck can remove excessive amounts of loose abdominal skin. However, loose abdominal skin does not mean that a tummy tuck is necessary. After liposuction, abdominal skin often contracts to a surprising degree so that an excision is not necessary.

4. What are the disadvantages of a tummy tuck?

Tummy tucks are often associated with ugly scars producing a deformed appearance of the pubic and lower abdominal areas. Although the lower abdominal area is usually covered when a bathing suit is worn, the scars are quite apparent without clothes. The removal of a large segment of lower abdominal skin requires that the belly-button be repositioned and surgically reconstructed. A surgically altered belly button often does not have a natural appearance. Tummy tucks are far more dangerous than abdominal liposuction. Tummy tuck surgery has a much higher risk surgical complications such as blood clots in the lung (pulmonary embolism) compared to liposuction. In most cases, liposuction alone, without a tummy tuck, produces excellent cosmetic results and avoids the risks and additional expenses associated with a tummy tuck.

5. When is liposuction sufficient and when is a tummy tuck necessary?

The majority of female patients who have excessive abdominal fat find that they are very happy with the results of a simple abdominal liposuction. Several months after having had an abdominal liposuction, the vast majority of women are so happy with their results that they decline a subsequent tummy tuck.

6. Is the cost of a tummy tuck greater than liposuction?

Tummy tucks are approximately twice as expensive as liposuction of the abdomen. The recovery time required before a person can return to work after a tummy tuck is typically two to four times longer than after liposuction of the abdomen.

7. If liposuction is safer, what are the reasons for doing a tummy tuck?

Abdominal liposuction is safer, gives superior cosmetic results, and has a more natural appearance without disfiguring surgical scars. Thus, liposuction has now largely replaced tummy tuck surgery as the preferred technique for improving the silhouette of the abdomen. There is another reason why a surgeon might recommend a tummy tuck. Some surgeons and some patients believe the aesthetics benefits of a maximally flat tummy outweigh the disadvantages of an abnormal appearance of the belly button and the unnatural appearance of the lower abdominal scar. Patients should be aware of this issue when deciding on liposuction or a tummy tuck.

8. How can one minimize the risk of complications associated with a tummy tuck?

When a tummy tuck is indicated, some surgeons believe it is safer to first do a liposuction and then, several months later, do the tummy tuck. Often the patient is so pleased with the initial liposuction that she no longer sees a need for a tummy tuck. Second, if the results of the liposuction are not sufficient, then dividing liposuction and tummy tuck into two separate relatively minor surgical procedures is usually much safer than one major surgery.

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