In the world of Cosmetic Surgery, an Abdominoplasty (Tummy Tuck) can be one of the most life changing procedures — especially when done as part of a Mommy Makeover. The Tummy Tuck, however, still has limitations as a stand alone procedure because today’s cosmetic surgery patients also desire contours of the waist line. Can this be achieved? With advances in surgical technique that allow surgeons to combine liposuction with the Tummy Tuck procedure, it can.
“Just understanding how to do an Abdominoplasty does not make you a great cosmetic surgeon,” said Dr. Chad Deal, a Double-Board Certified Cosmetic Surgeon at Southern Surgical Arts. “It is the uniquely exceptional details like combining Liposuction of the abdomen, carefully creating a new pleasing belly button, creating a smaller and very low scar that is hidden well in the bikini bottom that show the artistic and surgical talent of a surgeon.” This attention to detail as well as other finishing touches create the overall beautifully contoured abdomen and waist. Recent advances in medicine and surgery technique has allowed surgeons to perfect their Tummy Tuck skills to provide patients with a more optimal desired outcome.
In the past, if a patient possessed a large amount of abdominal wall fat and excess skin, he or she was limited to only the removal of excess skin, which could also include repair of abdominal wall laxity (Rectus Diastasis Repair). And while the technique of Liposuction to remove the excess abdominal wall fat has been around for approximately 30 years, surgeons shied away from the combination to the Tummy Tuck and Liposuction. And for good reason.
The concern to combine a Tummy Tuck with Liposuction is that the blood supply to skin and fat (the flap) will be compromised so much that the wound will not heal well and potentially a large amount of skin could die. This is because much of the blood supply to this area comes from vessels that perforate through the abdominal wall to feed oxygenated blood to this area. These “perforators” are cut during an Abdominoplasty. The only remaining blood supply comes from the remaining perforators, as well as a network of vessels in the skin/fat flap itself that are fed from several vessels at distant locations. The blood finds its way to the undermined flap through this network of vessels.
Adding Liposuction to this same area where the perforators are cut could damage some of the network of vessels leaving the flap of skin and fat without a good blood supply. This is why many surgeons for years have avoided combining Liposuction of the abdomen at the same time as a Tummy Tuck. While patients are happy with the excess skin removal and tightening of the abdominal wall, they are still disappointed with the overall contours because of all of the abdominal fat left behind. Therefore, patients would come back for second procedure to have the desired areas liposuctioned about 6 months later after the wound from the Tummy Tuck is well healed.
As of recent, though, there is a better understanding of the anatomy and limitations of body contouring that allow surgeons to combine the Tummy Tuck with Liposuction. Some surgeons, including Dr. Nease and Dr. Deal at Southern Surgical Arts, combine the procedures for an improved aesthetic outcome. This provides much higher patient satisfaction because the patient is closer to their desired goals of the contoured abdomen and waist when combining the two — often avoiding a second Liposuction procedure that was needed when the surgeons did not combine the two procedures.
At Southern Surgical Arts, most of our Tummy Tucks are combined with liposuction although there are some patients are not good candidates. Primarily, patients that are significantly overweight who have enlarged livers, as well as an abundance intra-abdominal fat (omentum), are not good candidates. This is fat that cannot be removed as part of an aesthetic procedure and thus this will limit how small of a waist one can achieve with an Abdominoplasty.
When you schedule a consultation with any cosmetic surgeon, ask them if they will be combining the two procedures. We invite you to schedule a complimentary consultation in-office or online with Dr. Nease or Dr. Deal to find out if the combination of Liposuction and a Tummy Tuck is right for you.
Chattanooga, One North Shore: 423-266-3331