Tummy Tuck: With or Without Liposuction? - Hourglass Tummy Tuck
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Tummy Tuck: With or Without Liposuction?

Tummy Tuck: With or Without Liposuction?



The tummy tuck is one of the most complex plastic surgery procedures that can be performed. It aims to correct the unsightly appearance of the abdominal wall and make the tummy firm and flat again. The procedure can significantly change the overall appearance of the patient’s body when performed with other plastic surgery procedures such as liposuction.     

The traditional tummy tuck technique aims to improve the appearance of the abdomen by strengthening loose abdominal muscles and eliminating the skin excess present in the lower tummy. But if the patient is also confronted with an excess of adipose tissue on the tummy and flanks, the results of the traditional abdominoplasty might not deliver the desired results. This is why it is important to choose a board-certified plastic surgeon who can guide you through the process of choosing the procedure or combination of procedures that are the most suitable for your particular case.

In this article, we will discuss the details of abdominoplasty and the results achieved when it is performed with or without liposuction.

Who are the best candidates for an abdominoplasty?

Different categories of patients can be good candidates for the procedure. In a vast majority of cases, these are women who had one or multiple pregnancies and who didn’t manage to regain the firm and beautiful appearance of the abdominal wall after giving birth despite getting back to a normal weight. They might have stretch marks on the abdomen, especially on the lower part of it, the muscles of the abdominal wall might be loose and distended, and there can also be skin sagginess on the tummy as well. 

The condition that affects the abdominal muscles and creates a gap is called diastasis recti, and it occurs during pregnancy due to the growing size of uterus. Diastasis recti can’t be fixed with exercise or diet, and plastic surgery is the only effective solution that will restore the beautiful appearance of the tummy. Otherwise, the loose muscles of the tummy can create a protruding appearance of the belly that prevents it from looking flat and firm. Physical exercises not only can’t correct the condition, but they can even accentuate it and make it more visible.

Another important category of patients who are good candidates for abdominoplasty are people who underwent massive weight loss, often after bariatric surgery. The excess skin can be pretty significant for these patients, with skin folds that can partially or entirely cover the suprapubic area. These patients can be both men and women who want to improve the appearance of the tummy and redefine their overall body appearance after weight loss.

Patients who are confronted with an excess of adipose tissue on the tummy and who have lost skin elasticity due to aging are also good candidates for the tummy tuck.

Tummy tuck without liposuction

So how is the tummy tuck performed as a stand-alone procedure? The plastic surgeon will make an incision on the suprapubic area. The length of the incision is directly dependent on the excess of skin tissue to be removed. The skin and subcutaneous tissues are detached from the muscles and the excess skin is surgically removed. If needed, the loose abdominal muscles are sutured together to correct diastasis recti. If umbilical hernia is present, it will be corrected as well. The surgery can last up to two hours, depending on the complexity of each case.

This type of tummy tuck is recommended for patients with a normal weight and without an excess of adipose tissue on the tummy or the flanks. 

After the traditional tummy tuck, the aesthetic effects will affect just the front of the body, and the patient will have a flat and firm tummy. However, the results of the traditional tummy tuck might be not as impressive when performed on patients with fat accumulation on the midline.

Tummy tuck with liposuction

Liposuction is one of the most commonly performed plastic surgery procedures nowadays. It safely allows for a considerable reshaping of the body by eliminating localized fat pockets that are stubborn and difficult to remove with exercise and diet. 

Liposuction is often recommended for patients who are undergoing a tummy tuck procedure after massive weight loss or bariatric surgery, as in most cases there will be a layer of fat that needs to be reduced to improve the appearance of the tummy. Moreover, liposuction is also recommended for patients who have fat deposits on the flanks. Not addressing the flanks with liposuction will result in a square body shape after the procedure. The abdomen will be flat and firm, but due to the adipose deposits on the sides, the patient won’t have beautiful curves and a nice silhouette. 

When the tummy tuck is performed with liposuction, the plastic surgeon will first address the areas with an excess of fat tissue and only after removing the excess skin present on the inferior abdomen. 

Small incisions of no longer than 3 to 4 mm are made on the abdomen and the flanks. The liposuction cannula is inserted through the incisions, and the plastic surgeon starts making back and forth movements with the cannula to dislodge the fat. Once dislodged and liquefied, the fat is suctioned with a medical vacuum device. Liposuction is performed until a symmetric and aesthetic result is achieved and until the layer of fat is considerably reduced and the flanks are remodeled. When this first step is complete, the plastic surgeon can move on and perform the classic tummy tuck technique to eliminate the excess skin tissue.

Tummy tuck: With or without liposuction?

This is a question I get from many patients, which is easy to answer once the patient comes to the pre-operative consultation and undergoes a physical examination. At the same time, this is a difficult question to answer if you don’t see the patient. In other words, to understand what procedure would be best for you, you need to see the plastic surgeon for a consultation. Keep in mind that each patient is different, each body shape has its own characteristics, and we have a tendency to deposit fat according to our morphology. 

With a tummy tuck, liposuction is often performed on the abdominal wall and the flanks, but it is not uncommon for patients to ask for liposuction to be performed on the thighs as well. Discuss your aesthetic concerns with the plastic surgeon during the consultation and take into consideration his recommendations before scheduling your surgery.


The tummy tuck is a complex procedure that can deliver spectacular results with one condition: to have the right medical indication. An experienced, board-certified plastic surgeon will know what procedure will help you achieve your goals. 

There are different categories of patients that want or need to undergo a tummy tuck. The traditional tummy tuck performed as a stand-alone is a good option for patients with loose abdominal muscles and skin sagginess on the lower part of the tummy, but without considerable fat tissue on the belly or the flanks. 

When the patient has saggy skin, weak muscles and also an excess of fat on the abdominal wall and the sides of the body, the plastic surgeon might recommend the tummy tuck with liposuction to achieve superior results. Liposuction will reduce the thickness of the adipose layer and make the tummy flat and firm and the waist smaller.









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