Abdominal contouring is one of the most commonly sought-after procedures in cosmetic surgery. However, the differences between surgical liposuction and abdominoplasty (commonly called tummy tuck), what these procedures can accomplish, and who makes a good candidate for each procedure is not often known.

Surgical liposuction is a technique to decrease the fat layer that exists between the skin and the abdominal muscles. Small incisions are made in the abdomen, fluid is infiltrated through these incisions, and then suction is performed through the small incisions. The fluid is used to help break up the fat, minimize bleeding, and to maintain fluid balance in the patient. Many surgeons also use ultrasonic energy to help break up the fat further. This is done just prior to suctioning the fat. It is helpful in areas of fibrous fat and is felt to help with skin retraction more than suction alone.

Liposuction can be used in other areas of the body as well. It is important to remember that liposuction does not address excess skin. Instead, liposuction relies on the patient’s skin to retract on its own after surgery. Patients wear a compression garment to help reduce swelling and to help with skin retraction.

Abdominal contouring is one of the most commonly sought-after procedures in cosmetic surgery. Patients who are better suited for liposuction are those with good skin elasticity, minimal skin excess, and only pockets of fat, not overall obesity.

The recovery for liposuction is usually less than abdominoplasty and many patients are back to work in less than two weeks.

Abdominoplasty is a technique to remove excess skin and tighten the abdominal muscles. A long transverse incision is made in the lower abdomen. The skin and fat just under the skin are lifted off of the abdominal muscles up to the breast bone. Then this apron of skin is pulled downwards and the excess skin is removed. The abdominal muscles are tightened from the level of the breast bone all the way down to the pubic bone. Many surgeons use drains to help eliminate any fluid between the skin and the muscles which facilitate the healing of these layers back together.

In this surgery, as in liposuction, patients wear a compression garment after surgery to help reduce swelling and expedite healing. Recovery time is longer than liposuction and time to get back to work can take longer as well. The scar for this surgery is long but is hidden within the bikini area on most patients.

Patients who are better suited for liposuction are those with good skin elasticity, minimal skin excess, and only pockets of fat, not overall obesity. Smokers and older patients generally have worse skin elasticity. Skin elasticity must be assessed prior to any surgery. Patients who have skin excess, but still have significant fat under the skin can still undergo liposuction. These patients should be warned that their skin excess may worsen after surgery and they may want an abdominoplasty eventually.

Patients who have had children or those who have lost a great deal of weight have experienced an increase in their intra-abdominal contents and then a subsequent decrease. These patients often have skin excess and a separation in their abdominal muscles or a weakness which allows the intestines to push forward and cause a rounding or pooching of the abdomen. These patients are best suited for abdominoplasty which will address both the skin excess as well as the space between the muscles.

Patients should be as close to their ideal weight as possible to get the best results for either surgery. Women considering abdominal contouring should ideally have completed their child bearing.

While both liposuction and abdominoplasty are excellent body contouring procedures, it is important to determine what specific issues need to be addressed for each particular patient. As every patient has different needs and expectations, consultation with a board certified plastic surgeon is recommended prior to making this important decision.

About the author

Dr. Dash is a board certified Plastic Surgeon and Section Chief of Plastic Surgery at UCHealth Memorial Hospital
Dr. Krishna Dash

Dr. Dash is a board certified Plastic Surgeon and Section Chief of Plastic Surgery at UCHealth Memorial Hospital.

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