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Do I need a Tummy Tuck or Liposuction?

Two of the most common procedures performed by plastic surgeons are Tummy Tucks and Liposuction. In fact, according to the American Society of Plastic Surgeons, these two procedures account for almost half a million procedures per year. These are two very different procedures, but are commonly confused. Each one addresses different things and may not be the right procedure for everyone.  To get the best possible results from your plastic surgery, it is important to make sure you get the right operation. To understand if a tummy tuck or liposuction is best for you, you must understand the difference between these two procedures. To understand the difference, we need to take a closer look at what each procedure is, what each procedure does, and who is a candidate for these procedures.

Tummy Tuck:

  • What is a Tummy Tuck?

A tummy tuck is a procedure that addresses the abdominal skin, fat, and muscles in a one operation.  This is why it is such a powerful procedure. The result is a firmer, flatter, and smoother abdomen. Specifically, a tummy tuck includes:

  • Removal of excess abdominal skin
  • Tightening of loose or separated abdominal muscles
  • Removal of excess fat with liposuction
  • Rejuvenation of the belly button
  • Who is a Good Candidate for a Tummy Tuck?

A tummy tuck is so popular because it offers advantages for so many different people, all in different situations.  A tummy tuck may be indicated for people who have lost weight, have skin changes associated with aging, or have abdominal changes from pregnancy.  A tummy tuck will specifically address the excess or loose skin, the belly button, and the separated abdominal muscles. Because of the removed skin, the scar will be a longer scar hidden beneath the underwear line.

  • What type of anesthesia is used?

A tummy tuck is performed under general anesthesia. This allows you to be completely relaxed so that the maximum amount of skin can be removed and your abdominal muscles can be tightened as much as possible.

  • What is the Recovery from a Tummy Tuck?

After a few hours in the recovery room, you will be allowed to go home with your escort. You will have pain medication and antibiotics. The first few days is usually the worst, since you will be “hunched over” and in pain, but it will be manageable.  After about a week, most people feel better, but not great. You should plan on having help at home for a few weeks. You are encouraged to walk throughout this process to promote good circulation. While everyone is different, most patients will require about 3 weeks off from work and 6 weeks off from heavy exercise.


  • What is Liposuction?

Liposuction is a procedure to specifically remove excess fat. It can be performed on virtually any part of the body. Obviously, liposuction is most commonly directed towards the abdomen, back and flanks. However, it is commonly performed on areas such as the neck, arms, and thighs.  This is specifically done using a small suction tube and inserted into tiny incisions.

  • Who is a Good Candidate for Liposuction?

Liposuction is a good procedure for anyone who has excess fat and good skin quality. Even though it is a fat removal procedure, it Is not intended to be a weight loss procedure. Instead, it is a body shaping procedure. This means that the best candidates for liposuction are those who are in good shape but have “problem areas” that are resistant to diet and exercise. Additionally, those with loose skin may be poor candidates for liposuction, since skin laxity may increase afterwards, causing more hanging skin.

  • What type of anesthesia is used?

The type of anesthesia required for your liposuction will vary depending on exactly what you need done. For small areas, it may be possible to have liposuction done under only local anesthesia. For larger areas, or more areas, it is best to have your procedure performed under general anesthesia, allowing your surgeon to more completely remove fat.  

  • What is the Recovery from Liposuction?

Liposuction is a less invasive procedure than a tummy tuck, since no skin is removed. After the procedure, you will be monitored in our recovery room for about an hour. You will experience soreness, bruising, and swelling in the area that you had fat removed. The severity of the recovery will depend on the areas you had liposuction and how much fat you had removed. Most people can return to regular activities in about a week.

How do I know which procedure I need?

Many people are confused whether they need a tummy tuck or liposuction. However, determining which is best for you, should not be difficult. The most important thing to figure out is whether you have excess fat or excess skin.

If you have loose, hanging skin on your abdomen, then a tummy tuck is best. This is because the tummy tuck operation will directly cut off the excess skin. Usually, women who have lost significant weight or have had multiple pregnancies, have excess skin and would do best with a tummy tuck.

If you don’t have excess skin, and only have excess fat, then liposuction may be a better option. Liposuction will remove the fat, but not the skin.  Liposuction tends to be best for people with good skin quality but no skin laxity.

Can the two procedures be combined?

Yes, it is very common to combine a tummy tuck with liposuction. In these cases, the tummy tuck removes the excess skin, rejuvenates the belly button, and tightens the underlying abdominal muscles. Liposuction will then be performed on the sides and flanks, removing excess fat and further improving the waistline.  It is also common for people to want a tummy tuck and liposuction of a separate area such as the thighs, neck, arms, etc.  So, it is also possible to have a tummy tuck and liposuction of separate areas at the same time.

What Happens if I need a Tummy Tuck but only get Liposuction?

It is important to get the right procedure, because if you don’t, your results will not be ideal. So, what if you have excess skin and need a tummy tuck, but for some reason, you get liposuction instead. The result will be increased laxity of the skin. This is because the liposuction will remove the fat, but not the skin. The skin will then appear more loose, since there is less underlying fat. Also, if your abdominal muscles are separated, as is common after pregnancies, your abdomen will skin protrude and appear round after liposuction. In a situation like this, you will likely need a secondary procedure (a tummy tuck) to remove the skin and improve the outcome.

Discuss with your Board Certified Plastic Surgeon

To truly learn which procedure is best for you, you should meet with a board certified plastic surgeon. You should select a surgeon who is experienced in both procedures, so that he or she can give you the best advice.  During your consultation, your surgeon will examine you to figure out how much excess fat you have and how much excess skin you have.  This will determine whether you will get a better. Result with a tummy tuck or with liposuction. Perhaps you would do best with a combination of the two.

If you would like to learn more about whether a tummy tuck or liposuction is right for you, contact New York City, Board Certified Plastic Surgeon, Dr. Matthew Schulman.