Board Certified
Plastic Surgeon
Since 1989

Tummy Tuck & Lipo

Q: Can liposuction of the abdomen and tummy tuck be done at the same time? Is it safe?

Front and side view pictures would have been helpful to answer as it varies for each individual. Cosmetic surgery is purely elective (you do not have to have it); and as such, complication rates should be reduced to a minimum.

In my practice of over 30 years, I do not combine tummy tuckand liposuction of the abdomen, because of the significant increase in severe complication rates, including death.

In a recent article in the plastic surgery journal that was based on data from cosmetic surgery only insurance company, it was revealed the combining tummy tuck and lipo increase the severe complication rate 10 times higher than a tummy tuck alone!

In Florida, it is illegal to perform tummy tuck with lipo of over 1,000 CCs (small amount), after a government investigation revealed a significant increase of severe complication rate—including death—due to combining the two procedures!

So, as you can see: An ounce of prevention is better than a pound of cure!

Always consult with experienced board-certified plastic surgeons who operate in an accredited surgery center for your safety. Most importantly, check the “before & after” pictures in the photo gallery, make sure that they are numerous, consistent, and attractive with flat stomachs, tight and youthful looking skin, nice belly button, improved body posture, and low scarring.

To view real patient results for Tummy Tuck before & after photos, click here.

Full Tummy Tuck

Q: I’m scheduled to have a hybrid tummy tuck (short-scar/mini, floating umbilicus tummy tuck with flank liposuction) in 10 days. I’m starting to get nervous that my surgeon hasn’t chosen the right operation for me. Should I be getting a full tummy tuck? I’m 5’7?, extremely athletic with minimal body fat, and 120 pounds. I’ve had four pregnancies, but have gained very little weight in each one. I don’t seem to have much skin laxity, though there’s some when I bend over and suck in my abdominal muscles.

Thanks for posting your pictures. In my previous response to your question, I suggested that you consult with other experienced board-certified plastic surgeons. Now that you posted your pictures and detailed your surgical plan, I can tell you that it will be in your best interest to consult with other surgeons.

I have been in practice for over 30 years and performed tummy tuck surgeries on well over 1,000 patients.  From observing your pictures, I can tell you that you have a good reason to be nervous about your surgeon’s plan for you.  You should seek better options.

There is only one procedure that will give you the flat stomach, tight and youthful looking skin, nice belly button, and nice posture. That procedure is full tummy tuck—and anything less will be a regrettable compromise that will make you unhappy, and eventually require a full tummy tuck, thus doubling cost and recovery time. If you will have the floating belly button procedure, your belly button will have to be reconstructed in order to make it look natural and attractive.

So, consult with experienced board-certified plastic surgeons who operate in an accredited surgery center for your safety. Most importantly, check the “before & after” pictures in the photo gallery; make sure that they are numerous, consistent, and attractive, with the above-mentioned features and low scarring.

Abdomen Skin Tightening

Q: Will skin tightening treatments work, or do I need a mini tummy tuck? I had smart lipo in May 2016 to my flanks. However, my lower abdomen seems to have excess skin and no longer feels tight, as I can literally pull it away from my body. I am 5′ tall and weigh 105 pounds. I have never been pregnant. Would something like thermitight help? Or would I require a mini tummy tuck?

Thanks for posting your pictures, though side view pictures would have been helpful.

From observing your pictures, you are a great candidate for liposuction with PAL (Power Assisted Liposuction). This procedure, when performed correctly and aggressively from multiple directions, brings significant skin tightening.

So, as long as you do not have abdominal muscles laxity (best seen on side view), you do not need a mini tummy tuck, but rather liposuction. However, you have to realize that not all results are the same, because experience, skills, and aesthetic eye are critical for a good outcome. Do your due diligence carefully, and choose your surgeon wisely.

Always consult with experienced, board-certified plastic surgeons who operate in an accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery to make sure that they are numerous, consistent, and attractive, with flat stomachs, nice hips- and waist-silhouettes, and smooth skin.

Plastic Surgery Implications for Weight Loss | Tummy Tuck and Liposuction

Weight Loss and Plastic Surgery

A welcome side effect of plastic surgery is that many people who have a tummy tuck or liposuction experience additional weight loss.  Dr. Shlomo Widder discusses this natural phenomenon and why it is important to maintain healthy eating habits post surgery.

Q: How does the tummy tuck procedure result in weight loss?

The reason you lose weight after a tummy tuck is that the procedure is not only a tightening of the abdominal skin but also tightening of the abdominal muscles. When you tighten the muscles, you increase the pressure on the stomach, and that in turn sends a message to the brain that says, “Stop filling me up.  Stop eating.”  That’s how patients lose weight.

I always tell my patients about that; it is part of my initial talk.  I tell them that hunger is managed in two ways.  One is a chemical, which involves sugar.  When the blood sugar goes down, you feel hungry and you eat.  The other is mechanical.  When the stomach is empty, it starts contracting and you might hear all those gurgling noises.  It is saying to the brain, “I’m empty – Fill me up.”  The stomach has special cells that measure pressure, but the brain is not so sophisticated as to tell the difference between pressure from food in the stomach or pressure from the outside.  So we can fool the brain by adding pressure from the outside by tightening the muscles.

I just did a tummy tuck for a military guy.  He told me that he was constantly hungry.  He was in good shape – trim and muscular – but he hadn’t reached what he physically wanted to achieve.  His stomach muscles were loose from lifting heavy weights.  Sometimes men, due to heavy lifting, rip the attachments of the abdominal muscles and it causes this problem.  For some women, a similar thing can happen when they have children.  The pregnancy stretches the abdominals and laxity of the muscles result.  If the muscles are loose, they just extend outward when you eat.  You don’t feel satisfied, so it is easy to keep on eating.  After his tummy tuck surgery, this man I mentioned, felt full and much less hungry.  He’s already lost 10 to 15 pounds and he’s achieved his weight goal.

Q: What will occur if you get liposuction or another procedure that encourages weight loss, and then continue a habit of overeating?

It depends on the surgical technique used.  When my patients have liposuction, I tell them that they have to lose, at least, the same amount of weight that I remove from them.  If they don’t lose that amount of weight, any new fat gained can go into those sections where I did not do the liposuction.

In order to do effective liposuction, you really have to enter with the suctioning cannula from many different directions in order to remove as many fat cells as possible.  For this reason, I take a very aggressive approach and go from multiple directions.  If a surgeon goes from only one or two entries, fat cells will be left between the tracks of the cannula, the tube that is used to aspirate the fat.  Each fat cell is able to store more fat by increasing its size by 50%.  So if you leave a lot of fat cells, two to three months after the procedure, it may look as if nothing was done.  But if you go from multiple directions and are very aggressive with the fat cells removal, the number of fat cells that remain will be reduced dramatically.  Then, no fat or very little can go in those areas in the future.  However, it can go elsewhere. If a patient keeps overeating in the same fashion as before, since the fat can’t go into the liposuction area, it might go to the shoulders, face, butt, breasts, and so on. So the secret really is for me to do a very thorough removal of the fat cells and for the patient to lose the same amount of weight that was removed by the liposuction.

 Q: If a person has a tummy tuck or liposuction, how long before he or she can take on an exercise regimen?  Are there exercises you recommend in addition to a shift in dietary lifestyle? 

 For liposuction, I limit their exercise for two weeks, and then for the following two weeks, they can increase exercise in a gradual fashion. On the first week back, they can exercise at a 25% capacity of what they did before.  The following week, I advise they go to 50% of their former activity level.  Then one month after the surgery, they are free of any limitation.  For a tummy tuck, they have to wait six weeks before any physical activity or lifting.  Then as with the liposuction, they can gradually return to normal activity over a two week period.  After two months, they are back to full speed.

The main type of exercise I recommend is cardiovascular, or aerobic.  Any type of cardio can get you in good shape.  It could be a stationary bike, it could be a treadmill –all of those machines at the gym are good.  The key is to put forth at least 20 minutes of constant effort during which the heart rate is raised to two-thirds of maximal capacity.  Do this, and you’ll be burning fat and lose weight.

For a free consultation and 5% off any surgical procedure, schedule an appointment on our website! http://www.widderplasticsurgery.com/contact.php

*Individual results are not guaranteed and may vary from person to person. Images may contain models.