Even after sticking with a diet and exercise program and shedding most of the extra fat, many people still are not happy with the appearance of their belly or midsection. This is one of the most common complaints we hear as plastic surgeons.
Patients commonly are most frustrated with the fact that no matter how much exercise they do or how strict their diet, they cannot seem to get a flat-toned tummy. There are many possible explanations why this scenario is so common. For example, child-bearing or previous obesity can stretch the abdominal tissues to the point where simply burning off fat cannot create a flat stomach. Others can have a genetically determined poor distribution of fat making it very difficult to create a beautiful contour with the generalized or even fat loss that occurs with only diet and exercise. In many of these cases, body contouring surgery may be the only option to obtain the desired result, but the question remains: what is the right procedure, liposuction or a tummy tuck?
For patients with excess fat or stubborn pockets of fat with good skin tone and a flat abdominal wall, liposuction is the best treatment. The best candidates are typically within 20lbs of their ideal body weight and don’t have a history of massive weight loss or pregnancy. Women after pregnancy can still be good candidates for only liposuction but more commonly the skin and abdominal wall is permanently stretched and is best improved with a tummy tuck. Liposuction involves making small incisions in the skin and suctioning away the fatty tissue between the skin and abdominal wall. The key is to not simply remove as much fat as possible but sculpt fat in the proper proportions to create a beautiful three-dimensional shape and figure. Common areas for liposuction include the abdomen, hips, waistline, outer and inner thighs, and arms. The advantages of liposuction include minimal scarring and short down time.
If there is loose abdominal skin or a stretched abdominal wall, liposuction alone is not the best treatment. Liposuction performed on an area with loose skin will result in even more laxity and droopiness of the skin. In order to address not just the fat layer but also the skin and abdominal wall, an abdominoplasty (tummy tuck) is required. A tummy tuck consists of making an incision at the bikini line from hip to hip and lifting the skin and fat off the abdominal wall. The excess skin is then pulled down and removed. With the abdominal wall exposed, stitches are then used to tighten the abdominal wall. This stitching resembles the affect of a girdle and is often necessary to repair the stretching that occurs with childbearing or morbid obesity. In addition to improving the skin and abdominal wall, liposuction is typically included with a tummy tuck in order to treat the fatty layer and provide a more comprehensive improvement in contour.
To determine if body contouring is right for you and which procedure would give the optimal improvement in abdominal contour, seek a consultation with a board certified plastic surgeon. Dr. Dino Elyassnia is a board certified plastic surgeon in the San Francisco Bay Area who specializes in aesthetic plastic surgery including body contouring procedures. After a discussion of your goals and a careful exam evaluating the skin, fat, and abdominal wall layers, Dr. Elyassnia will help you decide if body contouring surgery will help you achieve the figure you want.
Dino R, Elyassnia, MD, PC
Board Certified Plastic Surgeon