Two at Once: Undergoing Liposuction and Abdominoplasty (Tummy Tuck) Surgery at the Same Time (Lipo-Abdominoplasty)

Lipo-abdominoplasty is a combination of two surgeries, liposuction and abdominoplasty. This procedure offers the benefits of a tummy tuck and liposuction without the need to undergo two separate procedures. A lipo-abdominoplasty candidate has stubborn fat deposits, excess skin, and stable weight.

Today I want to take a moment to discuss the possibility of undergoing both liposuction and abdominoplasty at the same time. This combination procedure, known as lipo-abdominoplasty, can be a breakthrough for individuals who struggle with stubborn fat deposits and want to address excess skin.

Lipo-abdominoplasty offers more comprehensive results than the two surgeries performed separately, while also reducing risks, rates, and recovery time.

By addressing these issues simultaneously, a more streamlined and toned appearance is achieved, while the risk of blood loss and clots is reduced, as is the need for surgical drains.

Typically, a candidate for lipo-abdominoplasty has maintained a stable weight for several months, excess skin, and stubborn fat deposits that are resistant to diet and exercise.

Like any other major surgery, however, lipo-abdominoplasty carries its share of risks and complications, which is why it is crucial that we carefully weigh these factors to ensure the best possible outcome. As your surgeon, I will work closely with you to determine if this body contouring procedure is right for you.

What is Lipo-Abdominoplasty?

Lipo-abdominoplasty is a combination of two surgical procedures: liposuction and abdominoplasty. The procedure is designed to tone and contour your body to achieve a slimmer profile with improved contour, which might not be as pronounced if the surgeries were done separately. Additionally, having one combined surgery can be more cost-effective and may result in a shorter overall recovery time compared to having two separate surgeries. 

During a lipo-abdominoplasty procedure, I target excess fat deposits using VASER liposuction and remove excess skin using abdominoplasty surgery techniques.

What is an Abdominoplasty (Tummy Tuck)?

Abdominoplasty (tummy tuck) is a procedure that addresses excess skin and weak muscles in your abdomen. There are different types of abdominoplasty surgery, such as Fleur-de-Lis, Full, Extended, and Mini tummy tuck.

Most abdominoplasty patients have undergone significant weight loss or back-to-back pregnancies. The type of abdominoplasty you get depends on your overall health, the extent of skin laxity, and excess skin.

You must lead a healthy lifestyle by prioritising a balanced diet and exercise to achieve long-lasting body contouring results.

Liposuction vs. VASER Liposuction: What is the Difference?

Both liposuction and VASER liposuction (Vibration Amplification of Sound Energy at Resonance Liposuction) remove excess fat from targeted body parts. The main difference between the two procedures is the method of delivery.

Traditional liposuction uses a cannula tube to break down and suction out fat manually. This method is forceful and can cause bruising or swelling in your abdomen. A VASER liposuction uses ultrasonic energy to liquefy fat deposits and suction them out. This procedure is mild on the skin and promotes collagen production.

What is the Difference Between a Tummy Tuck and Liposuction?

Liposuction and tummy tuck procedures are both body contouring procedures aimed at improving the appearance of the abdominal area, but they address different issues and involve distinct surgical techniques.

A tummy tuck addresses loose skin and diastasis recti, while liposuction addresses stubborn fat resistance to exercise and diets. During a tummy tuck, I make an incision above your pubic area, separate the skin, remove the excess from underlying tissues, and stitch the collapsed and separated abdominal muscles together to strengthen them. A liposuction procedure involves inserting a small cannula tube, which breaks up and removes excess fat. However, I prefer using VASER liposuction for most of my procedures because it is precise, targets both superficial and deep layers, causes minimal damage to the surrounding tissues, and removes the most stubborn fat tissues.

The recovery period for a tummy tuck procedure is more extensive than for liposuction.

Advancements in Tummy Tucks: High Lateral Tension Abdominoplasty

When the High Lateral Abdominoplasty was introduced in 1955, it revolutionised the procedure by demonstrating that limited undermining could achieve impeccable results while maintaining blood flow.

Unlike traditional abdominoplasty, which focuses on vertical tension to tighten the abdomen, this method also applies tension laterally (horizontally). The approach tightens both the central and lateral parts of the abdomen, resulting in a more defined waistline.

An article published by PubMed states that “[h]igh-superior-tension abdominoplasty dramatically decreases or eliminates most complications of abdominoplasty and achieves more aesthetic results. This procedure is used in standard cases, for patients with massive weight loss, and for patients with very limited epigastric skin excess.”

Combining Liposuction and Abdominoplasty

From my 15 years of experience, I can attest that liposuction and abdominoplasty procedures each carry their share of success. However, when the two procedures are combined, they yield even better results than when performed separately. By removing the excess fat deposits using VASER liposuction, lipo-abdominoplasty becomes safer because it limits dissection by emulsifying subcutaneous fat in the targeted area. This reduces the need for extensive undermining, which preserves blood vessels. Undermining increases the risk of complication because it causes trauma to the surrounding tissues, resulting in prolonged swelling or bruising and, eventually, tissue and skin necrosis.

According to a study published by PubMed, “[t]he combined procedure is similar in discomfort level to abdominoplasty alone (both 7.5 of 10) and produces the highest level of patient satisfaction (99.2 percent), with 97.6 percent of patients saying they would undergo the operation again and 99.2 percent recommending it to others.”

How Effective is Lipo-abdominoplasty vs. Undergoing the Two Surgeries Separately?

Lipo-abdominoplasty has more comprehensive results than undergoing the two surgeries separately. It reduces the risks of complications, reduces the recovery time and increases patient satisfaction. Most of my patients are thrilled with their results (both contour and scar formation). If you are a suitable candidate, this procedure is your ideal option.

Benefits of Combining Liposuction with a Tummy Tuck Surgery (Lipo-Abdominoplasty)

Combining liposuction and a tummy tuck has several undisputable benefits, making it ideal for the right patients. Here are the main advantages:

Reduced Recovery Time

While the abdominoplasty portion of the body procedure will involve a similar recovery process as a traditional abdominoplasty, the addition of liposuction reduces the overall recovery period. This is because the liposuction portion can be performed simultaneously with the abdominoplasty, eliminating the need for separate procedures under anaesthesia and the knife and reducing the overall number of incisions. As a result, my patients can expect a shorter recovery period and a more streamlined surgical experience. 

Reduced Cost

Lipo-abdominoplasty will ease your financial burden since you get two procedures done in one session. This combined approach reduces the overall cost of the surgeries because it eliminates the need for separate anaesthesia, operating room, surgeon fees, and other related charges. Additionally, the surgeon needs to make one incision, which reduces the cost of dressing and post-operative care. Furthermore, the combined procedure often requires less hospital stays and follow-up appointments, resulting in lower overall costs. 

Addresses Exercise-resistant Fat and Loose Skin Simultaneously

I will address exercise-resistant fat, loose skin, and muscle separation simultaneously, eliminating the need to have a second procedure. 

Can Eliminate Post-surgical Drains

Post-surgical drains are necessary to remove excess fluid buildup after a traditional abdominoplasty. However, lipo-abdominoplasty eliminates the need for a drain because removing excess fat helps the body manage fluid levels naturally by reducing the dead space where the fluid could accumulate. The liposuction process also stimulates the lymphatic system, which drains excess fluid from your tissue. 

Risks and Complications of Lipo-Abdominoplasty 

Every surgical procedure poses some degree of risks and complications. It could be caused by underlying health issues, medical history, and post-surgery care. Below are some prevalent risks and complications that we will discuss during our consultation sessions.

• Infection: Post-operative infections can occur despite preventative measures. Wash your hands before touching your wound dressing to promote proper healing and reduce the risk of infection. Signs of infection include redness, increased pain, swelling, and discharge at the incision site.
• Scarring: All surgical procedures result in some degree of scarring, and lipo-abdominoplasty can result in more prominent or keloid scars. However, I use all necessary measures to minimise the extent of scars. Additionally, proper wound care and sometimes additional treatments can help reduce scar visibility.
• Seroma: Seroma is the fluid that accumulates under the abdominal skin after surgery.
• Blood clots: Blood clots develop if you remain immobile for a long time. They travel to the lungs and cause pulmonary embolism, which causes further complications such as deep vein thrombosis.
• Numbness and changes in skin sensation: Temporary or permanent changes in skin sensation can occur due to nerve damage during the procedure, leading to numbness, tingling, or reduced sensitivity.

Recovery From Lipo-Abdominoplasty vs. Undergoing the Two Surgeries Separately

Recovering from lipo-abdominoplasty is less tedious than recovering from liposuction and abdominoplasty separately, as it has a single recovery period.

After your surgery, I will provide you with post-abdominoplasty guidelines on how to take care of your incisional site to get the desired results and a smooth recovery. A typical recovery period for lipo-abdominoplasty is 4-6, however when performed separately, your recovery time for abdominoplasty alone will be 4-6 weeks, while that for liposuction will be a few days to 2 weeks. 

Cost Considerations of Lipo-Abdominoplasty vs. Undergoing the Two Surgeries Separately

Insurance doesn’t cover cosmetic surgeries but should cover part of the cost if your condition is deemed medically necessary. While lipo-abdominoplasty may be more expensive upfront, it can be more cost-effective in the long run. By combining the procedure, you can benefit from overlapping costs associated with anaesthesia, administrative fees, and facility time.

Preparing For Surgery

As you approach the D-day of your Lipo-abdominoplasty surgery, it’s essential to prepare your body and mind for the transformative journey ahead. I encourage you to begin by scheduling a consultation where I will explain the surgery process in detail. I will also conduct physical and medical check-ups to ensure you’re fit and ready for the procedure.

I encourage you to adopt a healthy diet rich in fruits, vegetables, and lean protein to optimise your body’s natural healing abilities. Stock your home with essential items like pain medication and stool softeners to make your recovery as comfortable as possible.

Avoid strenuous activities, smoking, and drinking alcohol to minimise complications and promote healing.

Operation Overview

During your surgery, I will follow the following steps to ensure a comfortable procedure:

Step one: Markings

Before you go under the blade, I will make markings on your abdomen to guide me during the surgery. These markings will represent where I will make the abdominoplasty and liposuction incisions.

Step two: Anaesthesia

I use general anaesthesia for all of my body contouring procedures on my patients. The type of anaesthesia I chose depends on your medical history and the extent of the surgery. General anaesthesia puts you to sleep, allowing you to avoid the pain and fear associated with major surgery. 

Step three: Incision

Once the anaesthesia takes effect, I will make a horizontal incision across your lower tummy. The size of the incision depends on the extent of the sagging skin. I will also make small incisions where I intend to remove fatty tissue.

Step four: Surgery

During your lipo-abdominoplasty surgery, I will first perform VASER liposuction to remove the stubborn fat tissues in your abdomen. The procedure entails inserting the cannula tubes in the incision, breaking down the fat tissues, and suctioning them out.

After the liposuction, I will remove the loose skin, repair abdominal muscles, and tighten the excess skin. In some instances, I will reposition the belly button to achieve your desired body shape.

Step five: Post-op

After your operation, I will dress the incisional site using a PICO dressing that exerts negative pressure on the wound. I will also fit you with compression garments that support the repaired tissues and reduce swelling and discomfort.

Step six: Recovery

I require my patients to stay in the hospital overnight. Depending on the procedure, this may extend to a few days. The hospital stay gives you enough time to rest and heal while under close supervision during the early days of recovery. I will also give you a list of guidelines and instructions on taking care of your incisional wound to achieve optimal results.

Incision and Scarring for Lipo-Abdominoplasty vs. Two Procedures Separately 

During lipo-abdominoplasty, an incision is made horizontally across the lower abdomen to allow easy access to the abdominal wall. Smaller incisions are then made on the targeted areas for stubborn belly fat removal. Scars resulting from lipo-abdominoplasty are concealed under swimwear and clothing.

Liposuction incisions are made near the targeted areas for fat removal, making it precise when performed separately. The resulting scars are less noticeable because of their small sizes. An abdominoplasty incision resembles that of a lipo-abdominoplasty procedure. The incision runs horizontally across your abdomen and is more visible due to the intensity of the surgery.

After Care of Lipo-Abdominoplasty

After your lipo-abdominoplasty surgery, taking care of your incisional site is essential to avoid complications, promote a smooth recovery, and attain your desired results. Here is how you take care of your incisional wound:

• PICO Dressing: I highly recommend it to my patients because of its benefits. By applying negative pressure to the surgical site, PICO dressing increases blood flow to the area, reduces the risk of infection, and manages fluid buildup. You should wear your PICO dressing for the recommended amount of time.
• Compression Garments: Compression garments help reduce swelling and promote blood flow by exerting pressure on the incisional site. You should wear compression garments as long as I recommend to reap their full benefit.
• Sun Exposure: Exposing the surgical site to direct sunlight can cause hyperpigmentation, delay healing, and make your scars more visible. To ensure your wound heals nicely, wear protective clothing or use sunscreen when going outside.

How Long Will I Be Out-of-Commission with Lipo-Abdominoplasty vs. Undergoing the Two Surgeries Separately

When you get a lipo-abdominoplasty, your recovery time is less compared to someone who gets both surgeries separately. The following is a list of activities and their standard downtime:

Returning to Work

Most of my lipo-abdominoplasty patients return to work 2-4 weeks after surgery, depending on the nature of their job and the type of abdominoplasty. You should wait longer if your job demands high physical energy.

When performed separately, you can return to work 4-6 weeks after a tummy tuck and 1-2 weeks after your liposuction procedure, with a rest period between the two surgeries. But again, this will depend on the type of surgery.

Exercising

After your lipo-abdominoplasty procedure, you should do light exercises like walking during weeks 2-3. Exercising promotes blood flow, which aids in healing. You should avoid strenuous activities like heavy lifting to avoid complications.

A liposuction procedure alone is minor, so you can start moving around after 1 week. Avoid straining your body in the process. An abdominoplasty requires 4-6 weeks of rest before you start light exercises. To fully start exercising after concurrently getting the two procedures, you will need a downtime of 6-8 weeks.

You can find out more about exercising after a tummy tuck in this article: Exercising After Tummy Tuck (Abdominoplasty)

Driving

Driving is a strenuous activity that requires a little waiting period. After a lipo-abdominoplasty surgery, you can wait 2-4 weeks to start driving. If you opt for two separate surgeries, you should wait 4-6 weeks before you can drive.

Housekeeping

Housekeeping requires the lifting of heavy objects. After lipo-abdominoplasty, wait at least 4-6 weeks before you start housekeeping. Start slow with light tasks that will not strain your abdomen.

Showering/Bathing

Avoid full immersion baths until your wounds are fully healed. If there are no drains inserted, you can shower 48 hours after the surgery. For lipo-abdominoplasty, immersion baths can happen between 4-6 weeks and 8-12 weeks for separate surgeries.

Pet/Childcare

You can resume light activities within 2-4 weeks of lipo-abdominoplasty surgery. On the other hand, if I perform your procedures one after the other, you will need a cumulative period of 6-8 weeks before you can perform your normal pet/childcare duties. Avoid lifting pets or children before your incision wounds are healed. 

Consultation

A thorough consultation with a FRACS surgeon like myself is the first step to your lipo-abdominoplasty journey. I will assess your physical health and medical history to make a personalised recommendation on the most favourable types of abdominoplasty procedures. We will also discuss your surgical goals, expectations, and the safety measures I will implement to avoid complications. I welcome you to book a consultation with me today so that we can have a one-on-one discussion about your needs, goals, and everything in between.

FAQs

Here are some of the frequently asked questions I get from most of my patients during consultation. 

How long does a lipo-abdominoplasty procedure take?

The length of a lipo-abdominoplasty surgery depends on the extent of loose skin and excess fat I remove. A standard procedure lasts between 3.5-5.5 hours.

How should I prepare for lipo-abdominoplasty?

You should prepare for lipo-abdominoplasty by being physically and emotionally ready. Start by doing exercises to maintain a stable weight and quit smoking 6 weeks before your surgery. I also encourage you to adopt a healthy diet before and after surgery.

What are the main benefits of lipo-abdominoplasty?

Lipo-abdominoplasty offers the benefit of two surgeries in one sitting. It saves on time and cost while also reducing the recovery period.

Who is an ideal candidate for lipo-abdominoplasty?

To qualify for an abdominoplasty surgery, you must have loose skin and stubborn fat tissues, and your body mass index should be stable. You should also be a non-smoker.

Dr. BB’s Final Thoughts

Lipo-abdominoplasty offers the benefit of undergoing two surgeries at once. It saves time, cost, and lessens the recovery period and downtime.

Lipo-abdominoplasty suits you if you can’t maintain a straight posture due to weak abdominal muscles or struggle with loose skin and excess fat. I have seen the benefits of the combined procedure first-hand in most patients. With the guidance of Lockwood’s protocol, we can reduce the likelihood of complications by preserving blood flow. Book an appointment with me today for more insights if you are unsure about your decision to get lipo-abdominoplasty surgery.

References

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