Lipo vs Abdominoplasty – Which is Better for Your Needs?


Dr Bernard Beldholm

Can you just get liposuction instead of a tummy tuck? There are a lot of patients that just want abdominal liposuction, but sometimes find out they need a tummy tuck with lipo instead. This articles discusses the reason for this, along with who can get liposuction, and reasons why a tummy tuck with liposuction tends to make patients happier.

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What is liposuction?

There are many types of liposuction. However, it’s important to understand that none of them remove excess skin. Liposuction is a surgical procedure that removes fat only. It does not tighten loose skin — a common problem patients have after major weight loss or a pregnancy.

Types of liposuction

There are various techniques used to perform liposuction.

  • Traditional liposuction
  • Tumescent liposuction
  • Radiofrequency-assisted liposuction (RFAL)
  • Laser liposuction / ultrasound liposuction such as Smart Lipo and VASER

Traditional liposuction

The old-school method of fat reduction is an aggressive surgical procedure that gets rid of body fat, but leaves telltale liposuction scars. Traditional lipo uses a hollow suction tube that is inserted into an incision. The fat is then removed with a scraping motion.

As you can imagine, general anesthesia and stitches are required for this type of procedure. Of all the types of liposuction that are available today, this is the least modern technique. Because the fat is suctioned away in an abrasive manner, recovery tends to be more painful. Patients may experience excessive bruising and swelling and a prolonged downtime.

This method is also rather imprecise. It can cause bumpy skin after liposuction and rippled skin after liposuction, which is not the cosmetic result patients have in mind when they come in for body contouring. There are better liposuction techniques available today that produce a better result.

Tumescent liposuction

One of the most popular types of liposuction today is tumescent liposuction. Unlike traditional liposuction, it is less painful and usually does not require general anesthesia — a medical preparation administered by an anesthesiologist in the operating room to put a patient to sleep so they are not conscious of a surgery. As an outpatient procedure, the recovery time tends to be quicker as well.

Why does tumescent lipo usually not require anesthesia? A special fluid containing a mixture lidocaine, sodium bicarbonate, epinephrine and saline solution is injected into the target site. This local anesthetic numbs the area that it is injected into, thereby reducing sensations of pain. It also causes the blood vessels in the target site to constrict temporarily. This reduces blood loss and minimizes swelling and bruising after liposuction.

Most importantly, fluid-injected liposuction hydrates the fat so that it can be more easily removed. For large areas such as the tummy, light sedation may be needed to make the patient more comfortable.

When the procedure is done by a trained physician, tumescent liposuction is said to safely and effectively reduce body fat from large areas such as the tummy and thighs,  as well as smaller areas such as the arms, neck or chin.

RFAL liposuction

One of the most popular radiofrequency-assisted liposuction is BodyTite liposuction. Radiofrequency liposuction is performed under local anesthesia or light sedation. It works by using thermal energy to liquify and then remove fat cells.

RFAL lipo devices are also said to have a skin tightening effect, according to manufacturers. While it does tighten skin to a degree, that statement can be misleading to patients. It can tighten loose skin a little, but it won’t remove hanging skin folds. Doctor Bernard’s patients usually have too much extra skin for this to work effectively. Abdominal skin, in particular, often has more laxity than skin on other areas of the body. Thus, a tummy tuck may still be needed for loose skin removal.

Essentially, RFAL lipo tightens skin to a degree, but it will not permanently remove loose, hanging skin.

VASER liposuction

VASER is the latest fat reduction laser technology. Doctor Bernard loves VASER lipo and highly recommends it. This is his favorite type of lipo. In his experience, it gives most patients very nice results. VASER gets close to the skin surface for better fat removal and smoother results. It also helps tighten the skin slightly — something that is not possible with some other types of lipo. Click here to learn more about the benefits of VASER liposuction.

In addition to removing fat cells, it does tighten skin a bit, but only to a limited degree. Like RFAL liposuction, VASER tightens skin, but it will not surgically remove excess hanging skin. While the VASER results are impressive compared to older liposuction methods of the past, it does not have a skin tightening effect that is anywhere close to what a tummy tuck can provide.

Doctor Bernard performs liposuction-assisted tummy tuck (abdominoplasty) using VASER so his patients can remove stubborn pockets of fat while removing extra abdominal skin that hangs on the abdomen. The result is a beautiful flat tummy, free of unwanted fat.

What is a tummy tuck?

A tummy tuck is a cosmetic abdominal surgery that trims away excess skin folds and fat. The belly skin is then pulled nice and taut, then sutured closed. The incision is typically placed on the lower abdomen where it can be hidden in the underwear line.

However, there are many different types of tummy tuck procedures, some of which require different types of incisions.

This procedure is common among patients that have sagging skin on the abdomen after losing a significant amount of weight or after pregnancy. A tummy tuck is a permanent skin removal surgery for a flat tummy.

Can you just get liposuction instead of a tummy tuck?

Many patients come to Doctor Bernard seeking liposuction. Often, they just want the tummy to be a bit flatter. However, it is important to know that with lipo, we rely on the patient’s own skin to tighten around the new shape that is revealed once the fat is removed. Some patients have a better chance of good skin retraction, such as younger women prior to age 30 that have not experienced major weight loss or pregnancy. With less body fat to be removed with lipo, these patients can get a great result with liposuction alone. It won’t leave them with loose skin.

As a body contouring surgeon, Doctor Bernard usually has patients that are hoping to improve their bodies after age 30. Frequently, patients come to the clinic to remove stubborn fat after a major life event such as having a baby or reaching their goal weight with the help of gastric bypass or bariatric surgery.

These patients usually don’t get a good result with liposuction alone. The skin loses elasticity with age. Stretch marks are often present, indicating the skin has stretched in a way that it won’t contract well once the fat is removed. In many cases, just getting liposuction won’t do these patients any favors. In fact, it can makes things worse.

If there is a lot of loose skin, all you’re going to do with the liposuction is get even looser skin. That’s not an attractive result.

The tummy is a big area for liposuction. And the tummy tends to have the loosest skin on the body Doctor Bernard finds that liposuction is often problematic in the tummy area specifically.

So, what’s the solution to this problem?

For many patients with belly fat and loose skin on the tummy, the answer is a tummy tuck with liposuction. Combining procedures is an effective way to remove stubborn abdominal fat while ensuring the patient has a nice, flat tummy with no loose skin in sight.

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Is getting two cosmetic surgeries at once a good idea?

There are benefits to getting two procedures done at once. First, it costs less than having procedures done separately. For example, if you get abdominal liposuction only to find it leaves you with loose skin, then you will have to come in for a tummy tuck in order to remove the loose skin. Since we know that liposuction creates loose skin on the abdomen in many patients, we can prevent that from happening by doing a tummy tuck with lipo together in one surgery. This gives you fat reduction and loose skin removal at once!

Additionally, combining surgeries saves money. A big part of the tummy tuck cost is the anesthesia and operating room fee. Adding liposuction to the procedure only adds the cost of liposuction, rather than paying for the liposuction cost, anesthesia, and operating room fees again separately.

Finally, combined cosmetic surgery saves time and speeds recovery time. With our patients’ busy lifestyles, few people can take off work twice for two separate recovery periods. Nor do they want to endure this discomfort of recovering from surgery twice. Getting a tummy tuck with lipo at the same time streamlines the process so there is only one recovery period. That also means less time off work to recover.

What is the difference between lipo and tummy tuck surgery?

The biggest difference between tummy tuck surgery and lipo is that liposuction doesn’t remove loose skin.

A tummy tuck is needed to achieve significant skin tightening. Only younger patients (in their 20s) will have skin that retracts well enough after lipo to get a good result. Most of our patients are in their 30s, 40s and beyond with less skin elasticity than younger patients. Add stretched, loose skin to the mix, and you’ll need a tummy tuck with lipo to get a good result, instead of liposuction alone.

Most of Doctor Bernard’s patients are getting surgery after pregnancy or weight loss surgery. Pregnancy and major weight loss stretch the skin a lot, so it won’t retract well after intensive lipo. These patients may need a tummy tuck with lipo.

Did you know Doctor Bernard’s tummy tuck includes lipo? That way, patients get 2 benefits in 1: fat reduction and loose skin removal.

His tummy tuck procedure also includes abdominal muscle repair — something liposuction can’t do. For new mums and post-weight loss patients with stretched ab muscles (diastasis recti), they are often left with a visible belly bulge. Doctor Bernard’s tummy tuck with lipo lets you tighten ab muscles in addition to removing fat and loose skin.

Who is a good candidate for abdominal liposuction?

There are some patients that can benefit from abdominal lipo, without necessarily having a tummy tuck. These are mainly patients that do not have a lot of belly fat, have never been pregnant, and are in their 20s with great skin elasticity. This group gets an excellent result with liposuction alone.

Who is a good candidate for a tummy tuck with lipo?

Typically, patients that have undergone a pregnancy or major weight loss are better candidates for a tummy tuck. Liposuction can be added to the procedure to improve the results. Doctor Bernard’s lipo-abdominoplasty surgery is one of the most popular procedures since it gives two incredible benefits in one.

Lipo vs. tummy tuck — Which is better?

It depends on the patient’s age, skin laxity, lifestyle factors such as pregnancy or major weight loss, amount of loose skin, and the result the patient hopes to achieve. In summary, older patients with loose skin and stretch marks that want loose skin and fat removal may be better candidates Doctor Bernard’s tummy tuck with lipo. Patients in their 20s with a small amount of belly fat can sometimes get a great result with liposuction alone.

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30 Belmore Rd
Lorn NSW 2320


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