The best way to get this question appropriately answered is to have a consultation by an experienced board certified plastic surgeon. If you consult with a dermatologist or a medical aesthetic physician who performs liposuction in their office, you will not likely get the option of a tummy tuck, as it is not a procedure that they perform. Getting liposuction when a tummy tuck is a better option will likely make you worse rather than better.
Liposuction is an appropriate procedure for recontouring the abdomen when there is excess fat but good muscular structure and adequate skin tone. Patients who are good candidates for liposuction alone are generally younger in age and either near their ideal body weight or only mildly over weight. Liposuction only removes fat; it does not tighten loose muscles or improve skin tone.
Women who have had several children, particularly if pregnancy has resulted in severe stretch marks on their stomach and anyone who has lost a considerable amount of weight are generally better candidates for tummy tucks than liposuction as they can benefit from muscle tightening and excess skin removal.
Massive Weight Loss Patients
Patients who have had bariatric surgery or anyone who has lost a tremendous amount of weight essentially always need skin excision for adequate body contouring and there are numerous surgical options available depending on their wants and needs. Rather than tapering the skin excision out to the hips as in a standard tummy tuck, large amounts of skin can be removed from the sides, lower back and upper buttocks at the same time. This is referred to as a lower body lift or circumferential abdominoplasty.
Fleur-de-lis Tummy Tuck
Some individuals who have lost a significant amount of weight have enough excess skin around their trunk that removing a horizontal wedge of skin from the lower abdomen is not adequate. In these cases, a vertical wedge of skin in the shape of a large inverted ‘V’ can be removed at the same time. This helps to tighten the stomach circumferentially as well as vertically but as a trade off, leaves a long vertical scar that runs in the middle of the abdomen from the rib cage down to the pubic area.
Those patients who have just a little excess skin, loose lower abdominal muscles only and some excess fat may be candidates for a mini-abdominoplasty, which is generally a combination of a small tummy tuck and liposuction. In these mini cases, only the lower abdominal muscles are tightened and a smaller amount of skin is removed compared to a standard tummy tuck.
At the risk of being redundant, the most important thing to do to determine what type of procedure is best for your tummy is to see an experienced plastic surgeon that is certified by the American Board of Plastic Surgery and not someone who just performs liposuction in their office.