Belt Lipectomy Vs. Tummy Tuck

The Question

Would I Benefit From A Belt Lipectomy Or A Tummy Tuck?

Even a surgeon with the experience of Atlantic Coast Aesthetics’ founder and Chief Medical Officer can sometimes receive a question from a patient that surprises and tests the boundaries of their experience. One example of this is the focus of this week’s Ask Dr. Pane segment. The patient, in her late 40s, asks, “Would I benefit from a belt [abdominoplasty] or a tummy tuck?” The patient adds that she is concerned that a belt, or circumferential, abdominoplasty might be problematic because she feels the weight of her buttocks may cause the scar to open up in the back.

The Case

Dr. Pane evaluated the photographs the patient submitted with her question to generate his answer to this particular constellation of concerns. He noted that the patient does have a depressed abdomen with some looseness in the front of the abdomen and around the sides, but relatively little in the back. This forms the basis of his analysis, but patients are reminded that in-person clinical evaluation remains the gold standard for determining the ideal way forward to give them the best possible results.

The Answer

In this patient’s case, Dr. Pane says a belt abdominoplasty, in which an incision is made all the way around to the buttock crease, would not be the optimal solution. This is because the patient doesn’t have enough loose skin in the back to warrant this particular procedure. He further mentions that in his opinion, belt abdominoplasties should be reserved for patients who have both lost a lot of weight and have sufficient slackness around the entire circumference of the abdominal area to justify the added risk and recovery time which may accompany such an invasive procedure. However, many surgeons jump straight to this option even when it is not really indicated, something Dr. Pane prefers to avoid when and where possible.

While the patient did not specifically mention Brazilian butt lift, Dr. Pane says doing this procedure using fat transfer may actually get her better results than any type of abdominoplasty. This is because by harvesting the fat from the abdominal area and placing it in the buttocks, it may help to cause the skin to lie down flatter without the need for deeper and more invasive intervention. If the patient’s interests lie in that direction, it is an avenue she may wish to explore.

If necessary, the patient may wish to consider a regular abdominoplasty either with or without the BBL. This is most likely to give her the best results and eliminate the slack skin around the front of the belly region without putting her through a procedure which would give her a larger scar to no greater benefit overall.

With regards to her concern that her buttocks might cause a belt abdominoplasty incision to open up, Dr. Pane says he has never seen or even heard of this happening, although he concedes it is certainly possible and maybe even has actually occurred somewhere at some time. The reason he is not concerned about this possibility is because of the very secure way in which such an incision would be sutured, to minimize the possibility of exactly that happening during normal activity such as sitting, standing or moving around during recovery. While it is not impossible, it is not sufficiently likely to merit any concern and certainly should not be a bar to the patient choosing the right course of action for her.

Once again, and this cannot be stressed enough, photographs are great for forming an initial impression and giving a baseline for possible avenues of exploration. However, they are very limited in what they show and may conceal other factors which may impact the surgeon’s opinion. For this reason, an in-person clinical evaluation coupled with a complete medical and surgical history is still by far the best way to obtain a definitive answer which meets all the patient’s needs.

If you have an interest, question or concern about anything related to cosmetic surgery, the staff of Atlantic Coast Aesthetics, from our founder on down the line, is here and happy to discuss your needs and desires. Simply contact us through our website; call us at (561) 422-4116; or follow us on Twitter, Instagram and/or Facebook. Your question might even be the topic of an upcoming Ask Dr. Pane segment, helping us inform and educate others while giving you the information you need to choose the options which are best for you. Remember, at ACA we believe the only bad question is the one you don’t ask!


*Individual results may vary

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