Should I get Lipo w/ Mini Tummy Tuck or full Tummy Tuck

Dr. Pane discusses the difference between mini and full tummy tucks as they apply to a specific case.

Atlantic Coast Aesthetics gets quite a few questions about different tummy tuck procedures from both men and women of all ages and body types. Sometimes, especially when there has been weight loss and gain, patients may want to consider revision procedures. An example of this is our ACA Question of the Week for our latest Ask Dr. Pane segment. The patient says, “Can’t get rid of muffin top even though I work out like crazy, should I get lipo w/ mini tummy tuck or full tummy tuck? I had a full tummy tuck 10 years ago. After that I had 2kids and this is my end result 🙁 . I workout like crazy but still cannot get rid of my muffin top and lower back fat. What is best for me?

Differences between mini and full tummy tuck

Dr. Pane stresses that it is important to understand the difference between a full and mini tummy tuck and the advantages and limitations of each kind of procedure. In a full tummy tuck, the fat deposits beneath the skin are liposuctioned out and sculpted across the abdominal area. Then the loose skin is excised, or cut away, and the ends reattached to produce a sleeker, more defined profile. A mini tummy tuck is generally restricted to the sides or front, and is usually sought out by patients who want the results of a tummy tuck without the scarring that can result. However, both procedures are invasive surgical operations that do cause a certain amount of insult to the tissues in the areas in which they are performed, so scarring would still be a consideration.

Why didn’t the tummy tuck last?

Every person’s body, anatomy, metabolism and chemistry are just a little bit different. Some people store fat in the hips, buttocks and breasts, while others carry it in the stomach and lower back region. With patients who underwent pregnancy after having a tummy tuck, it is almost expected that a certain amount of adipose tissue, or fat, will reassert itself because of the changes that pregnancy causes in the female body. To what degree this will occur varies on a case by case basis. Some patients never have this issue again, while others fight a lifelong “battle of the bulge” because of the way in which they metabolize and store fat in their bodies. It doesn’t mean that the patient did anything wrong or that they’re not living a healthy lifestyle, it simply means that this is how their body is programmed at the genetic level.

Case evaluation

After reviewing the photos the patient provided, Dr. Pane observed that it is rare to do a complete tummy tuck for a patient who has had one in the past. The most common exception to this rule is if the initial procedure was done in a manner that was not as effective as would reasonably be expected. For this particular patient, assuming good skin condition on the flanks, where the “muffin top” effect is usually the most pronounced, liposuction may be all that is required.
However, if lipo alone would appear not to be effective after an in-person clinical evaluation, the next step to consider would be the mini tummy tuck. The reason for this is because the patient already has a scar, which is advantageous because by “tracing” the original scar contour, the scarring from the revision can be masked to a certain degree. This would really depend on the condition of the skin, as well as how much subcutaneous fat needs to be removed and how much loose skin is projected to be left behind after the lipo phase is complete.

Other points to consider

Generally, most cosmetic surgeons try not to make a complete revision of a prior surgery the “go-to” corrective measure. This is because where there has already been invasive, intrusive procedures done, there is a greater risk of complications with each succeeding procedure. Some patients don’t take the risk of complications seriously enough, gauging the expectations for the revision off the recovery and results from the initial procedure. This can be dangerous because by underestimating the risk, patients may feel better and more physically capable than they actually are, ignoring aftercare protocols that would minimize the associated potential issues. For these reasons, when and where possible, a “lighter,” less invasive approach is preferred. That is not to say that a complete revision is never appropriate, necessary or doable; it simply means that complete revision is usually considered more drastic and therefore is less frequently considered as the first option.
If you have a burning question about cosmetic surgery and what it might mean for you, the staff and physicians of Atlantic Coast Aesthetics are always glad to take some time and “talk shop” with you. Email us at, follow us on Facebook and Twitter, or call us at (561) 422-4116 with your questions. It’s just possible that you might even help us, and Dr. Pane, help others if your question is chosen for our next “Ask Dr. Pane” segment, answered live in an upcoming Google Hangout by Dr. Pane personally. Remember, at ACA we believe the only bad question is the one you don’t ask!

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