The Question

Cosmetic surgery can do some fairly amazing things in terms of developing the sort of body a person has always dreamed of having, and we have come a long way with both the science and art of plastic surgery in the last decade, never mind the last fifty years! Still, cosmetic surgery does have certain limitations. One example of these limitations is the focus of this week’s Ask Dr. Pane segment. The viewer, from Facebook, asks, “For a flat stomach, should I go for lipo or a tummy tuck?” The viewer adds they have experienced weight fluctuation over the past several years, which is an important consideration moving forward, as we will see shortly. 

The Answer

The question of whether to do lipo or a tummy tuck is a classic in the cosmetic surgery field, Dr. Pane says.

 Usually, liposuction will be done as a standalone procedure if the patient has generally tight skin of good quality in the areas under consideration, and in patients who are done having or do not plan to have children. This procedure removes pinchable fat and if done properly, will have no or minimal effect on the overlying skin, which will contract and shrink to accommodate the underlying tissues.

Tummy tucks are usually reserved for situations where the patient has excess amounts of loose skin, as may occur from radical weight loss stemming from pregnancy, illness, diet and exercise, bariatric procedures or all the above. Usually the patient’s primary concern will not be the amount of fat present, but an overabundance of stretched or sagging skin which needs to be removed so the remaining skin can be tightened up to present a sleeker profile.  

One problem patients tend to overlook is the fact that these procedures are cosmetic in nature and are not a substitute for diet and exercise and/or bariatric surgery such as gastric sleeve, lap band or gastric bypass. While yes, cosmetic procedures can and do remove pinchable fat to a degree, what they cannot and do not do is substitute for weight loss through other means. A key factor in getting optimal results from lipo or tummy tuck is to make sure the patient’s weight has reached a stable plateau and remained there for a while, so as to minimize the chance of complications or problems which may develop later if weight continues to fluctuate.

In this case, there are a great many unknowns, Dr. Pane notes. The patient didn’t state their age, whether they have had or are planning to have children, or whether the weight is up and down historically, i.e. over a period of several years versus being in flux at the present. All these factors play a crucial role in helping determine which procedure would best suit the patient’s needs, or even if surgical intervention is appropriate for this given patient at this time. Not every patient is necessarily a candidate for cosmetic surgery, and these factors are key to determining their suitability for the procedures in question.

If the patient is planning on having bariatric surgery such as gastric sleeve, which is the most common procedure of that type nowadays, and/or intends to have more children, Dr. Pane says he recommends getting those out of the way first. Once these are resolved and the patient’s weight has reached a stable plateau in the range they want to be, then it would be more feasible to evaluate the patient for lipo or a tummy tuck, depending on which is more appropriate for the patient’s build. However, without seeing the patient in person and being able to evaluate the patient and their medical history in a clinical setting, there is really no way to properly assess this patient’s specific body type or determine what the optimal approach would be. Thus, this answer discusses generalities, but should not be taken as patient-specific.

If you have a question about any aspect of cosmetic surgery, Dr. Pane and the staff of Atlantic Coast Aesthetics are always happy to discuss the areas of interest or concern to you. Simply follow us on Twitter, Instagram, Facebook and LinkedIn; call us at (561) 422-4116; and/or email us through our website’s Contact page. Your question might even be the focus of an upcoming Ask Dr. Pane segment, helping us to inform and educate others who share your interests with real talk and honest answers to your questions. Remember, at ACA we believe the only bad question is the one you don’t ask!

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