Liposuction and abdominoplasty, also known as tummy tuck, are the two most popular cosmetic surgical procedures in America. According to the statistics of American Society for Aesthetic Plastic Society (ASAPS), among the most performed surgeries in 2011, liposuction was adjudged no.1 with over 320,000 procedures and abdominoplasty at at no.3 with over 149,000 procedures.

Liposuction provides quick solutions to the patients who have local pockets of fat in the back, buttocks, flanks, thighs, abdomen and other locations and are unable to get rid of these pockets despite pursuing the normal ways of shedding general fat through healthy diet and exercise.

It has long been observed that despite the patients carrying out sincerely the conventional and the modern non-invasive ways of losing fat pockets, they do not achieve the desired results. Most of them eventually turn to liposuction for achieving what they wanted in the first place.

When the fat pockets are removed by liposuction, often the body contour in the area becomes irregular due to the skin already being stretched over the fat pockets and then being unable to go back to the original smooth contour due to loss of elasticity of the skin and underlying tissues. The skin remains loose and may hinder in getting into clothes and doing physical work.

Liposuction may also have to be performed on women after pregnancies and on people undergoing bariartric surgeries if they still retain pockets of fat.

In all such cases, tummy tucks are required to tighten the skin and underlying fat or muscle tissues.

Some follow up studies have shown that liposuction followed by abdominoplasty after allowing healing time for the former often give the best results in terms of patient satisfaction. However performing the two procedures together may not be advisable particularly if a full tummytuck is to be done in the abdominal area.

Mini tummy tucks in the upper arms, back, hip or flank areas are deemed less risky if it is to be done in conjunction with liposuction. The additional risks of full tummy tuck in the abdomen arise due to conditions such as:

i)  affecting blood supply  in the abdomen- The abdomen receives oxygen rich blood in three ways – groin arteries from both sides; a number of blood vessels passing across through the muscles; and blood vessels under the lower ribs continuing in the abdomen. During the tummy tuck the first two sources of blood get affected with the last source remaining unaffected.

In absence of any other arterial blood supply source in the abdomen, there are risks of the skin in the area dying out due to lack of oxygen and also of the incision wounds separating out.

ii)  More surgery time – The risks and chances of complications increase with the increased length of the surgery time. There are several of these risks such as anesthesia risks, blood clots, hematoma, seroma, risks of stroke, cardiac and pulmonary mal-functions.

Because of the above risks of a full abdominoplasty, most surgeons discourage combining this full procedure with liposuction. Some surgeons however may agree to do a mini tummy tuck along with liposuction when there is not much fat pockets in the middle of the abdomen. They however perform such combined procedures with abundant caution.

The patient should discuss in detail with the surgeon before deciding to combine a mini tummy tuck with liposuction. If it is not necessary combining the two surgeries, it is better to do the surgeries one at a time i.e liposuction and healing followed by tummy tuck.