The Surgeon Minute

Sweet Synergy: A Tummy Tuck with Liposuction

Sweet Synergy: A Tummy Tuck with Liposuction

Pregnancy delivers a bundle of joy along with profound physical whiplash, some of which may only respond to liposuction or abdominoplasty procedures. Each woman is affected differently, with age and genetics playing a significant role in how their body recovers or doesn’t.

Abdominal stretching of muscle and skin, and local collections of fat, lead many moms to seek a consultation with a plastic surgeon to restore their pre-pregnancy figures. Dr. Mark Epstein who practices in Stony Brook, New York believes the combination of a tummy tuck and liposuction not only counteract post pregnancy woes, but can actually improve upon a woman’s pre-pregnancy figure.

“It’s a very safe and satisfying combination of procedures. In the past I used to think about whether a patient needed liposuction or abdominoplasty depending upon their excess fat or excess skin. Now, I would say approximately 90% of my patients really benefit from both.” – Mark Epstein, MD

How Liposuction and Abdominoplasty Differ

A tummy tuck should not be confused with liposuction. The two are distinct procedures and cannot substitute for one another.

In general: Abdominoplasty flattens and repairs. Liposuction removes and sculpts.

An abdominoplasty, or tummy tuck, is the recommended treatment for sagging or projecting lower abdominal wall tissues. Candidates are women who have muscles and skin stretched by multiple pregnancies with loose skin and fat in the tummy area. The tummy tuck procedure helps to flatten the abdomen by removing excess skin and tightening up stretched muscles.

Liposuction can be performed on many parts of the body to remove fat deposits and sculpt a more pleasing contour. Hips, thighs, flanks, abdomen and buttocks are some of the more common areas addressed. Because the fat cells are permanently removed, bulges cannot come back in that place.

Epstein prefers doing Vaser liposuction in conjunction with a tummy tuck for most patients. “Vaser lipo by itself is a very effective tool for multiple areas of the body,” shares Epstein. “I believe that Vaser lipo is a very important component when considering abdominal contouring. You want to thin the skin of the abdomen so when you remove the excess skin, tighten those abdominal muscles, and redrape skin, you deliver a much thinner and shapelier contour. Both patients and I have been amazed at the results we have achieved using this combination.”

abdominoplasty with liposuction before and after

A Safety Moment

Patients often ask about the risks associated with multiple procedures. Studies have found that these combined procedures are not significantly more risky for the patient than a single procedure would be. It is important to stress that these procedures are best performed by board certified plastic surgeons at a fully-equipped surgical facility.

“Doing abdominoplasty with liposuction is very safe,” says Epstein. “…and I select my patients carefully because that is the best way to avoid complications.” Performing multiple procedures on patients with any significant medical problems can compromise their recovery.

The benefits to the patient of performing multiple procedures as opposed to several separate procedures include

  • a reduced overall time under anesthetic
  • downtime is combined
  • reduced cost is realized when charges for surgical facilities, anesthesia, and medical staff are not duplicated

Secret to Easing Discomfort

If you ask patients who have had a tummy tuck, the majority would say they would do it again, but would also admit the recovery can be quite uncomfortable. To combat this, Epstein uses a special drug that has been a game-changer in easing his patients’ recovery experience. “The drug is called Exparel,” explains Epstein. “It is a long acting local anesthetic we actually place during surgery.”

Exparel has been an exciting new tool for plastic surgeons specifically, blocking pain up to 3 days post-surgery. According to Epstein, using Exparel significantly accelerates recovery. “There is less need for narcotics, so patients don’t suffer with those side effects. It also reduces complications. Patients are up and around and feeling better, faster.”

tummy tuck with liposuction before and after


Epstein underscores the importance of being mobile immediately after surgery. “These procedures take a relatively long time to perform and we want to reduce risks like blood clots. Our patients typically get up and walk out the door. One of my nurses will stay with them at their home the first night making sure they are comfortable and taking in enough fluids.”

After a tummy tuck and liposuction, patients are sent home with compression garments that they will wear for 12 weeks to insure that the skin lies properly, fluid is mobilized and swelling is reduced. Epstein clears most patients to drive between one and two weeks after surgery. Those who do office work can usually return to work in two weeks or less without a problem.

The Beauty of Synergy

There is more to successful body contouring than advanced technology or surgical technique; an understanding of aesthetic body proportions can mean the difference between a good and a great result, so it is important to choose a surgeon who has a keen artistic eye.

“The synergism of combining Vaser lipo and abdominoplasty is real,” says Epstein. “The results are truly greater than the sum of their parts. It is a sort of multiplied factor I can’t quantify in numbers but I can tell you the results I get when I use these two procedures in tandem are far greater than I would achieve if I did one or the other alone.”

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