Abdomen Liposuction
Another gravitational prone area, where I approach is the abdomen in one of two ways.
- Central Abdomen – The upper and lower abdomen are done as a unit. In many individuals, if only the lower abdomen is done, the upper abdomen will not tighten from the liposuction and gets looser with time. When the entire area is done as a unit, not only does it blend well, but it a stays tight and firm. The central abdomen is prone to irregularities if not done well. Common mistakes are poking the skin with the cannula from underneath, which causes dimpling. Another mistake is being overly aggressive in individuals with poorer skin elasticity, causing loose, sagging skin. I find that I am able to still get a perfectly smooth result and achieve skin tightening in patients with poorer elasticity by having a lot of respect for the skin. In these patients, I recommend staying deeper in the fat layer and generally being more conservative. In all patients, I always crisscross the tunnels from either two or four directions, then finishes with a very small spatula cannula for a smooth skin surface. It is great mistake to approach the abdomen from only one access point. This will increase the risk of irregularities and leave a doughnut of fat around the belly button.
- Upper, Lower Abdomen, Waist and Flanks – The other half of patients that I perform liposuction on in these areas have the abdomen done all the way around, as these individuals waists essentially need to be more defined.
If the surgeon only does the center abdomen on these patients, they will look wider and flatter. The waist is one area that positioning is extremely important in order to achieve a great result. Many years ago, I found the best way to bring the waistline down is to have the patient lie on their side and hyperextend their back. I then approach the waist from above and below, while crisscrossing the tunnels without poking the skin. I find this far superior then trying to go around the waist as many surgeons do. In those cases, the waist will not be brought down properly and, inevitably, the skin will be jabbed with the cannula tip.
A word on pregnancies, liposuction, and tummy tucks: It is generally better to liposuction the abdomen prior to pregnancy. Due to better skin elasticity, I can choose to remove more fat. However, most women I perform liposuction on have already had children. In these cases, I simply adjust how aggressive I’m being on the level of skin elasticity. When properly done, even with poorer skin tone, great improvements in reducing the fullness of this area and tighter skin tone can still be achieved.
Unless the muscle and skin have become extremely loose, these patients can usually avoid a tummy tuck. Even if a tummy tuck is eventually necessary, I feel, and studies support, that it is safer to do these as separate procedures and a more complete final result will be achieved. If a liposuction and abdominoplasty are both necessary, I will usually liposuction the abdomen first and refer the patient to an abdominoplasty specialist after several weeks of recovery if necessary. It is important to note that I specialize in liposuction not tummy tucks.
