Summary: Both lipoplasty or abdominoplasty address very separate cosmetic concerns, yet can deliver complementary results. Performing both procedures simultaneously may lower the overall risk of complications rather than increasing them, and offers superior body contouring as well. This article discusses safety factors to consider to reduce complications and achieve superior results.
Whether choosing lipoplasty or abdominoplasty, the bottom line is that both surgeries address very separate cosmetic concerns, yet can deliver complementary results. While some textbooks still advise against combining abdominoplasty with lipoplasty, more recently published studies indicate that performing both procedures simultaneously actually lowers the overall risk of complications rather than increasing them, and offers superior body contouring as well.
Safety Factors to Consider
There are three primary safety factors to consider when combining liposuction with abdominoplasty:
- Blood supply integrity: Maintaining sufficient blood supply to the abdominal flap following surgery is essential for preventing necrosis and promoting healing. Liposuction, especially when performed above the umbilicus, may compromise this integrity.
- Incidence of seroma: Risk of seroma (a pocket of serous fluid) remains the largest concern following abdominoplasty, with or without the inclusion of liposuction.
- Length of surgery: Combining procedures makes for a lengthier surgery, which increases patient risks associated with anesthesia.
All three are legitimate concerns for the patient and plastic surgeon. However, with the right approach and a high level of expertise, potential risks are mitigated and plastic surgeons are instead seeing the superior contours that the combining procedures, sometimes referred to as lipoabdominoplasty, can deliver.
Maintaining Blood Supply Integrity
Not long ago, it was considered a given that any surgeon who planned to perform both abdominoplasty and liposuction on a patient would do so in staged procedures, typically beginning with abdominoplasty and only proceeding with lipo after healing had completed. With the significant blood supply present through the fatty tissue, removal of subcutaneous fat cells during a tummy tuck seemed like an unnecessary risk for increase of necrosis following surgery.
When abdominoplasty is performed with a minimal superior undermining technique instead, the surgery involves the least invasive level necessary to allow for muscle plication (surgical tightening). This technique preserves maximal blood supply integrity to the distal flap, allowing for the safe inclusion of liposculpture, even above the umbilicus.
Fluid buildup is particularly common after major cavity surgery like abdominoplasty, making seroma one of the largest post-operative concerns and one of the most frequent complications during recovery. Historically, post-surgical drains have been utilized to eliminate fluid buildup. While this is an effective approach to removing fluid, drains fail to address the problem at its source: alleviating fluid collection in the first place.
When progressive tension sutures (PTS) are used in combination with limited undermining and liposculpture, the muscles and tissue are “quilted” together, preventing the larger open cavity that is more likely to collect fluid. Not only is the incidence of seroma dramatically reduced with the use of PTS, but drains can be avoided altogether and better body contours are achieved.
Finally, complications related to general anesthesia remain the number one risk for any major surgery, including cosmetic procedures. Combining abdominoplasty with liposuction does increase time on the table, especially for a plastic surgeon who is less familiar with the technique. However, the patient spends less total time under anesthesia during a combined procedure than when having both procedures performed separately.
The decreased post-operative risks, superior results and shorter recovery time granted by taking this combination approach are strong positive factors to take into consideration when weighing all the pros and cons. In the end, the benefits of combining procedures present a strong argument in favor of lipoabdominoplasty.
Ensuring Superior Results
The concept that lipoabdominoplasty is a needlessly high-risk surgery needs to be revisited, along with other common myths about tummy tucks and liposuction having to be performed as distinct procedures. Combining these two body contouring surgeries instead brings out the best in each one for truly superior body contouring results.