Liposuction vs. "Tummy Tuck" or Abdominoplasty

The "tummy tuck" is one way to improve saggy "pot bellies." The surgeon takes the saggy skin of the lower abdomen and cuts a big "smile" incision from hip to hip, removes the skin and fat between the belly button and pubic hair, and sews it all up. This is major invasive surgery. There are significant chances for infection and skin death, and the procedure has the highest fatality rate of all cosmetic surgeries (refer to the Tummy Tuck section for photos and scientific articles about this). I don't want to give the impression that this sort of thing can never happen with liposuction, but it is extremely more rare. Some tummy tuck patients have difficulty walking without pain for several weeks. Additionally, most tummy tucks produce unacceptable scarring. A patient who was ashamed to show his belly before because it hung down is still ashamed of the area afterwards because of the one- or two-foot-long scar. The "belly button" often has to be repositioned, and this can look strange. And the contours are not always very natural. From the side, the profile may show a very flat abdomen, while from the front, the hips may be too big. If weight gain occurs after the surgery, odd effects may result. Frequently, it is difficult to sew the skin together at the ends of the incision properly, and a "dog-ear" (this really is the medical term) occurs, where a strange little pouch of fat and skin is left at the ends of the scar on each hip.

Most "pot bellies" can be treated with liposuction alone. If properly done, the liposuction shrinks the skin and results in a reasonably good lower abdomen shape, but this requires an experienced surgeon. Sometimes the skin texture is altered and wrinkles result, but it's generally better than taking a chance with the many problems mentioned above.

More information about both procedures and associated complications can be found in chapter 14, "What's the Worst That Can Happen?"