Dear Dr. Winder:
Q. I've had two children and my stomach shows it. I have loose skin and some bulges. Do I need liposuction or a tummy tuck or another procedure altogether?

A.. Liposuction is used when there is excess fat that doesn't respond to diet or exercise, but the skin is still tight and has good elasticity. If your skin is loose or if you have a lot of stretch marks, you may not be a good candidate for liposuction. Liposuction is technically straight-forward for a board certified plastic surgeon; the surgeon takes a very thin tube, called a cannula(we use the latest reciprocating cannulae) and inserts it into the fatty area through a very small incision. The tube is connected to a vacuum machine and the fat is suctioned out. We use a variety of different sized tubes to help achieve precise sculpting, and an established technique called "tumescent" liposuction, along with EUA (external ultrasound assist), which allows for even greater control over the final results.

On the other hand, a "tummy tuck" which is the common name for "abdominoplasty", is specifically designed to remove excess skin and fatty tissue from the middle and lower portions of the abdomen. For women who have had children, we often tighten the ligaments of the abdomen, as well. There is a full range of "mini and complete" abdominoplasties that you and your surgeon can choose from, depending upon the amount and location of the excess skin, fat, "pooch" and other factors. In many situations, however, optimal results are achieved by combining the two techniques, removing the excess fat with liposuction and removal of fatty tissue, excess skin and tightening of the underlying ligaments which allow the "pooch" with an abdominoplasty. The only person who can tell you the best surgical approach is a board certified plastic surgeon. He or she will help you establish realistic goals and go over the procedures that will help you achieve those goals.

Read more about Abdominoplasty.

Abdominoplasty can Repair your Tummy after Pregnancy