How Do You Decide Between a Tummy Tuck or Liposuction?

Our San Antonio patients are pretty savvy about the aesthetic world and the various procedures and treatments out there to keep you looking your best. But there is some confusion about the difference between a tummy tuck and liposuction for the pooch on the lower tummy.

Dr. Coleman performs both procedures, and while they can involve the same target area, the abdomen, they are completely different procedures and really are right for different conditions.

Here’s a little primer on the difference between these two popular body-contouring procedures.


Liposuction removes pockets of stubborn fat that are resistant to changes in diet or exercise. Today’s tumescent liposuction that Dr. Coleman uses is far different than the original procedure that was developed in France and debuted in the U.S. in the 1980s. That original procedure was quite traumatic on the tissues and created extensive bruising that could last for a few months before it fully cleared. That’s because the cannulas used to suction out unwanted fat were larger and had to be moved about aggressively under the skin to break up and remove the unwanted fat. This caused bleeding and bruising under the skin.

In tumescent liposuction, Dr. Coleman first injects the treatment area with a solution consisting of saline solution, epinephrine, and lidocaine. The saline solution expands the skin just a bit. The epinephrine shrinks the blood vessels to lessen bleeding and subsequent bruising. It also constricts the fat cells, making them easier to suction away. The lidocaine acts as a local anesthetic. Plus, Dr. Coleman uses a small cannula and it doesn’t have to be moved around violently under the skin. All of this makes for a much easier procedure with far less bruising and downtime. The incisions needed today are also so small they don’t usually require a single stitch, just a bandage in most cases.

Liposuction is a great procedure if the patient has pockets of unwanted fat on the abdomen, thighs, upper arms, and even under the chin. It’s important that the patient doesn’t have sagging skin, and that the skin is still very elastic. This is necessary for the skin to tighten down to the slimmer contour once the fat is removed.

Tummy tuck

The goal of a tummy tuck is really loose skin. These procedures are intended to remove loose, sagging skin and fat in the abdomen. Unlike liposuction, tummy tucks involve a lengthy incision stretching from hipbone to hipbone and often a second smaller incision around the belly button to address sagging above the navel. The skin is then separated from the muscle beneath, and any muscles that may have become separated by the localized weight gain from pregnancy are brought back to the center and stitched back into place. This narrows the waist and returns muscle strength to the center of the stomach area. Next, Dr. Coleman pulls the skin downward and trims away any excess skin before closing the incision. The navel is usually moved upward due to the skin that was pulled downward.

Tummy tucks are great procedures for women who have had children, as the localized weight gain and loss of pregnancy often stretches the stomach skin to the degree it cannot tighten back down to the same degree of firmness that existed before pregnancy. They can also be great for patients who have gained and then lost a large amount of weight and are left with sagging stomach skin. Dr. Coleman often uses a small amount of liposuction with his tummy tuck procedures to remove pockets of unwanted fat.

Interested in either of these body-contouring procedures? Winter is a great time to have them done. That way your slimmer contour will be ready for next summer’s bathing suits and sundresses. Call Dr. Coleman at (210) 251-4362 to schedule a consultation.

Posted in: Liposuction, Tummy Tuck


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