Will The Lumps Of Fat Above My Bellybutton Be Liposuctioned During My Tummy Tuck?

Q: Dr. Eppley, I know a tummy tuck focuses on the abdomen below the belly button. However, I have two fat “dumplings” immediately above and to the left and right of my belly button. If this skin gets pulled down because the lower skin is excised, I was worried that these two fat “dumplings” would look like a new pannus. (if that makes sense).Is liposuction ever being performed on the area immediately above the belly button during a tummy tuck also?

A: In a tummy tuck, the excision of full-thickness skin and fat in the lower half of the abdomen results in an advancement or stretching of the undermined upper abdominal skin flap. This will ‘unravel’ much of the upper abdominal fullness and irregularities because this tissue unit must now stretch out and cover twice the surface area that it used to. Liposuction is never done on the upper abdominal skin flap during a tummy tuck because of blood supply and healing concerns. By doing so there is a very significant risk of causing skin necrosis and wound healing problems of the tummy tuck incisional closure. Once the upper abdominal skin flap is undermined to allow it to stretch out, the perforating vessels feeding the tissues are cut off from the underlying muscles. The skin is now surviving on the more superficial vessels near the skin that comes in from the sides. Liposuction will injure those vessels and make the central upper abdominal tissue have jeopardized vascular perfusion. The small increase in aesthetic improvement is not worth the risk of major tummy tuck wound healing problems. But those areas you are referring to above the belly button are not going to be carried lower as they now exist. They should be completely flattened out for the most part.

Dr. Barry Eppley