Many times we have the dilemma which of the abdominoplasty or liposuction is the most appropriate procedure. It is often clear, but in the interim situations, there is a dilemma which one we should try, and the best answer to that is to solve this with our plastic surgeon.
Sagging skin is a clear indication for performing abdominoplasty where the person has enough loose skin, streaks and lack of tone. Having this person undergo liposuction to remove only local fat is likely to cause worse aesthetic problem due to further deterioration of sagging. In such cases, removal of skin with abdominoplasty is necessary.
In contrast, people who have firm skin, with a local accumulation of fat, if it is caused only by fat accumulation and not stretched abdominal wall, should be treated with liposuction.
We must be cautious in cases of individuals who have swelling in the abdomen, which seems to be due to fat accumulation, but we eventually realize that it is distension of the abdominal wall. These individuals may have enough elastic skin, but will not benefit much from liposuction and they may need abdominoplasty.
Some others have swelling on the abdomen, which is due to fat on the abdomen and not accumulated fat. These people will not benefit either from abdominoplasty or liposuction. These persons will only benefit from weight loss by adjusting their diet.
All of the above lead to the conclusion that the decision on the type of surgery to be followed is not an easy task. Only the experience of the plastic surgeon can lead to a right decision.