There are many patients who rightfully wish to have the least invasive cosmetic plastic surgery possible to get the greatest cosmetic results. In fact, that should be the aim of any plastic surgeon: perform the smallest possible procedure for the greatest possible result. At times, though, the correct procedure to give the plastic surgery patient the desired result is not the easiest, least invasive or quickest. Doing the wrong procedure will condemn the patient to a second surgery with extra cost and repeated discomfort and time off work.

Choosing the right cosmetic surgeon

One of the most common areas in which a “mistake” in judgement is made is in the area of the abdomen where patients are trying to improve their abdominal contour. I should preface this discussion by saying that even though a board-certified plastic surgeon can also choose the least preferable technique for reaching a particular cosmetic goal, because of their extensive training, they are less likely to make that error in judgement and will usually advise the patient  to have the right surgery. The problem in judgement is much more common with doctors and surgeons who have not been trained in plastic surgery who often do not know how to perform the required surgical procedure. So they perform the only procedure they know, usually a liposuction, and the results are… terrible.

Abdominoplasty/tummy tuck

When there is looseness of the abdominal skin, weakness of the abdominal muscles and extra fat in the tummy area, patients are prime candidates for the wrong procedure to be performed upon them. Almost all of these patients, especially if they are women who have had full-term pregnancies, will require an abdominoplasty or tummy tuck to improve their body shape. The plastic surgeon will almost always advise them to undergo this procedure. A tummy tuck is one of the biggest procedures a plastic surgeon performs and requires a ten-day recovery on average. The surgery takes about 2.5 hours and requires an incision over the pubic area that may extend from one side of the belly to the other. The skin is removed, fat is cut out or liposuctioned and the abdominal muscles are tightened.


Problems occur when the same patient goes to a doctor who is not a plastic surgeon but performs liposuction or “laser liposuction,” “slim lipo,” “hydro lipo,” etc., a gimmicky type of liposuction to entice patients through the door with promises of “less bruising” (not true), “less pain” (not true) and a “quicker recovery” (not true). These “liposuction-only” doctors are usually dermatologists or other non-plastic-surgeons who do not know how to perform an abdominoplasty. They will “sell” the patient on liposuction that will “shrink the skin enough” (not true) to avoid a tummy tuck. They will promise a smaller and quicker procedure (true and sometimes true) that will give the same result as an abdominoplasty (not true). For the right patient, liposuction is an excellent choice—for the patient below, it was the wrong choice.

Before lipo

Before lipo

Post -lipo; should have had a tummy tuck!

After lipo


Here are before and after photographs of a patient who needed an abdominoplasty but only had liposuction. Notice that the patient is less “big”—she is slimmer because fat has been removed; but note what has happened to the skin that was drooping before the surgery and only looks worse now. The result is terrible, and she would have been better off not having any surgery until she was ready to have the right one.

Having your board-certified cosmetic plastic surgeon advise you on the correct surgery and on your options will ensure the best cosmetic result (true).