Every patient seeking body contouring surgery has a unique shape. Different body shapes require different procedures to get the optimal result. In some patients, liposuction is the procedure of choice, and in other patients, a tummy tuck (abdominoplasty) is the procedure of choice. The primary difference between liposuction and abdominoplasty is liposuction removes only excess fat, and abdominoplasty removes excess fat and skin. If there is very limited extra skin, then liposuction is more likely to be the procedure of choice. If there is excess fat and excess skin, then a tummy tuck is more likely to be the procedure of choice. While liposuction can be performed on patients with a large amount of excess skin, the final appearance after surgery would not be ideal due to the excess skin. For patients with limited extra skin, and for patients with large amounts of excess skin, the recommendation for a procedure is clear-cut.

In addition to the ideal patient for liposuction and the ideal patient for abdominoplasty, there is an “in-between” patient. This “in-between” group of patients may be reasonable candidates for liposuction or tummy tuck surgery. The choice of procedure for the “in-between” patient depends on his/her goals and the advantages and disadvantages of both procedures. If keeping scars to a minimum is a primary concern, liposuction may be the procedure of choice. If minimizing loose skin is the major concern, then abdominoplasty may be the procedure of choice.

To clarify the above information, three patient examples are included below. The patients all presented for body contouring procedures, and they represent examples from the three aforementioned groups. Each patient has a very different body type and would benefit from a different procedure.

Patient 1 has very little extra skin, a small amount of extra fat, and favorable skin elasticity. This patient is a good candidate for liposuction. Because there is very little extra skin, she would not benefit enough from a tummy tuck to justify the large scars that result from that procedure. Because her skin elasticity is favorable, she would not have a large amount of extra skin with a liposuction procedure. The liposuction procedure would give this patient a very small scar burden compared to the abdominoplasty procedure.


Patient 3 has a large amount of extra skin, a large amount of extra fat, and less than favorable skin elasticity. This patient is a good candidate for a tummy tuck. Because there is a large amount of extra skin, she is not an ideal candidate for liposuction. If liposuction was performed on this patient, which would remove only fat, the patient would still have extra skin. Liposuction could make this look worse (by subjective evaluation) due to the impression of more extra skin. The abdominoplasty procedure would give this patient a larger scar burden compared to the liposuction procedure, but in this circumstance, the large scar burden could be justified by the removal of large amounts of excess skin. This patient could undergo a liposuction procedure to remove excess fat, but the final result would be less than ideal.

Patient 2 is an example of the “in-between” patient. She has some extra fat, some extra skin, and some skin elasticity. A recommendation for liposuction or tummy tuck surgery would be reasonable for this depending on the patient’s goals. If minimizing scars is the patient’s primary concern, then liposuction may be recommended. If the patient’s primary concern is minimizing extra skin, then abdominoplasty may be recommended. In this group of patients, the surgical procedure is largely based on the patient’s goals.

This is a very simplified view of the factors determining the best procedure for body contouring surgery. There are many other factors that are considered and discussed during the consultation process, and these other factors can influence which procedure or combination of procedures is recommended. For example, if a patient plans to have children in the future, then liposuction may be the procedure of choice. In some circumstances, liposuction and abdominoplasty are recommended together to achieve the ideal result. The unique situation of each patient and the options available are explained and discussed during the patient’s in-person appointment with the informed consent process.

Dr. Stephen Herring is an experienced, Board-Certified Plastic Surgeon known for his personalized surgical approach and exceptional body contouring outcomes. If you have additional questions regarding liposuction or tummy tuck surgery), or if you wish to schedule a consultation at our practice, please contact us today. We cater to both local and out-of-town patients!