Q&A: Is Smart-Lipo or Tube Lipo Better Than Liposuction?

Ask A Doctor Question: 

My name is Cynthia, and I have had three children, I have a pouch under my belly button, I love to drink beer, and watch my Bama play football. I was wondering if smart-lipo or with a tube lipo would be better than lipo, and also if the skin would need to be removed, or if it would tighten again. I will soon be 57 years old. Thanks.


William Georgis, M.D. -

Usually after delivering children the skin has loosened sufficiently that abdominoplasty, which includes liposuction, tightening of the muscles, and removal of loose skin, will give the best result.  Liposuction alone in the presence of loose skin such as you describe often results in a worsening of the appearance of the skin.  Also, after childbirth, the muscles of the tummy are stretched and the best treatment would be tightening of the muscles.  The tummy tuck procedure is often performed as an outpatient in the office setting.  There are plenty of photos of abdominoplasties available on including in my listing.  Best wishes to you.

--William Georgis, M.D.
Rockford, IL


William W. Ehrlich, MD FAACS -

Dear Cynthia:
For 17 years, my preference has been "true tumescent liposuction" with micro-cannulae. This is an outpatient or office procedure, IV sedation and general anesthesia are not needed.
Some will use a laser during the procedure (it is almost always not really necessary or particularly helpful) but is a wonderful marketing tool for patients who love the word "laser," and think that it somehow give magical results.  Also beware of all the marketing words for types of liposuction, such as SmartLipo, PureLipo, MicroLipo, LaserLipo, SonicLipo, etc.  They mean next to nothing. 
Your tummy is numbed with tumescent anesthetic solution, and the fat is removed with small tubes called cannula.  If done by an experienced liposuction surgeon, you should be back to work in 48-72 hours, exercise in 5-7 days.  It is very difficult to know how much your skin will retract at age 57, it is extremely variable.  Unless you insist on having a "six pack" after surgery (not beer), or want to "bounce a quarter off of your tummy,"  there may be no reason to consider skin removal, unless you will be modeling swimsuits and/or giving up the beer. 
Done correctly, you should be able to enjoy a 75-85% improvement of the fatty area with minimal risk, no systemic anesthesia, no cutting, and a rapid return to work and play.  There is absolutely no reason to have general anesthesia or a tummy tuck with scarring.
Good Luck.

--William W. Ehrlich, MD FAACS
Oklahoma City, OK does not evaluate or guarantee the accuracy of any Ask A Doctor Q&A content. Read full conditions of use here.