Liposuction involves removal of the fat from the layers outside the abdominal muscles. This is done with the help of small tubes which are inserted through the skin. The access incisions are usually lesser than 5 mm. The resultant scarring is usually inconspicuous. There may be some amount of contraction of the overlying skin in individuals with good skin tone.
Tummy tuck is a more extensive procedure and includes a series of steps to 'tighten' the abdomen. It is indicated in patients with excess skin and lax abdominal muscles. It is preferred when there are coexisting hernias of the abdomen. The incision is placed in the lower part of the abdomen such that the scar is easily concealed by an undergarment. Laxity of abdominal muscles is tackled by plication (tightening) of the layers of fascia which invest these muscles. Excess of skin is removed in the shape of an ellipse immediately above the incision. Liposuction is often combined with a tummy tuck in case there is excess fat in the upper abdomen and flanks. The recovery period of a tummy tuck is longer when compared to liposuction.
To summarize, the parameters that help one decide between isolated abdominal liposuction or tummy tuck depend on the following:
1. Excess skin with poor skin tone
2. Laxity of abdominal muscles
3. Excess fat
If the patient has an excess of skin with a poor tone of abdominal muscles they are usually better served with a tummy tuck. Patients with isolated fat excess are good candidates for abdominal liposuction.