Medically reviewed by Dr. John Rosdeutscher – Written by Sine Thieme
So you want a flat stomach. Not too long ago, you would have been right to believe that a tummy tuck was your only – and best – way to achieve it. But in the year 2021, you have more options. With radio frequency assisted lipolysis (RFAL) aka non-surgical skin tightening, you can achieve results close to those you could formerly only achieve with surgery.
If you pair skin tightening with liposuction, it provides an excellent alternative to a tummy tuck. To fully understand the differences, read on. Our staff at NuBody Concepts Cosmetic Surgery in Nashville and Memphis, TN, would like to help you understand the pros and cons of each procedure to help you decide which one fits you best.
Minimally-Invasive Skin Tightening
If you would prefer not to have surgery, you’re not alone. Some who consider a tummy tuck ultimately do not go through with it because they are concerned that it is too invasive. You might just be uncomfortable with going “under the knife.” Or you might not have the time for the lengthier recovery a tummy tuck entails.
Compared to a tummy tuck, skin tightening with liposuction (both minimally-invasive) is less invasive. While it does require small incisions to insert the cannula under the skin that is required for both fat removal and skin contraction, these small nicks heal within days and typically don’t even require stitches. They are not likely to lead to any scarring. The anesthesia is also much lighter or can be avoided altogether, meaning the recovery is much swifter and easier to handle for your body. Recovery times after RFAL range from 1-5 days, whereas a tummy tuck can set you back up to a month or even 6 weeks.
Pros of Skin Tightening
- minimal downtime
- minimal trauma
- no scar
- can contract skin up to 60%
- fast recovery of 1-5 days
- works great for BMIs under 30
Cons of Skin Tightening
- does not shrink all excess skin
- less immediate or drastic results
- does not remove visceral fat
- less effective for BMIs over 30
Tummy Tuck Surgery
As a surgical procedure that entirely removes the offending skin, a tummy tuck can achieve more than skin tightening alone. It removes excess fat, including the visceral fat resistant to liposuction. And it contracts the skin by more than the 35% – 60% that procedures like BodyTite or Renuvion have been shown to achieve. If the surgeon cuts out (excises) the sagging skin, by definition you’re going to be left with mostly tight skin. Skin can lose its elasticity over time and particularly after pregnancy and childbirth. In almost all cases, a tummy tuck is going to give you more beautiful results but also require much more downtime. There is a tradeoff between both procedures and it’s up to you to choose between the two.
A tummy tuck can also repair abdominal muscles that have split (diastasis recti) during pregnancy and childbirth. This of course cannot be achieved with skin tightening by itself. And lastly, your plastic surgeon can relocate and beautify your belly button while your’e undergoing tummy tuck surgery.
Pros of a Tummy Tuck
- immediate, drastic results
- removes excess skin entirely
- removes all fat – including visceral fat
- can be used to repair muscles
- can be used to beautify the belly button
- yields good results for BMIs between 30 and 35
Cons of a Tummy Tuck
- requires surgery with sedation
- longer and more painful recovery
- possibility of infection, anesthesia risks, and other risk factors
- leaves a scar (although placed discreetly at bikini line)
Should I have Skin Tightening or a Tummy Tuck?
As we’ve said before, there is going to be a trade-off between skin tightening and a tummy tuck. What you gain when you choose the less-invasive (i.e. skin tightening) procedure in terms of a faster recovery, lower anesthesia risks, and a scar-free midsection, you give up in terms of results. The tummy tuck is the most aggressive form of fat removal, but also the most effective one. You’re practically guaranteed a flat stomach with a tummy tuck, whereas skin tightening will almost certainly not get you the same dramatic results. if you’re willing to accept the scar under your bikini line, a tummy tuck may be worth it to you.
Choosing skin tightening vs tummy tuck also depends on which procedure you’re a good candidate for. If you’re younger and haven’t gone through pregnancy and childbirth, your skin has more elasticity and is better suited for skin tightening. If you’re older and/or have undergone substantial weight loss and are left with many folds of sagging skin, no amount of skin tightening will be able to shrink it back to the extent you need for a flat stomach. In this case, only a tummy tuck might be able to achieve results you’re happy with.
Skin Tightening vs Liposuction
If you wonder whether you should have skin tightening or liposuction, you’re probably asking the wrong question. In almost all cases, liposuction achieves the best results when combined with skin tightening. And skin tightening alone is rarely as effective as when preceded with liposuction to first remove the last remnants of fat.
If you are looking for an alternative to a tummy tuck, you wouldn’t ask whether skin tightening or liposuction is better. Yes, they are both minimally-invasive, but they are much more powerful together than alone. Neither one by itself will yield satisfying results when compared to a tummy tuck, but in combination they provide a good alternative in milder cases of stomach fat and excess skin.
Using Your BMI Choose the Right Procedure
One easy way to get a general idea whether skin tightening or a tummy tuck is ideal for you is to calculate your Body Mass Index or BMI. It is a simple formula based on your height and weight.
While your BMI does not measure your body fat directly, it can be useful for pre-screening. You don’t have to see a plastic surgeon to know your BMI. In fact, you can calculate it right now:
BMI under 30 ==> Skin Tightening or Skin Tightening/Lipo Combo
If your BMI is under 30, you are likely to see good results from skin tightening to address those fat pockets resistant to diet and exercise.
BMI 30 – 35 ==> Tummy Tuck
With a BMI between 30 and 35 you may still qualify for skin tightening, but you are likely to see better results from a tummy tuck. Your overall weight is still low enough that your’e not likely to experience too many complications during surgery. But your weight is on the high end and indicates that your abdominal skin has been stretched out. With those numbers, it is very likely that you will experience moderate to severe sagging even after the skin has been contracted. You might go down a pant size or two after liposuction, but you won’t like the way your tummy looks.
BMI over 35 ==> Weight-Loss Program
With a BMI over 35, we may advise you to enter a weight loss program before proceeding with any kind of cosmetic surgery. Candidates with BMIs between 30-40 qualify for the Orbera Weight-Loss Balloon.
Ultimately, it’s best to meet with a plastic surgeon to decide between radio frequency assisted non-surgical skin tightening and a tummy tuck. If you are ready to get started, use the pink button to schedule a consultation with our board-certified plastic surgeon in Nashville or Memphis.