You would certainly benefit from a full abdominoplasty and probably a muscle plication. The back photo shows fullness in the flank area that can probably be reduced with liposuction, but if you grab that area and there is lots of loose skin the expenced abdominoplasty might get a more thorough result. Unfortunately it takes an exam to really be sure. Why not go back to the doctor who said you don't need the extended TT and ask him why not?
The answer unfortunately is maybe/maybe not! It is hard to say without examining you. Part of the difficulty of plastic surgery is that it is relatively subjective so you will get a few different opinions when you see different doctors--part of the artistic nature of the field! Based on these photos alone and without an exam I would say my best guess for the optimal treatment would be a staged treatment. First stage liposuction to the circumferential trunk to reduce the fat layer. I would then wait about 4-6 months and see how much skin retraction you get, especially on the flanks and back. It seems highly likely that you would at least need a full tummy tuck and if you don't achieve adequate skin retraction to the flanks and/or back it can be extended to remove as much excess skin as possible. The back often tightens pretty well in most people unless massive weight loss is involved, as you mentioned. If you don't mind excess fat layer and just want to get rid of loose skin then you could maybe jump straight to an extended tummy tuck. Make sure you are consulting with board certified/eligible plastic surgeons with experience in body contouring surgery! And as always stick with a good diet and exercise plan because that will only help make your results even better! Good luck!!
Based on your photos, your flanks could probably be treated with just liposuction. You don't have the excess skin that is addressed with a body lift, which carries the skin removal into the flanks and lower back.
In my practice, you would likely be treated with an abdominoplasty and liposuction.
Although a physical exam is needed to make any recommendations, based on your photos alone, I would likely just suggest a tummy tuck with liposuction of your waists and posterior flanks. A common first line of attack for patients who have lost weight is a body lift procedure. Most plastic surgeons refer to a body lift as a circumferential body lift = belt lipectomy = lower body lift. This procedure is essentially 3 procedures in one: extended tummy tuck + waist/lateral thigh lift + buttock lift (with the option of buttock augmentation).
Please visit with a plastic surgeon certified by the American Board of Plastic Surgery to learn more about your options.
It is difficult to tell from your photos. Based upon your height, weight, age, and general impression from the photos, I do not think you would need a body lift. At 23 y.o., you should have good skin tone and elasticity. A tummy tuck might help flatten your belly, but your hip/back area looks like it would be amenable to liposuction
There are many ways to achieve contouring of the abdomen and flanks. Patients need to know all of the options and the associated risks and benefits in order to make on informed decision.
In my practice, the lower body lift and belt lipectomy procedures are common. Therefore, the circumferential approach will be offered to many patients interested in a tummy tuck. The body lift procedure is very powerful and can result in excellent contouring of the waistline in those with extra skin. However, many patients will choose an abdominoplasty only and do just fine.
Circumferential procedures are not just for patients with massive weight loss.
I think a tummy tuck with liposuction of the sides and back would likely be sufficient. Look for a plastic surgeon with great credentials, before and after
pictures, and reviews. Also, the surgeon should be an expert all forms
of body contouring to give you the best result possible.
Kenneth Hughes, MD
Los Angeles, CA
Thank your for your question and as other have discussed, it is difficult to determine without fully examining you. However, our significant knowledge from our involvement with massive weight loss body contouring has opened doors, such as lower body lift, that we did not have before. Although a frontal abdominoplasty is a good operation, in some, it can be a uni-dimensional procedure only addressing the frontal laxity. The flanks and the dreaded "muffin top" is simply not addressed. With an extension of the abdominoplasty into the flanks either in the form of an extensive andominoplasty with flanks or a lower body lift an optimal three dimensional re-contoruing can be done. Best wishes.
There are 2 ways to look at your situation/ decision. The first is to consider what do you NOT like about your appearance, and what are you willing to pay to have it improved. You never said what it is YOU want!
The second option is to simply ask..." where do you, Dr. PS, think I need improvement, and what would you suggest I do?"... I will answer the second option...
You need improvement in your hips, lower back, and abdominal area. Lipo suction alone will leave you with extensive skin redundancy even though you are young, and you will experience some skin retraction after lipo. In my opinion, you would benefit from lipo and skin subtraction (body lift) all the way around your body at the waist level. You might also consider some buttock sculpting...
Thanks for your question and photo. Unfortunately it is hard to give you a definitive answer without an exam. You would definitely benefit from an abdominoplasty, and I always recommend addressing the trunk in a circumferential manner. You have some excess fullness in your back and flank that may be treated with liposuction alone. If you have excess loose skin, then you may need a full body lift. Seek out a board certified plastic surgeon and discuss all of your options. Good luck.