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I want a flat stomach. Would I be happy with the outcome of an abdominoplasty w/plication and flank lipo? (Photo)

37 years old, 5'4" tall, 185 lbs for 13 yrs, except while pregnant with twins. I hate the rolls above & below my belly button. Lower hangs over my c section scar. I wear a spanx-type garment every day. I want a flat stomach (no indent or roll!) and to keep some curve at my side - avoiding the straight/rectangular/boxy sides I see after some TT's. Can you tell from the pics how much of this fat is behind the stomach muscle? Would this procedure do what I want? Would I get the results I want?

Doctor Answers 16

Optimal Tummy Tuck Results Will Need Weight Loss First

A completely flat stomach is not going to come from a full tummy tuck and flank liposuction as your body is right now. It will help tremendously but a completely flat stomach with your body type is not a realistic goal. It would require substantial weight loss and the surgery to make that happen. But you could get rid of the rolls and have more of a one-piece slightly convex stomach shape with tummy tuck surgery as you are right now.

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I want a flat stomach. Would I be happy with the outcome of an abdominoplasty w/plication and flank lipo?

No but at the ht vs weight you could lose 30 to 40 pounds to see an effective reduction of the abdominal girth. Than a full TT would be in order... 

Totally right

you have read well about plastic surgeries and you know which procedures will cause a excellent improvement in the shape of your body, you have to consider we are not able to determine how much fat you have behind your muscles in your abdominal cavity unless you have a CT or MRI so you have to be aware that you will get good results and depending on this factor mentioned before you will get a flat stomach. Best Wishes!

Australia Fragoso Baez, MD
Dominican Republic Plastic Surgeon
4.5 out of 5 stars 303 reviews

Abdominoplasty will fix the rolls

Yes, I do think you can achieve a smooth, flat stomach after abdominoplasty, and not have to wear spanx every day. A photo from the back would help determine how much excess volume you have at the flank region to see if liposuction is a good idea for you. You bring up an important point- that abdominoplasty only corrects the contour of extra-abdominal fat/tissue, not the intra-abdominal fat. It is tough to say how much intra-abdominal fat you have without seeing you in person. Yet the "rolls" you speak of are part of the extra-abdominal component, and tightening this part with abdominoplasty will get a noticable result. Often with twin pregnancy the rectus muscles have widened, so plicating these will also help the contour. I recommend seeing a board certified plastic surgeon for a full consultation to go over all of the details.

Anita Patel, MD
Beverly Hills Plastic Surgeon
4.5 out of 5 stars 12 reviews

I want a flat stomach. Would I be happy with the outcome of an abdominoplasty w/plication and flank lipo?

Thank you for your pictures and congratulations on your twins! I see patients similar to you often in my office and we always have a very lengthy discussion but I can summarize for you here.  First of all, we can't really make specific recommendations over the internet and with pictures because we really need to do an examination and assess your medical history to see if you are a good candidate for cosmetic surgery. That being said, here are my thoughts. If you are not, you need to get on a good diet and exercise program and try to get as close to your ideal weight as possible. I prefer my patients to have a BMI under 30 before this type of surgery to lower the risk of operative complications such as infections, blood clots, and wound healing problems etc. (You can calculate yours with an online BMI calculator by searching Google (or similar) but you are above 30 right now).  If you need help you can certainly seek out the help of your doctor and a nutritionist/fitness trainer to help get you on track.  This process is very important for your overall physical health but also for your mental health. When you are on a good fitness program and diet, you will feel and look better!  Next, in patients similar to you once we get a little closer to your ideal weight/BMI then I would consider doing 360 degree liposuction to thin out both front and back by debulking fat first.  Then several months down the road you can undergo tummy tuck which from what I can tell, you will most likely need.  The goal would be to get rid of the extra fat you don't need first and thus be able to remove as much extra skin as possible with the tummy tuck.  If you were to do the TT first then lose the weight you may need to just redo it after the weight loss because of the loose skin or if you don't lose weight, can sometimes lead to a "belt-like" appearance to the hips with residual extra fat in the upper and middle part of your trunk.  In my experience with body contouring patients, this is the best recipe for success to reach your goal appearance.  Some patients who mostly have back/flank fat and not as much central/upper abdominal fat can undergo combined flank/back liposuction and TT at the same time.  Additionally, keep in mind that the best candidates for this type of transformation are done with pregnancies, living a relatively healthy lifestyle, non-smokers, and have the time to make the commitment to make themselves look/feel better.  Part of the job is the surgeons, but part is yours. As always, make sure that you consult with board certified/eligible plastic surgeons with experience in body contouring surgery! Good luck!

Megan Jack, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 12 reviews

Abdominoplasty is a good option, however

Abdominoplasty is a good option, however it would be in your best interest to attempt weight loss before a surgical procedure, patients with a BMI higher than 30 have a significantly increased number of complications mainly higher wound breakdowns (yours is 31.7). Abdominoplasty will eliminate the extra skin and the excess fat located under the removed portion of skin, of course you have extra fatty tissue all over your abdoman and back, liposuction can help, however liposuction is not a way to obtain weight loss.
These surgeries will help but they will not give you a completely flat stomach, and there is no question you have intraabdominal fat, which can not be addressed by these procedures.
Be sure you see board certified plastic surgeons (American Board of Plastic Surgery).
Good Luck

Victor M. Perez, MD, FACS
Kansas City Plastic Surgeon
5.0 out of 5 stars 13 reviews

You are a good candidate for an abdominoplasty.

Perhaps are not the ideal candidate for an abdominoplasty because of your BMI but you would get a very good result from abdominoplasty aided by liposuction of the waist.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 14 reviews

Lateral tension abdominoplasty tummy tuck

Thank you for your question. You are a very good candidate for a lateral tension abdominoplasty Tummy tuck in addition to liposuction of the flanks. My patients undergoing this procedure on average lose 15 to 20% of the bodyweight after surgery. You live in the birthplace of lateral tension abdominoplasty. Few surgeons actually do this procedure, please look for a board certified plastic surgeon and have a discussion about this procedure.

Kevin Tehrani, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 58 reviews

Better candidate for an abdominoplasty if you lose 20 pounds

There are four components that need to be addressed with an abdominoplasty, excess skin, excess fat, anterior abdominal wall laxity and intra-abdominal fat.  It appears that you need work on all of these areas. My advise to you would be to lose at least 20 pounds prior to considering an abdominoplasty.  This would help to decrease the intra-abdominal fat.  If you have excess intra-abdominal fat, no matter the technique used to perform an abdominoplasty you will never be as flat as your desire.  Otherwise I believe your goals can be met.  Currently your BMI is 31 a 20 pound weight loss puts you a 28 a much more acceptible weight. 

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 12 reviews

Flat stomach

you look like the type of person who gains and loses weight in their abdomen predominantly. you do not appear to have any saddle bag issues with your lateral thighs.  this being said the slimmer you get yourself, the more you will lijke your surgical result.  I imagine if I give this advice to 100 women only about ten will do it. lose some weight first then have the abdominoplasty. you will appreciate the result so much more,.

Jonathan Saunders, MD
Newark Plastic Surgeon
5.0 out of 5 stars 43 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.