Mummy Tummy Lipo and Thermage Vs Tummy Tuck?

Question

Hi, I am 26 years old with two children, youngest is 2. I am slender at almost 5' 8" and 130lbs. I lost all my baby weight by diet and exercise but I continue to have the typical "mummy tummy" I have moderate stretch marks below my belly button and my muscle are not seperated and feel flat. I have a loose bulge starting below my belly button and love handles. Heard lipo and a skin tightening treatment are the new "mummy tummy" makeover. Anything to the hype?

Jed H. Horowitz, MD, FACS · Answer

Mommy makover: #mummytummyMummy Tummy is a term given to modified tummy tucks which can
use liposuction and skin tightening with radiofrequency such Vanquish, Vela3,
thermage, thermiRF and others.  The
actual fat contouring can be done non-surgically as well with UltraShape or
Cool-Sculpting#Stretch marks, #striae, which occur during pregnancy, can be improved in a variety of
ways through various techniques. A tummy tuck may surgically remove many of the
skin changes. Topical treatments which have shown some benefits include laser
therapy and some medications such as Retin-A. Some specialized Lasers such as
the Diolite laser which we have at Pacific Center for Plastic Surgery may
diminish redness for some patients and possibly improve the texture of the skin
and the diameter, width, of the stretch marks.

Richard J. Bruneteau, MD · Answer

It’s not unusual for patients with redundant abdominal
tissue to look for alternatives that are less invasive than
abdominoplasty.This group of patients
wants to avoid the expense, scarring, risks and longer recoveries associated
with abdominoplasty.Unfortunately,
your pictures suggest the presence of significant amounts of redundant
skin.Under these circumstances,
liposuction combined with Thermage would minimally impact the area.For this reason, abdominoplasty is probably
necessary to adequately address your problem.It’s
therefore, important to consult a board certified plastic surgeon with
experience in this area.This surgeon
should be able to formulate a treatment plan that addresses your anatomic
deformity and achieves your aesthetic goals.

Eric Swanson, MD · Answer

Your photos are classic.  You would make an excellent patient for a combined tummy tuck and abdominoplasty.  You appear to have an "apple" shape and this would give you more of an hourglass shape.  We almost always use liposuction to treat the upper tummy and love handles at the same time.  It's not hype.  It works.  But don't take my word for it.  Check the photos.  I've attached a link to my website.

	 

	If someone offers Thermage for your tummy, you need to keep looking.

Vivek Bansal, MD · Answer

Some can benefit from this, but the results seem to be too inconsistent. I recommend you see a Board Certified Plastic Surgeon and consider a mini TT or full TT, and be rid of the skin you do not want.

Thomas Fiala, MD, FACS, FRCSC · Answer

The amount of skin tightening you get from Thermage isn't even in the same league as what you get from a properly performed tummy tuck.  They really aren't comparable.  Also, not everybody responds to Thermage predictably.

	Although I would have to examine you to tell you which one is best, I would suggest that your options are:

	1)  abdominal liposuction + mini-abdominoplasty (for skin resection)

	2)  standard abdominoplasty

	I don't think that liposuction + Thermage will give you a satisfactory result.

	 

	All the best,

Richard H. Tholen, MD, FACS · Answer

You have loose skin that any form of liposuction will further empty, causing more laxity and making your stretch marks even more visible. Thermage is of VERY limited value in improving stretch marks or tightening skin--that is why tummy tucks are still necessary for a majority of women who have had  babies.

	There will always be a few women who qualify for liposuction because their skin tone is still great and their babies were small, but truthfully, these women are in the minority. You will waste your money on ineffective treatment and cause yourself heartache if you expect lipo plus Thermage will give you the results you hope for.

	Make sure your consultant is an ABPS-certified plastic surgeon, not some bogus-boarded "cosmetic surgeon." I believe an honest and ethical plastic surgeon will steer you away from ineffective treatments that do nothing but lighten your wallet! Get several opinions--you can see what my colleagues here are saying! Good luck!

Sean Younai, MD, FACS · Answer

There are a variety of Laser or Heat generating machines such as thermage who promise to tighten up skin and eliminate stretch marks. In my experience they have not been able to consistently show any real results. Lets put it this way, I would not do it for my own wife! Reviewing your pictures it seems that you not only have stretch marks but you also have lower abdominal wall weakness which give you a pouch. The only way to eliminate your stretch marks, tighten your skin and your abdomianl muscles, and to eliminate loose skin is to undergo a tummy tuck or abdominoplasty.

Dana Khuthaila, MD, FRCSC, FACS · Answer

Dear Bailey, 

	It is difficult to assess the status of your tummy from the photos, but from your description it seems you have a little bulge and some skin laxity.

	Skin tightening procedures whether it is Thermage or Laser lipo do not have long term effects and they are not a substitute for a tummy tuck.

	You may benefit from a mini tummy tuck that should take care of the excess skin and stretch marks on your lower belly as well as tighten the separation of your muscles.

	Best of luck!

Richard Baxter, MD · Answer

A few years ago I participated in the clinical trial of immediate post-liposuction Thermage for skin tightening, and reported the results at a national plastic surgery meeting in 2009. I found about 40% more skin shrinkage on the Thermage treated area as compared to lipo alone. This sounds impressive, and is indeed much more than reported for laser lipo (for example Smart Lipo), but it is still a lot less than what a tummy tuck does. For Thermage to work well there has to be a good layer of collalgen in the skin, and this is not usually optimal when there are stretch marks. The Thermage + lipo option is for those "in-between" cases where there is some skin laxity but not too much.

Tom J. Pousti, MD · Answer

Thank you for including your photos, it is helpful. When a patient has damaged skin and abdominal muscles that have separated due to pregnancy, usually a tummy tuck surgery is what will achieve the look that most are wanting to achieve. I do not perform Thermage and have heard from patients who tried it first and then came back for the tummy tuck surgery that it didn't give them the results they thought it would. Do your research and take a look at the credentials of the surgeon you are choosing. Make sure you look at before and after photos, talk to some previous patients who have had the procedure performed. Doing research is the way to make an educated decision.

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