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Tummy Tuck 5wk Please Help? (photo)

Something's not right. I have lost nearly 80lbs and decided to remove my horrid loose skin with a tummy tuck with lipo and muscle repair. As my swelling is going down my skin is loosening on my upper abs. It's really making me worry. I can't have any revision for 5 months. Just any help or guidance would be appreciated. Many many thanks I also had a complication with bacterial infection as to why I have a dressing on my tummy

Doctor Answers (7)

Concerned 5 weeks after surgery

+2

It is too early to jump to conclusions or determine your final result. You need to allow for at least 3-6 months. Continue to follow your surgeon's instructions and discuss your concerns.


Baltimore Plastic Surgeon
4.5 out of 5 stars 27 reviews

Tummy Tuck 5wk Please Help?

+2

The middle photo shows a nice before and after result. The photo on the left shows redundancy in the horizontal direction, which would not have been addressed by the procedure you had. 

Some patients following massive weight loss need to consider what is called a "vertical abdominoplasty" in which in addition to the standard low horizontal incision, a midline vertical incision is done to remove the horizontal excess. 

The before photos are not adequate to comment on whether that might have benefited from such a procedure based on the preop photos. At this point, that really doesn't matter. The solution may be conversion to a vertical tuck. I agree about a wait before a second procedure to allow all swelling to resolve and at least a couple months for the infection to be completely in the past. 

Best wishes. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.5 out of 5 stars 31 reviews

Skin quality after massive weight loss is often poor and can compromise an abdominoplasty results.

+2

Part of the formula for a good result after body recontouring surgery is the ability of the remaining skin to elastically accommodate the changes. After massive weight loss much of this elasticity may be gone in the results may be compromised.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 8 reviews

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Relaxing skin as swelling goes down

+1

You can always expect some laxity at the upper abdomen if your muscles were tightened.  The muscles pull the overlying skin with them as they are pulled together in the midline.  Revisions are usually needed and its best to wait 4-6 months after surgery before pursuing them.  Its really hard to hit grand slams on tummy tucks, especially in patients who have lost a lot of weight.  Keep your doctor informed of your concerns and you should have a good ending.

Curtis Wong, MD
Redding Plastic Surgeon
4.5 out of 5 stars 16 reviews

Tummy Tuck 5wk

+1

Thanks for your photos and questions, i think you should wait becuase it is very early to tell those are your final results, be patient, Best wishes!

Australia Fragoso Baez, MD
Dominican Republic Plastic Surgeon
4.5 out of 5 stars 232 reviews

Loose Skin After Tummy Tuck

+1

Patients who loose as much weight as you have lost, frequently have skin looseness in a side to side  direction as well as the up and down direction.  The standard lower abdominal, cross-ways tummy tuck incision, only removes excess skin from the up and down direction.  To remove the side to side excess skin, a vertical scar will be required.  This places an incision in the middle of the abdomen running from the tip of the breast bone to the pubic area.  Scars running in this direction take longer to fade than the standard side to side incision.  The trade off is tighter skin in the side to side direction at the price of a vertical scar that takes longer to mature. 

I would wait for all of the swelling to dissipate (3-6 months) before making a decision about revision surgery.  It is certainly better to have the up and down scar at a later time, when you are certain that you want it, rather than commit to that scar at the first surgery if you or your surgeon are not sure if it is wanted or needed.

Philip E. Fleming, MD
Nashville Plastic Surgeon
5.0 out of 5 stars 1 review

Tummy Tuck 5 Weeks post op

+1

Hello

It appears that you have excess skin in the horizontal direction on the abdomen which can not be addressed by the surgery you had.  After massive weight loss the abdominal skin is sagging in both a vertical direction as well as a horizontal direction.  Abdominoplasty only deals with skin in a vertical direction and to have the horizontal excess skin dealth with requires that a verticla component of skin needs to be removed in the uppe part of the tummy to tighten the flank and upper abdominal areas.  The type of abdominoplasty I am referring to is a Fluer-de-Lyse.

Your skin will still retract a further amount, however it will be difficult to predict how much more.

Good Luck with your further treatment.

Stephen Salerno

Stephen Salerno, MBBS, FRACS
Melbourne Plastic Surgeon
5.0 out of 5 stars 5 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.