It has been almost 2 years since my only Liposuction procedure. I still have large flanks and and a "funny" stomach. Should I go for a Full/Mini Tummy Tuck or should I simply try Liposuction again, avoiding the enormous scar? I'm afraid I don’t have enough skin for a Full Tummy Tuck. Thank you!
Male Tummy Tuck Surgery on Stomach
Doctor Answers 36
Liposuction (again) will help, but you really need an extended tummy tuck!
Some surgeons will opt to follow your lead and give you whatever improvements that can be achieved via liposuction. This will cost less, have much less scarring, but of course, will have less improvement. Since degree of inprovement is so subjective, whomever is advocating one thing over another will naturally emphasize the pros of their recommendation (while hopefully not entirely omitting the cons), and do the reverse for the "other option," in this case, extended tummy tuck or extended abdominoplasty.
I advocate the latter partly because you have already had the best that liposuction can deliver (assuming an experienced, proficient, board-certified plastic surgeon). Even if you have gained additional weight, there is still subcutaneous scar tissue from your prior surgery that can limit or reduce subsequent liposuction effectiveness. Also, as a general principle, emptying skin does NOT make skin tighter (despite ultrasonic or smart lipo claims that energy directed to the dermis actually"tightens" skin), it just empties it. If you have half a bag of marbles with wrinkles in the bag, how many marbles do you remove to tighten up or smooth out the bag's wrinkles? (HINT: This isn't a trick question!)
An extended abdominoplasty with proper scar placement can remove ALL of the fat within the excised area, as well as tightening the skin (including above the belly button) to a major degree. If your abdominal wall is flaccid, muscle plication (usually done in women who have had children, but also applicable in some men) can restore the six-pack muscles to the midline and flatten your abdomen. You have to take it easy for a couple of weeks, and do no sit-ups for about 6 weeks, but the results are truly worth it!
Repeat Liposuction Can be a Challenge
A secondary liposuction procedure can be technically more difficult because of scarring from the first procedure, particularly if you developed fluid accumulations (seroma) after the first operation.
Seroma can cause scar build-up leading to lumps and bumps, similar to what I see in your photo. Of course, I can't tell that for certain, even with an examination.
Weight loss is your first best option.
Repeat liposuction may or may not produce much change.
A tummy tuck is a reasonable consideration to redrape and smooth your irregularities.
Tummy Tuck More Suitable
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Liposuction vs Tummy Tuck
Liposuction addresses excess fat only, while a tummy tuck addresses fat, skin and muscle. Based on your picture, your problem still appears to be excess fat. I would try liposuction again and try to avoid the tummy tuck scar which is long and permanent.
Mini or full tummy tuck?
Thank you for the question and picture.
I think you will benefit from a full tummy tuck procedure. In my opinion, the mini tummy talk is an operation that produces very limited results and is very rarely indicated. It involves a shorter incision but does not address the majority of the abdominal wall issues present for most patients who present consultation. For example, the area of skin excised is quite small. The abdominal wall musculature is addressed below the umbilicus leaving the upper number wall potentially lax. The appearance of the umbilicus is not necessarily addressed sufficiently.
For most patients who have had pregnancies and/or weight loss a full abdominoplasty is necessary to achieve the desired results. Of course, there are downsides (including a longer scar and probably a longer recovery time) but for most patients the benefits outweigh the downsides. It is not unusual to see patients who've had mini tummy tuck surgery present for revisionary surgery.
It is important to work with a well experienced board-certified plastic surgeon to obtain advice (based on good ethics and judgment) to improve your chances of a successful outcome and minimize the need for further surgery.
I hope this helps.
Full or Mini Tummy Tuck after a Disappointing Liposuction
There is NO substitute for a physical examination and in its place several photographs are always better than one. In your case, your liposuction appears to not have been complete in the "love handles" / hip area leaving residual fullness and in the abdomen it uncovered a significant skin looseness.
The ONLY way to achieve tummy skin smoothness / tightness with an excess as significant as yours is to SURGICALLY REMOVE the excess overhanging skin. All other proposed nonsurgical "solutions" produce minimal if any results and will disappoint you after taking the load off your wallet.
In my opinion your best solution at this point is a full Abdominoplasty (Tummy Tuck) with liposuction of the hips / love handles.
Peter A Aldea, MD