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.
Male Tummy Tuck Surgery on Stomach
Thank you for your photographs and questions. Based on your picture, I think you will obtain the best result with a full tummy tuck procedure. This will help remove the excess skin and fat in your lower abdomen, while tightening your abdominal muscles. Additional liposuction along your flanks may be performed to further enhance your lower stomach appearance. Liposuction alone will be difficult to correct any contour irregularities that already exist, while likely leaving you with additional loose skin. Be sure to see a board certified surgeon for an in-person examination of your skin, and the amount of skin excess that will be able to be safely removed. Best wishes!
Male Tummy Tuck Surgery on Stomach
Thank you for sending your questions and photos. This is difficult to answer without a physical examination of your abdomen. Addiitonal liposuction would leave you with more skin laxity. A tummy tuck would give you a much superior result. I would recommend you discuss your option with your Board Certified Plastic Surgeon. Best wishes
Tummy Tuck More Suitable
Liposuction alone will probably not adequately address your concerns because the issue here is most likely skin rather than fat. It appears you'll need to remove excess skin to firm up your stomach, and liposuction will not do that for you. You'll most likely be better off with a tummy tuck. For a better assessment, please see a board certified plastic surgeon.
Tummy tuck vs. lipo
You definitely will get the best results with a full tummy tuck and liposuction of the flanks. I don't believe you will need a diastasis repair, however, so your recovery will be even shorter. Also, diet and exercise will help you look even better.
Loose skin after liposution
As you are 2 years from your liposuction procedure any swelling and skin tightening would have happened by now. Your picture looks as though you have loose skin on the lower abdomen but also above the umbilicus. If your goal is just to reduce the volume more then liposuction can accomplish that but if it is to have a flat smooth abdomen then there is no substitute for a full abdominoplasty.
Liposuction won’t help sagging skin.
is terrific for body contouring when you have some isolated pockets of fat that
won’t respond to diet or exercise. What lipo won’t do, however, is resolve any
problems with visible skin laxity. A tummy tuck can address both problems at
the same time, because it removes excess skin along with eliminating excess
fatty tissue. As for whether you have enough skin to perform the surgery, I
recommend scheduling a few consultations with board certified plastic surgeons
who can give you their opinions about the best approach. From there, you’ll
have the information you need to make a final decision.
Treatment of abdominal fat
In your case, liposuction would produce more sagging of the midline skin and I believe that you would benefit more from an abdominoplasty. There are gradations for tummy tuck, just as plastic surgeons perform breast reductions on DDs as well as J cups!
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.