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Best Procedure for Excess Fat and Skin After Lapband Surgery?

I've lost 100lbs after having a LapBand put in nearly 4 years ago. My stomach issues are very unique looking, which is why I'm having the difficulty in determining what procedure I need. My unwanted fat and loose skin are mainly only above the bellybutton, like it's sitting on a shelf. I am unsure of which procedure would benefit me the most between simple liposuction, a modified Tummy Tuck, full Tummy Tuck, or extended. I'm open to any other suggestions as well. I believe my skin has shrunk back as much as it can already. Thoughts?

Doctor Answers (14)

Surgery necessary when excess skin is present

+1

After a very large weight loss, the only way of contouring your face and body is to have the excess skin removed surgically. Depending on which area concerns you, would depend on the operation. Most of my weight loss baraitric patients are most concerned about their abdomen. This area can be helped with a tummy tuck.

I recommend that you visit www.ASBPS.org for more info and photos. I am president of this organisation, the American Society of Bariatric Plastic Surgeons and our members have been helping patients such as yourself complete their journey. I congratulate you on taking that major step to your health and well-being!


Newport Beach Plastic Surgeon
4.5 out of 5 stars 24 reviews

Skin tightness

+1

Congratulations on your weight loss. Your overall shape is quite good. The loose skin on your abdomen is best addressed with a full tummy tuck and muscle tightening. This will give you the flattened appearance you desire. Visit with several board certified plastic surgeons to get the pros and cons of the procedure. Good luck!

Dr. ES

Earl Stephenson, Jr., MD, DDS
Atlanta Plastic Surgeon
5.0 out of 5 stars 8 reviews

A Full Tummy Tuck will best correct the upper belly and belly button

+1

First and foremost, congratulations on your weight loss! What a wonderful transformation. In addition to your improved health, your figure already looks terrific.

Second, even though you might think that your tummy has "unique" issues, nothing could be further from reality. I see at least one patient per week whose tummy looks like yours.

Third, go for a full tummy tuck.

  • After 4 years, your skin is not going to shrink on its own any farther--no matter how much exercise you do.
  • Liposuction will not be helpful to treat the upper tummy and bellybutton. Since liposuction is a fat removal technique (without any significant skin tightening), liposuction is the wrong answer. You are already skinny! The problem is too much skin without good tone, not excess fat.
  • Mini tummy tucks are nonsense operations. I have never found the right patient for a mini tummy tuck--in 8 years of practice! A mini tummy tuck is for that very rare patient whose problem area is limited to her lower middle abdomen, just above her pubis. Obviously, this is not where you are concerned.
  • A standard tummy tuck will work. To minimize "dog ear" formation on the bilateral hips, weight-loss patients generally get their best results when the tummy tuck is extended all the way around circumferentially. Whether you choose to keep the surgery just in the front or all the way around will be your decision. Both are good choices, but the circumferential technique generally produces better contours.
  • Do not do a fleur-di-lis abdominoplasty. The vertical portion of the scar is ugly, and the operation is now recognized as obsolete. If a plastic surgeon offers you this surgery, run away! He is out of date!!

Fourth, make sure that your lap band port is exchanged from a high-profile to a low-profile. Now that you are thin, the low-profile port will be less visible. You don't need that extra prominence to find the port anyway; you've got no subcutaneous fat. (Congratulations again!)

Fifth, make sure that your surgeon is certified by the American Board of Plastic Surgery. And, better yet, research whether he specializes in weight-loss patients. I do a lot of post-bariatric contouring, and let me tell you that weight-loss patients are very different from "regular" plastic surgery patients. Your surgeon needs the expertise only garnered from years of experience with your peer group.

Good luck!

Michael C. Pickart, MD
Ventura Plastic Surgeon
5.0 out of 5 stars 2 reviews

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A tummy tuck is in your best interests

+1

Hi there-

Because of the quantity and the quality of your skin after your massive weight loss, you would be best served by an abdominoplasty.

Please understand, however, that the most important variable in attaining the result you want, as well as in maximizing your safety, is finding a surgeon with the right combination of education, training, experience, personality, and approach for you.

If you would like assistance finding a surgeon you like and can trust, please read this:

Armando Soto, MD, FACS
Orlando Plastic Surgeon
5.0 out of 5 stars 98 reviews

A full tummy tuck with give you the best results

+1

You will get great results with a full tummy tuck. Although most of your excess skin and muscle laxity (looseness) is located above the belly button, a full tummy tuck will address this and will allow the incision to be hidden in an acceptable place. A reverse tummy tuck, which places the incision in the crease below the breast and across the midline can leave an unacceptable scar. Liposuction will not help with your excess skin.

Hope this helps. Best of luck.

Sam Jejurikar, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 27 reviews

Full abdominoplasty

+1

For having lost 100 pounds, you have a very good result. To flatten the abdomen a full abdominoplasty( Full Tummy tuck ) is needed. Liposuction alone will not get ride of the upper abdominal excess tissue.

Walter D. Gracia, MD
Arlington Plastic Surgeon
5.0 out of 5 stars 2 reviews

Abdominal deformity following extreme weight loss

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This is a difficult problem. While a traditional full abdominoplasty can tighten the entire anterior abdomen, it is more effective for the mid and lower abdomen. Unfortunately, many post-bariatric surgery patients experiences stretching of the skin below the breasts with the inframammary fold of the breast drifting lower as well. The more logical and anatomical surgery would be one that tightens the skin radially from the belly button. There is a reverse abdominoplasty that pulls the skin upwards but this would result in a scar in the inframammary fold. It is not an easy operation since it may require moving the fold and a scar across the entire fold from side-to-side. There may be variations that might fit your situation but only an examination would tell.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 7 reviews

Tummy tuck after lapband weight loss

+1

The best procedure for you would be a tummy tuck. It would get rid of the excess skin and tighten the muscles. In addition many of us do liposuctiong at the same time

John P. Stratis, MD
Harrisburg Plastic Surgeon
4.5 out of 5 stars 14 reviews

Full tummy tuck following lap band

+1

Congratulations on the results! You are an excellent candidate for a full tummy tuck. Seek the skills of a board certified plastic surgeon. You may want to contact your bariatric surgeon for a referral.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 41 reviews

Tummy Tuck after weight loss

+1

I agree that a full tummy tuck, with or without a pubic lift as needed, will reveal the nice shape you have beneath the excess skin.

I'm not sure you have much excess fat at all to liposculpt!

Curious as to where your port is located...I cannot see it. Sometimes I will relocate those so they won't be so obvious under the newly tightened skin.

John LoMonaco, MD, FACS
Houston Plastic Surgeon
5.0 out of 5 stars 160 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.