Abraham Pathak, MD

Based on your limited photos, you would appear to anatomically benefit from some sort excisional body contouring procedure. The advantage of a full tummy tuck (with or without liposuction) over panniculectomy with liposuction of selective areas is that the former addresses diastasis recti (abdominal muscle laxity). It is difficult to definitively tell whether you are a good candidate without a physical examination and complete medical history. However your mentioning of 'hyperthermic muscles', has me thinking you carry the diagnosis of Malignant Hyperthermia which is a notable condition, and great cause for concern when undergoing any general anesthesia procedure. You should ensure that your medical candidacy is optimized, as safety should always be of prime importance.

In general, we aim to minimize the risks involved in such elective surgeries. Therefore, we advised that an abdominoplasty procedure be delayed until you are within 10 pounds of your ideal weight and have a BMI less than 30 and are medically cleared for anesthesia and the expectations of surgery.

Based on your limited photo, it is difficult to definitively comment on whether you may be anatomically a candidate for a full tummy tuck. It is difficult to tell whether you are a good candidate without a physical examination and complete medical history. It would depend on your anatomical findings, motivation, realistic expectations, and whether your self professed diastasis is something you want addressed. A mini-tummy tuck can encompass a C-section scar revision and treat laxity below the umbilicus, but does not improve any above the umbilicus. Again a physical exam would help clarify this and inform your indication. The same would be true for liposuction as the degree of focal adiposity/fat and treatment areas should be clearly outlined to you, as treating areas of lower fat content (as your pictures suggest) runs the risk of contour irregularities if not performed by experienced surgeon. If you are serious about undergoing any procedure, you should have a thorough consultation with a plastic surgeon having the appropriate credentials (board eligible/board certified), who will fully explain what is entailed in the procedures, including both the positives and potential problems.

You should be complimented on the fact that you are seeking valid information before jumping into any procedure  

This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment/evaluation with a trained medical professional  for appropriate care.

The key factor and advantage of a tummy tuck over liposuction is that it specifically address any midline muscle laxity, referred to as "diastasis recti." While difficult to definitively say from your photographs, your side profile picture lends towards you having a component of muscle laxity, with the focal outward bulge. You are best served seeing a board eligible/certified plastic surgeon in person, who can examine you and determine if this is indeed the case. Otherwise, treating the adiposity/excess fat areas of the trunk is easily addressed with liposuction, which often requires a 360 degree approach to render the best results.

It is important to pick someone you trust and have a good relationship with to facilitate a full informed conversation before proceeding with any surgery.

'This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment/evaluation with a trained medical professional for appropriate care.'

The mons area is a common topic of discussion in abdominal body contouring consults. Its inferior location has it being further affected by the status, weight, and laxity of the abdomen superiorly. As such, it can be improved with a tummy tuck procedure (and often is when fascial anchoring techniques are employed) .

In regards to Liposuction alone. The answer depends on various factors, such as your skin's retraction ability and the extent the local anatomy has "been stretched" over time. Liposuction does promote focal skin tightening to an area treated, but how much is variable and depends on the individual. That particular area of the body however often demonstrates laxity of not only the skin, but fat and soft tissue as well as its secured at only certain points. A surgical approach would provide the most tangible improvement. The extent of the incision and procedural details regarding anesthesia should be discussed with a board eligible/certified plastic surgeon in person.

Make sure you have a good relationship and conversation with your surgeon regarding all this before proceeding.

'This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment/evaluation with a trained medical professional for appropriate care.'

You have mentioned key aspects to be mindful of with undergoing higher volume liposuction. One being that your skin won't be tight, while there will be some skin retraction it would not be to the dramatic extent so as to have "tight skin." Which brings me to my next point. Your appearance will have an improved contour, but also look "deflated." You would be smaller and relatively flatter, but with a deflated feel. It is important that you are comfortable with this and have a good understanding of it all. You may find yourself uncomfortable with the loose skin over time, for which the formal treatment would be a tummy tuck to address the loose skin, and tighten your underlying muscles.

Have a good relationship and conversation with your surgeon regarding all this before proceeding.

'This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment/evaluation with a trained medical professional for appropriate care.'