Fernando Ovalle Jr., MD

Hello and thank you for your question. It is hard to say for certainty without photos, but if the bulge is on your "side boob" area near your armpit, liposuction can commonly help contour these areas. My best advice is to have an in person consultation with a board certified plastic surgeon with an in person exam to devise a plan to improve your concerns! Thank you and good luck on your journey.

Hello and thank you for your question. Based on your photos, you appear to have extra/loose skin above and below the belly button, along with some degree of muscle separation (diastasis). A tummy tuck would certainly offer you a transformation. Every surgeon has a different technique and set of criteria they evaluate in making their surgical decision. In my hands, a patient with loose skin above and below the belly button, with diastasis and with a high riding belly button is likely a good candidate for a full tummy tuck (incision from hip to hip) with muscle tightening, and I counsel them that there may be a small vertical incision at top midline of the horizontal incision, due to the native belly button being high and our goal of removing all of the skin between the belly button and the pubic incision. Your next best step is to seek another opinion from a board certified plastic surgeon with an in person examination. You need to be comfortable with the surgeon and the plan. Thank you and good luck on your journey!

Hello and thank you for your question, Your photos show some degree of ptosis (breast sagging), which is perfectly normal. However, when placing an implant, the implant would typically sit higher on the chest. If there is breast tissue that sits lower than this, it will create a "waterfall" deformity, where it looks like the breast tissue is not centered on the implant. Usually, with the amount of ptosis present in the pictures, I would typically advise patients on including a lift along with the augmentation for best results. In your case, I would advise an in-person consultation with a board certified plastic surgeon to perform an in person exam and counsel you on your options. Thank you and good luck on your journey!

Hello and thank you for your question. Congratulations on your weight loss journey - that is not an easy feat! Regarding the timing of a tummy tuck, the best advice is to be at or as close as possible to your goal weight prior to surgery (i.e. don't plan to lose more weight after surgery) and also have have stable weight for at least 6-12 months after notable weight loss (i.e. don't have surgery if your weight is still changing/fluctuating beyond plus/minus a few pounds. If this is the weight/BMI that you are happy and healthy at, then it is OK to proceed with a tummy tuck, in my opinion. And I do not believe you need the vertical FDL based on your photo, unless your goal was absolutely the tightest abdominal skin regardless of scarring. Yes, it is important to note the difference between visceral and subcutaneous fat. For best aesthetic results (i.e. the flattest possible belly), I usually recommend a BMI less than 30 for patients. This is due to the fact that the proportion of visceral fat (behind the muscles that cannot safely be removed with plastic surgery) is greater in BMIs more than 30. Different surgeons likely have different "cut offs" and recommendations. Nevertheless, in my opinion, many patients in the BMI 30-35 range can still have great results with abdominoplasty. I don't routinely recommend this surgery for patients with a BMI higher than 35 as not only does the aesthetic result become more unreliable, but there is also greater anesthesia and post-surgical complications risks involved with higher BMIs. Thanks again and good luck with your journey!

Hello and thank you for your question. This is a little mysterious to have an issue so far out from surgery. our belly button does not currently look inflammed or infected based on your photo, which is a good sign. However, from my experience, one potential issue that comes to mind is some mild chronic inflammation around the knot of the permanent suture used for the muscle tightening (if a permanent suture was used), sometimes called a called a suture granuloma. A common technique during a tummy tuck is to use a permanent suture to tighten the muscle above and below the belly button, and the knot for the "start"/"end" of these sutures is commonly near the base of the belly button. For some unknown reason, the body sometimes tries to "spit out" foreign suture material it doesnt like which causes some inflammation. Sometimes a bacteria finds its way to the foreign body (permanent suture) and this can cause a minor infection with some redness or drainage. The treatment for this is to perform an exploratory surgery to remove the foreign material and clean out the area, which in this case could be done through existing abdominoplasty scars. Your belly button also looks somewhat small/tight - if this has changed (i.e. smaller/tighter) over the years due to your body's changes with pregnancy that could also be a reason why you might be developing some symptoms in this area (moisture/lint/etc trapping inside the belly button which is harder to keep clean). The next best step would be a in-person consultation with a board certified plastic surgeon. Good luck with your journey!