Mustafa Aydinol, MD

What you’re experiencing is residual loose skin and soft tissue redundancy after an extended tummy tuck with hernia and muscle repair. This can happen when there’s significant pre-existing laxity, multiple C-sections, or when liposuction wasn’t performed at the same time. The result looks improved compared to before, but not yet as flat or smooth as many patients expect.

Surgical options that help most:
1. Revision abdominoplasty: A secondary surgery can remove additional excess skin and tighten the contour more definitively. This often gives patients the flatter, firmer look they were hoping for initially.
2. Fleur-de-lis abdominoplasty: Adds a vertical scar in addition to the horizontal one. This is especially useful in cases with central skin redundancy or significant laxity from weight fluctuations or multiple pregnancies. It allows more skin removal but does mean a longer, visible scar.
3. Liposuction (VASER or standard): Can contour the flanks and upper abdomen to reduce remaining fat deposits. However, if skin elasticity is poor, removing fat alone may make looseness more obvious—so it’s often combined with excision.
4. Scar and skin quality improvement: Techniques like Renuvion (plasma) or radiofrequency tightening can sometimes be added during revision to improve skin tone and reduce wrinkling.

Expectations: A second surgery often gives a much more definitive result. Whether you’d need a fleur-de-lis depends on your tolerance for additional scarring versus your desire for maximum flatness. Many patients who feel their first tummy tuck was “conservative” are much happier after revision when more aggressive tissue removal and contouring is done.

I’d recommend consulting with a plastic surgeon who frequently performs tummy tuck revisions and fleur-de-lis abdominoplasties, so they can guide you on the best balance between scar trade-off and contour improvement.

Dr. M. Mustafa Aydınol, Plastic Surgeon (Istanbul)

What you’re experiencing looks like dermatochalasis (excess upper eyelid skin) on the right side, with possible mild ptosis (drooping of the upper eyelid muscle). That’s why the eyelid looks partially covered and the crease is less visible compared to the other side.

Surgical options that help most:
1. Upper blepharoplasty (eyelid lift): Removes excess skin and creates a more defined upper eyelid crease. This alone will already improve the hooding and make the eyelid look more open.
2. Ptosis repair (levator tightening): If the eyelid margin itself (not just the skin) is sitting lower, then repairing the levator muscle in addition to blepharoplasty gives a more balanced, symmetrical look.
3. Bilateral surgery: Even if one side looks worse, it’s often best to treat both eyes for symmetry—removing a small amount of skin from the “better” eye to match the improved side.

Expectations: With the right surgical plan, you can expect your upper eyelids to look more open, refreshed, and symmetrical. The exact need for ptosis repair can only be confirmed during an in-person exam, where your surgeon measures eyelid height and muscle function.

I’d recommend consulting with a board-certified plastic surgeon or oculoplastic surgeon experienced in both blepharoplasty and ptosis repair, so they can evaluate both factors in one surgery.

Dr. M. Mustafa Aydınol, Plastic Surgeon (Istanbul)

What you’re experiencing is called bottoming out with lateral displacement—very common in athletic women with strong pectoral muscles, especially when implants are placed under the muscle. The wide gap and implants sitting toward the armpits are classic findings.

Surgical options that help most:
1. Pocket revision with capsulorrhaphy (internal sutures): This tightens and redefines the implant pocket so the implants sit higher and closer together.
2. Conversion to dual-plane or subfascial (above the muscle, below the fascia): For women with heavy pec activity, moving implants out from under the muscle prevents the constant pulling laterally.
3. Switching from saline to cohesive silicone gel implants: These feel softer and hold shape better long-term, especially after pocket repair.
4. Implant shape/size: Choosing a moderate-profile implant or wider base can help reduce cleavage gap, though some natural gap will always remain due to anatomy.
5. Mesh or ADM (acellular dermal matrix): In revision cases with weak tissue support, surgeons may add reinforcement to keep the implants stable and prevent repeat bottoming out.

Expectations: With the right combination of pocket repair + implant change, most patients achieve a much more centered, lifted look with a softer, more natural cleavage line. Your strong pecs will always influence positioning somewhat, but surgery can make a big improvement in both appearance and comfort (like shaving under the arm).

I’d recommend consulting with a plastic surgeon who regularly does implant revision cases—this experience makes a difference in choosing the right approach for you.

Dr. M. Mustafa Aydınol, Plastic Surgeon (Istanbul)

Short answer: Yes—this is usually fixable. What you’re describing looks like a tethered adhesion line (the skin has scarred down to the deeper fascia), often triggered by a tight or folded garment early after lipo. Massage, Emsculpt, or RF microneedling (Morpheus8) can help skin quality, but they don’t release the deep tether that creates the crease.

What typically works best
1. Subcision/adhesiolysis + micro-fat grafting: through tiny punctures under local or light sedation, the scar bands are released and a thin layer of your own fat is placed to keep the plane smooth. This is the go-to option for a linear post-lipo crease. Downtime is usually a few days of bruising; a soft, properly sized garment with foam (no hard edges) for ~2–3 weeks. One session often helps a lot; stubborn lines may need a second round.
2. Blending lipo around the line can be added in select cases, but over-lipoing the crease itself can worsen it—so this part is surgeon-dependent.
3. Skin-excision (mini tummy tuck) is an alternative if the crease sits low and there’s extra skin—but it trades the crease for a surgical scar, so it’s a preference discussion.
4. Injectables (e.g., Sculptra/HA) can be considered when fat graft isn’t an option, but results are subtler and temporary.

Expectation: Most patients see a marked improvement; perfection can’t be promised, but the line is usually softened enough that bikinis feel comfortable again.

Seek an in-person consult with a plastic surgeon who frequently does revision lipo, subcision, and fat grafting—bring your current faja to size/fit correctly for aftercare.

—Dr. M. Mustafa Aydınol, Plastic Surgeon (Istanbul)

In patients who have experienced significant weight loss, skin elasticity is often compromised more severely than in those with age-related changes or minor fluctuations. The wrinkles and creases under your buttocks are primarily due to excess, stretched skin — not something that can be corrected with exercise alone.