I want 360 Lipo. Flat stomach, no back rolls. Am I a candidate or should I lose weight to obtain hourglass shape? (Photo)

Question

I’ve had stretch marks on my stomach since high school my weight always goes up and down due to pcos. I know my stomach can be smaller because I lost weight in the pass unfortunately I’ve gained it back. I was recently told that because of stretch marks on my stomach after bbl my stomach will drop lower

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your
photograph, you are a better candidate for a tummy tuck with liposuction of your flanks and back.  This can be done through a low and short
incision, all completely below the bikini line. 
The belly button can be designed to look natural and have no scars on
the exterior.   Your muscles can also be
plicated resulting in a flat abdomen. 
Make sure you specifically look at before and after pictures of
real patients who have had this surgery performed by your surgeon and evaluate
their results.  The most important aspect is to find a surgeon you are
comfortable with. I recommend that you seek consultation with a qualified
board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Kenneth Hughes, MD · Answer

While liposuction will greatly improve those areas, it will not improve the skin on the abdomen or on the back.

David Hansen, MD · Answer

Sure dieting and exercising is always helpful but when you need motivation and also wants to see definite results, liposuction can't be beat.  It would be best to do 2 procedures which can be done just a day apart under local for best results.

Justin Yovino, MD, FACS · Answer

The most powerful way to reshape your body is liposuction techniques all the way around your abdomen, waist, love handles, bra rolls, and lower back. You will still have some folds over your back and your tummy wont be super flat because that's skin laxity.

Jason Emer, MD · Answer

You need to lose weight first before undergoing any cosmetic procedure to get the best outcome. For best results, it is recommended to be at your ideal or stable weight before getting a sculpting liposuction procedure. Liposuction is not a weight loss procedure, rather it is for sculpting and defining and removing problem areas that cannot be removed with weight loss and diet / exercise alone. With skin laxity, a tummy tuck or lifting procedure could be performed at the same time. I recommend getting a formal evaluation with a bariatric doctor or dietitian. Best, Dr. Emer

Daniel Barrett, MD · Answer

Dear fburgess
its difficult to tell without examining you but from your photos you would benefit the most from a Tummy Tuck. Heres why:
Liposuction gets rid of excess fat. You have laxity of your skin based on the shadows portrayed in your photo. Liposuction alone would alone make this more lax and likely make the appearance less aesthetically pleasing.
A mini tummy tuck is great if you are just looking to flatten the skin below the belly button. It does nothing for the skin above the belly button. This may be an option for you.
A full tummy tuck address all of the skin laxity and abdominal wall laxity. It repositions your umbilicus as well. It costs more and has more downtime associated then either of the above.
I would recommend consulting with a plastic surgeon that can go over in detail these three options and spends time answering your questions.
Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Michael Dobryansky, MD, FACS · Answer

It would help if you lost weight before having any procedures done. Your visceral padding (the tissue inside your abdominal cavity) will not be affected by any surgical procedures other than weight loss, diet and exercise. Once you are closer to your target weight, you can consider body contouring, which will most likely need to involve a tummy tuck since you will have extra skin with liposuction only.

Niki Christopoulos, MD, FACS · Answer

Hi and thank you for your questions and photos.  As in all cases, the best results from plastic surgery are obtained when you are at or near your ideal body weight.  That being said, you will have a nice result from liposuction of the back and flanks however a full tummy tuck with liposuction is the better option for your front side.  The stretch marks indicate loose or damaged skin and you have extra skin as well that hangs over.  Liposuction alone tends to make these issues worse. Best to meet with a plastic surgeon in person who can further discuss your options.  Good luck!

Andrew T. Lyos, MD, FACS · Answer

Thank you for sharing your question and photos.Based on the information and photos, I think you will have a stronger result with a Tummy Tuck. You would see a change with 360 liposuction, but it would not take care of excess skin or stretch marks.A Tummy Tuck is a procedure to correct the effects of pregnancy or weight loss. A tummy tuck is frequently combined with liposuction of the abdomen and waist. Good candidates for a tummy tuck are in good health and have reached a stable weight. I do not advise tummy tucks for those who are unable to stop smoking. A tummy tuck will correct:
1. Loose skin and stretch marks of the lower abdomen
2. Abdominal bulge resulting from separation of the abdominal muscle (diastasis recti)
3. Localized fat deposits of the abdomen and waist
Hernias of the abdominal wall may be corrected at the time of a tummy tuck, but are not part of the tummy tuck procedure. Generally, a tummy tuck is recommended for women after having their last child. I recommend surgery 6 months after your last baby. Also being 10-15 pounds of your goal weight before the Tummy Tuck would help.
I would recommend a consultation with a Board Certified Plastic Surgeon.
Best regards,
Andrew Lyos, MD, FACS

Ryan Neinstein, MD, FRCSC · Answer

Thanks for the question, it seems as though you would have a dramatic change from circumferential liposuction. That being said you will have significant excess skin. I would try and think in reverse and decide what outcome you are looking for and than pick the procedure. You may be happier with lipo 360 and a tummy tuck

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