Can a Tummy Tuck Fix Botched Lipo in the Tummy Area?

Question

I had liposuction on my stomach area 15 months ago. The dr was too aggressive (and didn't use tumescent). I now have much rippling that goes up to my rib cage but is really bad below belly button, a "pooch" and excess skin. Have met with the dr who performed the operation. He says a tummy tuck will fix this.  I see how it could. My concern is that when the skin that has some rippling above belly button area is pulled down (when doing the tummy tuck), won't that same rippling occur? What should I do for best result?

Brent Moelleken, MD · Answer

Irregularities from very aggressive liposuction are difficult to treat. One of the most gratifying solutions is a tummy tuck, or modified tummy tuck (short incision or low incision variants a possibility).

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding whether a tummy tuck can address skin ripples after liposuction. Based on your history and picture, yes, an abdominoplasty (tummy tuck) can often correct skin irregularities and ripples left from overly aggressive liposuction. During a tummy tuck, an incision is made low on the abdomen, and tissue dissection extends up to the rib cage. By detaching the skin from underlying tissues, this allows for a smoother pull and realignment, minimizing or ideally erasing ripples.

This maneuver of extending the dissection up to (and occasionally above) the rib cage enables the skin to be stretched more evenly. When this approach is combined with muscle repair, if necessary, the final result typically smooths out prior irregularities. Most experienced plastic surgeons would agree that a tummy tuck is an effective solution to achieve a flatter, more uniform abdominal area in cases like yours.

I hope this information provides clarity on how a tummy tuck can address your concerns. Best of luck, and always consult a board-certified plastic surgeon to ensure an optimal outcome.

Sincerely,
Dr. J. Timothy Katzen, MD, FASMBS, FICS

Jeffrey E. Schreiber, MD, FACS · Answer

HI Samantha6566 - It appears as though the rippling in the skin may be fixed with fat grafting. This involves liposuction from the hips or back and then re-injecting the fat into the areas of rippling. As far as tummy tuck goes, it's difficult to asses whether or not you're a candidate from the photo. A tummy tuck can be the standard one with a full incision and muscle tightening or a mini-tuck with a small incision, but still with muscle tightening.

Ricardo L. Rodriguez, MD · Answer

1. What is the defect?
The defect here seems to be mainly rippled skin.
There does not appear to be a lot of loose skin. There does not appear to be a big abdominal wall defect.
2.  What do the proposed operations accomplish?
Lipo will take away more fat, but not redrape the skin.
Tummy tuck will redrape the skin, but will give you a large scar, you have a high placed belly button, so you will probably have a vertical scar as others have noted. It is also a longer operation with a longer recovery.
3. Is there another operation that can redrape the skin without the disadvantages of a tummy tuck?
Yes. You can do a "Suctionless" lipo by using a small cannula to run through the entire area and break up the adhesions. Then through a small incision using an endoscope you can free up the abdominal skin and redrape it.

Farbod Esmailian, MD · Answer

Yes it can be helped by having a tummy tuck to an extent though.  Your skin will be tighter and you will have less rippling but some of the irregularities will remain at the expense of an incision.  Also sinch you dont have that much loose skin you will be left with a small vertical incision somewhere between the new belly button opening and the inferior incision mark.  Another approach would be to do a tummy tuck but "float" the belly button where you dont cut around the belly button but simply release it to allow the skin and belly button to move downwards.
So you just have to be realistc and then it would not be perfect but better.
Good luck.

Otto Joseph Placik, MD · Answer

I would have to agree largely with Dr. Yuan. I feel that a tummy tuck would largely correct the ripples above and below your belly button. However, the lack of skin laxity would problably leave you with either a small vertical scar below your belly button and a low transverse scar or the lathernative of a higher transverse scar.
Return to your plastic surgeon and be very specific about having him or her describe to the incision alternatives of the abdominoplasty options.
I have had gppd sucess in correcting some liposuction irregularities with a tummy tuck but you have to be prepared for the incisions/scars and the recovery.

G. Gregory Gallico III, MD · Answer

You could do more Lipo to try to even things off, but that probably won't make it a big difference. A full Tummy Tuck with a 'free float' of the belly button would help more, but would make a very long scar side-to-side. Repeat Lipo may be the best, but not great.

W. Tracy Hankins, MD · Answer

I think yo u would be helped by an abdominoplasty, although you should be prepard for a small vertical scar in addition to the horizontal scar as you might not have enough excess skin to remove the area wher the incision is made around the belly button.

Christopher L. Hess, MD · Answer

I can't imagine what kind of liposuction you got without tumescent unless it was SmartLipo or a similar kind.  This drastic amount of contour irregularity is due to the use of large diameter liposuction cannulas during the surgery and likely as well as the lack of a criss-cross pattern.  
A mini tummy tuck will not help the unevenness.  I would recommend liposuction, by someone much more qualified than your surgeon.  They'll need to use small, 2.5mm - 3.0mm cannulas.  I believe it will improve the contour but nothing will make it perfect. 
If there is extra skin after the lipo a mini tummy tuck can be performed to remove it.

Robin T.W. Yuan, MD · Answer

You seem to have relatively good shape with minimal looseness of your abdominal skin. Some surgeons intentionally try to contour the upper abdomen with transverse ripple to simulate the "six-pack" look whan a patient doesn't have that naturally. I don't know whether this wwas the case with your surgeon but if not or if you just don't like the look, then you can see how much pulling of the skin it takes to smooth out the ripples. If you can smooth it out, then some sort of tummy tuck will probably help. The question is, what type of tummy tuck and what are the drawbacks and risks? It is possible to do a modified tummy tuck by pulling the abdominal soft tissue with the belly button down. This will strtech out the upper abdomen , more around the immediate area around the belly button to the degree that you can move the belly button lower. Usually this is about 2-4 cm. and is limited by the position of the belly button that looks normal. If you need a more extreme tightening, then a full tummy tuck can tighten the soft tissues maximally but you will need a longer scar and as well as a scar around the belly button itself. The other alternatives are to do careful and minute spot liposuction to smooth out the bumps or to accept what you have until it is bad enough to do something more extensive. By the way, tumescent does not prevent the result you have.

Can a Tummy Tuck Fix Botched Lipo in the Tummy Area?

Answers (13)