Is an extended tummy tuck the best option for me? (photos)

Question

Hello, I'm 33 and weigh 150 pounds, with a body fat percentage of 15, according to a recent DEXA scan. My highest weight was 260 in 2013. The two surgeons I've met with so far have recommended an extended tummy tuck and said they are hesitant to give me the larger scars from FDL and 360. This seems like the right call. One doctor also said that down the road, I might want to consider a wedge excision of the flanks. Do you agree? Does anyone have any additional advice? Thanks.

Arif Eroglu, MD · Answer

Hello
Since there is no skin sagging in your waist area, performing an abdominoplasty that doesn't include the waist area will yield good results.

J. Timothy Katzen, MD, FACS · Answer

Hello leo2700,

Thank you for your question regarding whether an extended tummy tuck is the best option for you. Congratulations on your incredible weight loss! You've done an amazing job, and your health undoubtedly thanks you.

Based on your photos and history, if your buttocks and the backside of your hips do not bother you, you do not need a circumferential body lift. An extended tummy tuck will provide excellent results, addressing most of your excess skin and fat in the lower abdomen. This procedure typically results in a flatter, more toned abdominal area, and can improve the contour of your hips as well.

I agree with the recommendation to avoid a fleur-de-lis (FDL) procedure, as most of your excess skin is in your lower abdomen. This is fortunate, as an extended tummy tuck will effectively address this area, giving you truly amazing results.

However, if your buttocks and backside of your hips do bother you, then a 360 body lift might be worth considering. The 360 body lift will provide more comprehensive contouring, enhancing the appearance of your entire midsection, including your buttocks and back hips. While an extended tummy tuck will help your hips, it won't have the same impact as a 360 body lift.

If you are satisfied with your buttocks and backside of your hips, proceed with the extended tummy tuck. If not, discuss the potential benefits of a 360 body lift with your surgeon.

Good luck, and I hope this helps to clarify your decision. Thank you for your question regarding whether an extended tummy tuck is the best option for you.

Check out the Youtube video below for a patient who also had excess skin of the abdomen but had a more drastic weight loss.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic Surgeon

Moises Salama, MD · Answer

Thanks for your question. From your pictures, you seem to be a good candidate for a tummy tuck. I recommend scheduling a consult for a proper evaluation. Please always consult with a board certified plastic surgeon. Take care, Dr. Moises Salama, board certified plastic surgeon.

Jose Perez-Gurri, MD, FACS · Answer

Your surgeons have given you good advice. Congratulations on your weight loss and good luck on your surgical journey. Doc PG

Daniel Barrett, MD · Answer

Dear leo2700,
based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. Flanks liposuction would give you a better shape. I would suggest you to consult a board-certified plastic surgeon because only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Emmanuel Mallol Cotes, MD · Answer

Thanks so much for your inquire,

An extended tummy tuck could be a great option depending on your specific goals and needs. This procedure is designed to address both the abdominal area and the flanks, providing a more comprehensive result compared to a traditional tummy tuck.

If you have significant loose skin or excess fat not just in the abdominal area but also extending to your sides or back, an extended tummy tuck might be more suitable. Consider whether you want a more extensive contouring that includes the flanks or hips. An extended tummy tuck offers a more complete result in these areas.

The best way to determine if an extended tummy tuck is right for you is to consult with a board-certified plastic surgeon. They can evaluate your condition, discuss your goals, and recommend the most appropriate procedure.

Richard Zienowicz, MD · Answer

Hello and thank you for your question. I do agree that extending your tummy tuck scar as much as possible will help avoid dog ear scar deformity and remove more skin. Whether you end up doing a posterior body lift on the back depends on how much that area bothers you (and whether you are a good candidate). I would discuss with a board certified plastic surgeon and decide whether you'd like to do the two procedures together or just an extended abdominoplasty and decide to address the posterior at a later date. Best of luck!

Jeffrey M. Darrow, MD · Answer

Congratulations on your weight loss!  To improve your trunk contour, removal of the excess skin across your abdomen is needed.  However, your photos show excess skin at your flank as well.  Extending the incision onto your flanks would help avoid the lateral fullness which will likely develop there, at the end of the abdominal incision.  I believe your other doctor also anticipated this by telling you, you may need wedge excisions of your flanks in the future.  Why have 2 operations if it can be accomplished with 1?  Hence, I believe an extended abdominoplasty would be the minimum to reshape your trunk.  I’m not sure if you have buttock ptosis or whether this bothers you.  A 360/Lower Body Lift should be considered if this is true, as it corrects buttock ptosis.  Yes, the incision is longer, but only a small amount and allows for a total correction of the entire trunk, improvement of the inner and outer thighs and lifting of the lax buttock skin.  Adding a FDL is unnecessary and markedly increases scarring.  Best wishes.

Gerald Minniti, MD, FACS · Answer

At least by photos, you don't need a FDL not because of 'too much scarring', but because you don't (appear to) have that much circumferential laxity in the upper abdomen. Liposuction of your flank/hip complex will reveal further laxity and necessitate a longer incision that goes around to some point in the posterior hip area. Evaluation of your outer thigh and buttocks may also reveal a posterior body lift would be necessary.

Connie Hiers, MD, FACS · Answer

I suggest going with the extended tuck to remove most of your excess skin. This scar can also be easily hidden in swimming trunks.

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