How do my Tummy Tuck results look? (photos)

Question

THIS IS A FOLLOW UP TO MY FIRST QIESTION… additional pictures pre-op were asked for, so I am including them here. I’m not thrilled with how my procedure turned out and ammsokociting advice on what went wrong. To note, I initially asked if I should also get lipo, but was not advised properly on the difference between having it and not.

Nelson Castillo, MD · Answer

Thank you for sharing your question and photograph.  Although nothing was done incorrectly your results are suboptimal as your incision is quite high on your abdomen and the scarring was significant, considering the extent of loose muscle and skin your preoperative photographs demonstrate.  I would have recommended flank and waist liposuction at the time as well to improve upon your outcome.  You can certainly refine your results but an in-person discussion of your goals and limitations that now exist needs to be had.

Daniel Barrett, MD · Answer

Dear JeepJeepGirl,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Darryl J. Blinski, MD · Answer

After comparing photos of before vs after TT, I must state the results though present show NO attention to detail, poor placement of incisions, bilateral dog ear deformity. Revision of the dog ears with revision of the TT incision, along with lipo are indicated. Fee $8,000-$12,000.

Mats Hagstrom, MD (license on probation) · Answer

One way to compare or criticize the outcome of a procedure is to compare it to what an ideal outcome should look like.

When I help patients find a plastic surgeon for this procedure I tell him to look for a few classic hallmarks of quality work.

The first and most important is critically assessing the plastic surgeons outcomes when it comes to getting a natural looking belly button.

Creating a natural appearing belly button is the most difficult part of the procedure and it’s best done by plastic surgeons who are meticulous and detail oriented.

A natural looking Belly button will all have the entire mid abdomen contoured correctly to create the natural funnel shaped scene on the mid abdomen of a normal unadulterated belly..  generally I prefer plastic surgeons who make the belly button itself fairly small and one where the stalk of the belly button helps pull in the abdominal skin towards the muscle wall to create that natural funnel shape.

Some belly buttons are easier to work with the others. Typically patients who have deep belly buttons I’ve always had a slight advantage compared to those whose belly buttons are shallow.

Unfortunately patients who form highly visible scars will have an unnatural appearance regardless of how talented the surgeon was in creating a natural belly button though it certainly helps if the surgeon did not create an excessively large belly button opening on the abdominal skin.

The second hallmark or variable to look for is very low sets cars that follow an atomic contours naturally rather than looking like someone was simply cut in half.  The second hallmark or variable to look for is very low sets cars that follow an atomic contours naturally rather than looking like someone was simply cut in half. I personally like the modified Goldwing or W approach where the scar follows the natural curvature of the mons pubis then follows the hip crease all the way out to the side.

The length of the incision should be determined by how much skin laxity each individual patient has on the side of the abdomen, waist or even love handles.

If skin laxity continues to the backside then so should the skin excision.

A talented thoughtful plastic surgeon will consider the entire torso scene from all angles and take this into consideration when designing the procedure. Patients who are reviewing before and after pictures should ask to see what the results look like from the front, side and back side .  If someone has excess fullness and the love handles or hip area that this should be addressed as part of the procedure or else the patient will look like only the front was addressed.

For some patience additional Liposuction or extended scars are required to have a desirable contour and appearance from all angles.

And looking at your results the belly button lacks finesse and does not appear natural. The scar is that high and does not follow natural contours well. The scar has contour fullness at the end leaving you looking like the procedure wasn’t finished towards the hips or back side.

In other words your outcome does not have the hallmark signs of a high-quality tummy tuck.

Your procedure was not done incorrectly it just wasn’t done as well as it could have been by some of the best plastic surgeons I have seen.

Major body contouring procedures are kind of a one time deal in that they are fairly permanent and fairly irreversible.

I continue to encourage patient to be very selective and making great efforts in finding the most talented and experienced plastic surgeons for their procedures.

Surgeon selection is by far the most important variable patients can make.

Finding surgeons who deliver consistent high-quality work is more difficult than people think.

To do this correctly patients need to schedule exclusively in person consultations and have lots of them. During consultations patients should push their surgeons request seeing their entire collection of before and after pictures.

Highly experienced surgeon while have no difficulty showing you 50 or more sense up before and after pictures.

Seeing four or five example pictures that in fact represent the very best results of that provider‘s career is insufficient to understand what average results look like.

Patients should ask their providers to show examples of their best work, average work unless than results to have a clear understanding of what typical results look like or average results.

Seeing the best handful of outcomes over the providers career is insufficient.

Patients should look critically at The variables I described previously.

I also recommend reading all the reviews on all various physician review websites avoiding providers for any significant number of justified negative reviews.

The absence of justified negative reviews is more important and more telling than having an abundance of positive reviews.

When a patient meets a plastic surgeon who has an impressive collection of before and after pictures the reads like a telephone book, has virtually no negative reviews and spends enough time to clearly explain the procedure and the potential outcomes in detail and in an honest way they typically know they found their golden ticket.

When patients rely on virtual consultations or are only shown a handful of before and after pictures and don’t go out to interview multiple providers a chance of ending up with someone who delivers average or mediocre work is far higher. Likewise, ignoring previous patients experiences who have been undesirable should be clear warnings despite providers having positive reviews.

Patients are often confused and ill-formed and look for plastic surgeons who are famous, have certain ZIP Codes or are renowned for work unrelated to direct patient care.

Famous plastic surgeons are often not particularly talented at surgery but are often above average at self promotion.

There are talented providers in almost every community. Often the most talented providers have little online presence, no paid advertising and no social media campaigns.

They are typically focused on taking care of their patients and spending time with their family and do not need or desire to engage in self promotion.  Finding the best providers is in someways simply a stroke of luck but the odds are greatly enhanced by having multiple consultations.

I don’t know if revising your outcome would be justified. It’s possible that your incision could be lowered but doing so will inevitably add a new vertical scar representing the current scar around your belly button.

Improvements on the sides would be fairly easy but creating a quality result on the front of the abdomen is difficult once the primary procedure has been done.

Whether redoing the procedure is justified or not is a discussion that needs to be had through a proper consultation.

Best,

Mats Hagstrom MD

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