180 pound weight loss - FDL tummy tuck first? Body lift? What procedures next? (Photos)

Question

I have lost over 180 pds after having DS weight loss surgery. I had a consultation the Dr recommended that I do a FDL tummy tuck. I ideally want the Mommy Makeover because I want be able to combine procedures. If I go against the Dr recommendations essentially what would my results look like? Would love to hear your recommendations based on my pics. He also said I would not be good candidate for BBL, he thinks my next procedure after the FDL needs to be a lower body lift. Is this on track?

J. Timothy Katzen, MD, FACS · Answer

Hello Coxoxoxo,
Thank you for your question regarding an 180-pound weight loss and whether to do an FDL tummy tuck first or a body lift and what procedures next. Thank you for your history and your pictures.
In your pictures, you appear to have an FDL incision already.  Is this you or someone else?  Is your plastic surgeon suggesting another FDL? If so, most plastic surgeons would say you do not need another FDL incision. Regarding your breasts, you need a breast lift or mastopexy. If you desire more volume, breast implants may be a consideration. If you want less volume, a breast reduction may be a good option for you.
Your plastic surgeon is correct about your buttocks. Based on your pictures, you are not a good candidate for a BBL. A BBL is a surgical procedure where fat is harvested, purified, and then injected into the buttock for buttock augmentation and a buttock lift. You have severe buttock skin wrinkling due to weight gain and then subsequent weight loss. This condition has resulted in deflated buttocks. To reconstruct your buttocks with a BBL, you would need a lot of fat to inject. To begin with, there is not much fat available for injection. Second, not all of the fat would not survive. Third, the buttock would be very large after BBL augmentation and would not match your new body shape. Therefore, it’s better to do a buttock lift. During a buttock lift, an incision is made from the top of the vertical cleft and will join your FDL scar. Then, dissection is performed to the bottom of the buttock, adhesions are released, the buttocks are lifted, and excess buttock skin and fat are removed. The buttock lift is just the posterior portion of a lower body lift. A "lower body lift" is an abdominoplasty, hip lift, and buttock lift.  Most plastic surgeons would agree that you do not need a "complete" lower body lift. You just "need" a posterior buttock lift.
Regarding your arms, you need a longitudinal brachioplasty with arm liposuction. The arm procedure involves making an incision that runs from the armpit to the elbow. The incision is hidden between the biceps and triceps.
In terms of staging, you will need to be on your abdomen to allow your posterior buttock lift to heal.
Therefore, you cannot enhance your breasts and buttocks at the same time. However, you could have a brachioplasty with a posterior buttock lift. However, the best course would be to perform a posterior lift procedure and then wait 4 to 6 months before the procedure involving the breasts and arms. Alternatively, you could first do the breast and arm surgery, followed 4 to 6 months later by the posterior lift. Good luck. I hope this information helps. I hope I have answered your question regarding an 180-pound weight loss and whether to do an FDL tummy tuck first or a body lift and which procedures next.
If you have any more questions regarding the lower body lift, 360 circumferential lower body lift, belt lipectomy, belt abdominoplasty, or belt dermolipectomy, please contact an experienced plastic surgeon. Since the body lift is a big procedure, please seek an experienced, board-certified plastic surgeon with significant experience performing the lower body lift. Do your research. Make sure they have performed at least 150 circumferential lower body lift surgeries and have the before-and-after pictures to prove it. Carefully examine their before-and-after pictures and check their reviews on RealSelf. If you cannot find an experienced, lower body lift surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen, MD, MBA, FACS, FICS, FASMBS (President of the American Society of Bariatric Plastic Surgeons; certified by the American Board of Plastic Surgery; Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery; and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

John LoMonaco, MD, FACS · Answer

Hi, and congrats on your weight loss.  have you already had the FDL tummy tuck ?

The loose skin on your hips, waist, and outer thighs can easily be corrected with a lower body lift, possibly a bit of liposuction. DS abd other weight loss procedures really train your body to burn fat, and BBL is hard to get full, rounded results in my experience.  Cheers from Texas !

Zoran Potparic, MD · Answer

The front part looks good now. The next step should be shaping and lift of buttocks/thighs. This can be achieved in the form of lower body lift (posterior and lateral only) using deepitelized skin/fat flaps from both lower flanks to augment upper buttocks. Additional liposuction of flanks and hips will provide sufficient  amount of fat grafts to complete buttock shaping and augmentation of central and distal portion of buttock. I hope this helps. Good luck.

Mehmet Ozdemir, MD · Answer

Based on your photos and significant weight loss, your surgeon's recommendation is appropriate. An FDL tummy tuck is often the best first procedure to address both vertical and horizontal excess skin. A lower body lift can then further improve the waist, hips, and buttocks. Attempting a mommy makeover first may leave significant skin excess uncorrected and compromise your overall result. A staged approach typically provides the safest and most predictable outcome.

Manuel Diaz, MD · Answer

Helloo. Based on your photos, the next step will depend on your priorities and which area of your body concerns you most. If your arms and thighs are your main concerns, I recommend combining an arm lift with a thigh lift as a first step. Approximately six months later, you could undergo liposuction with a buttock augmentation to better define your body contour and correct any irregularities and the shape of your buttocks.Planning the procedures this way allows for a safer recovery, while achieving more complete and balanced body contouring results.A personalized evaluation is essential to determine the best surgical sequence based on your anatomy and goals.

180 pound weight loss - FDL tummy tuck first? Body lift? What procedures next? (Photos)

Answers (5)

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