115lb, mother of 2, what kind of TT for the bulge and loose skin? (Photos)

Question

115lb, mother of 2, sad that my tummy looks the way it does. I used to have a non-bulgy tummy with very clear two-pack definition. One doc I consulted said a mini TT may be fine, but only listed muscle repair on the quote. Given the bulge, and the side body loose skin, I was thinking I need at least a TT, possibly even a fluer de lis or 360 sort of surgery. Can anyone help advise what they think?

Daniel Barrett, MD · Answer

Dear vic danconia,
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

J. Timothy Katzen, MD, FACS · Answer

Hello VICDANCONIA. Thank you for your question regarding what kind of tummy tuck is needed for the bulge and loose skin for a 115-pound mother of two. Thank you for your history and your pictures. Let’s examine your pictures. Your pictures show muscle distention primarily below your belly button to the top of the pubic region. You do not have much excess skin and you do not have much excess fat. The only way to fix weak muscle is with a tummy tuck. Therefore, you do not need liposuction and only need a tummy tuck.

Now let's examine what kind of tummy tuck you need. There are several different types of tummy tucks. With a mini tummy tuck, a minimal amount of lower abdominal skin is removed, the belly button is not relocated, and the muscle is repaired. The extent of the muscle repair depends on the surgeon. In my opinion, I would repair your rectus abdominis muscle from the bottom of the sternum to the top of the pubic region. Some surgeons would call this a mini tummy tuck, while others would call it a full tummy tuck. Either way, you require full rectus abdominis plication from the bottom of the sternum to the top of the pubic region for the best result. In terms of removing skin, since you do not have much to remove, you could also undergo some liposuction on the side, but I believe this skin will tighten with the tummy tuck and muscle plication.

You do not need a Fleur de Lis tummy tuck, which is a combination of horizontal and vertical incisions, because you do not have much excess skin in the central portion of your abdomen above the belly button. You also do not need a 360 circumferential lower body lift as your hips and butt do not seem to have much excess skin or fat. Therefore, a tummy tuck with a primary focus on muscle repair would be the best course of action. Good luck. I hope this helps to answer your question regarding the type of tummy tuck needed for the bulge and loose skin on your abdomen.

Sincerely,

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

Finny George, MD · Answer

Hi, thank you for sharing your question. The need for a TT will depend on your muscle diastasis because the photos do not demonstrate any meaningful skin laxity. Your desired results can be achieved with liposuction alone unless you have diastasis.

Gary M. Horndeski, MD · Answer

If you are not planning future pregnancies, I recommend abdominoplasty with mesh reinforcement. The mesh creates a more hourglass figure by compressing the abdominal wall resulting in early satiety and helps maintain a reduced weight.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

John L. Burns Jr., MD · Answer

You have some loose skin and muscle which would benefit greatly from a mini tummy tuck:  low bikini incision, no scar belly button, corset muscle plication.

Ram Kalus, MD, FACS · Answer

Thank you for your question and photos. An examination in person would be required to properly evaluate you and provide you with specific treatment recommendations. That said, you are definitely NOT a candidate for a fleur de lys. That is reserved for patients who have had massive weight loss and a standard transverse (bikini) incision simply would not suffice to achieve the desired outcome. In your case, it appears you have minimal excess skin and would primarily benefit from a "floating umbilicus" abdominoplasty to correct the muscle bulge with a plication, but allow for your umbilicus to remain in its location or ever so slightly lower. A true abdominoplasty would result in a vertical scar beneath your umbilicus since it does not appear that you have enough skin laxity to be able to remove all of the skin between your umbilicus and your lower incision.

Please consult with an experienced board certified plastic surgeon whose realists appeal to you on his or her Before and After gallery, who can advise you on all of your options. Best of luck to you.

Please consult with an experienced board certified plastic surgeon whose realists appeal to you on his or her Before and After gallery, who can advise you on all of your options. Best of luck to you.

Connie Hiers, MD, FACS · Answer

You do not need the vertical incision and the mini tuck might work very well for you. Excess skin can also be removed with the mini tuck.

Camille Cash, MD · Answer

If you only have muscle separation below the belly button then you can consider  a mini tuck.  If there is separation above the belly button, which there likely is, then a standard tuck would be the better choice.  A fleur de lis approach is not needed.  I've included a video about the mini tummy tuck that I hope you find helpful.

George Lefkovits, MD - Account Suspended · Answer

Uou would need to be examined in the office  to  feel the bulge as well as the separation of the abdominal muscles. In addition the excess kin needs to be evaluated. A full Tummy Tuck is the most likely form of treament but an examination needs to be performed to best determinre the proper treatment. Yoiu should consult with a Board Certified plastic surgeon. Good luck!

115lb, mother of 2, what kind of TT for the bulge and loose skin? (Photos)

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