Do I need to revision? (Photo)

Question

I'm 8 weeks post op and I feel like this is skin that should have been taken during my extended tummy tuck. I'm scheduled to go back for lipo 360 in April but I'm worried with this skin still I'll have saggy skin again. This is my before day after and now 8 weeks out

Gerald Minniti, MD, FACS · Answer

First, there is nothing particular off about your surgery and you are on par for what would be considered a nice result. You still have a lot of swelling and April is possibly too early to do any revision surgery. It is clear from both pre and post op photos that you were very heavy and your skin is very poorly elastic, which makes tightening it difficult and also more prone to relaxation during the healing process; I tell all my weight loss patients that they may need a smaller procedure (still under general anesthesia) to retighten some areas. Having said all that, I think had I operated on you I would have included a vertical incision in the abdomen ('fleur de lys'), and possibly an entire 360 excision of skin; this would have really streamlined the hip/waist contour and lifted your buttocks. I also would have removed much more pubic tissue, creating a flatter pubis and a lower scar.

Ira H. Rex III, MD · Answer

You are certainly very early postop and can expect swelling for 6 months or so.  Only about then can a good decision be made about the possibility of a revision to improve anyone of a certain amount of concerns.  It is best to review your expectations and possible revision with your plastic surgeon.  Returning for liposuction surgery sometimes gives a surgeon a good opportunity to improve some areas of concern from the tummy tuck.

Matthew S. Kilgo, MD · Answer

Hello and thank you for your question.
It is absolutely normal to have continued swelling two months after your procedure. I tell my patients that they will not see their final results for at least 3 to 6 months following the surgery. If you continue to have access skin at the time of your 360 Lipo, perhaps you can ask your surgeon to remove it at that at that time.  Good luck,

Daniel Barrett, MD · Answer

Dear mkp9929,

I understand your concern and it is quite normal to be concerned about the outcome following a surgery. However, you are still in the very early stages of the healing process.
You will need to be patient at this moment and follow what your surgeon has instructed you to do post operatively.
At the early stage of the healing process, the tissues are still swollen. Once the swelling subsides you will be able to see the final result of your surgery.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Arif Eroglu, MD · Answer

Hello,
The issue comes from the wide stretch marks on your abdominal skin. Your skin quality is poor. There is both skin sagging and severe stretch marks on the upper abdomen. After a tummy tuck, the stretch marks on the upper abdomen remain by necessity, so it's impossible to improve the skin quality. Because stretch-marked skin remains on the upper abdomen, both the lower and upper abdomen will still have poor skin quality after the surgery. The issue is not related to the surgery or the doctor, but rather to the skin quality.

Chet Mays, MD · Answer

Thank you for your inquiry! Keep an open communication with your plastic surgeon regarding your concerns. We would also be available to see you in person and discuss your revision options. Schedule a consultation with a Board-Certified Plastic Surgeon to help you reach your goals!

Zoran Potparic, MD · Answer

You should wait at least 6 months before asking this question since there is a chance for some skin retraction. This should be discussed with your surgeon ahead of your next surgery in April.

Connie Hiers, MD, FACS · Answer

Talk to your surgeon about adding minimally invasive radiofrequency skin tightening like Renuvion to help tighten the skin when the liposuction is done.  Both issues might be taken care of in this way.

Camille Cash, MD · Answer

I know it is hard to be patient but you are still healing from surgery and it is too soon to judge your results.  If a revision is needed you can do so at the time of your liposuction.  I've included a video that I hope you find helpful.

Darryl J. Blinski, MD · Answer

Based on your post photos, the result seems to be very good to acceptable, but best of virtual consult with for more detailed viewing of your results. Then further discussions can be determined if revision is needed.

Do I need to revision? (Photo)

Answers (10)

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