Extended tummy tuck vs lower body lift? (Photo)

This is a great question. You are right - lower body lift typically is geared towards massive weight loss patients, however in patients who have a significant amount of skin and fat in the back (back rolls), a lower body lift can work well and be a good option. The drawback to doing a lower body lift instead of a tummy tuck is that there will be a long horizontal scar going across your back and a little more pain and downtime after surgery. The decision to have a scar on your back and a longer recovery should be weighed against having a better contour.
Alternatively, doing an extended tummy tuck with liposuction of your back may achieve the results you desire without adding significant scarring and recovery to your surgery. However, this largely depends on your skin quality and skin elasticity. With good skin quality, your skin will contract down after surgery better than if you have stretch marks and skin without skin elasticity. It is important to see a plastic surgeon who can evaluate you and personalize a plan based on your goals and needs.
Ultimately, this decision is based on your personal preference, weighing the risks and benefits from each procedure, and putting your trust in your plastic surgeon.

Thank you for your question regarding the choice between an extended tummy tuck and a lower body lift. Based on your description and photo, if your hips and buttocks do not bother you (in terms of sagging or excess skin), I would recommend an extended tummy tuck. This procedure focuses on removing excess skin and tightening the abdominal muscles while extending the incision slightly to contour the flanks and lower back.

It is entirely possible to achieve excellent results with an extended tummy tuck without dog ears. In fact, we perform extended tummy tucks routinely and ensure smooth, natural contours by tailoring the procedure to the individual’s body. A lower body lift is generally more appropriate for patients with significant weight loss or those with extensive sagging in the buttocks and hips, which doesn’t seem to be your primary concern based on the information you’ve provided.

If you decide to proceed with the extended tummy tuck, consult with an experienced, board-certified plastic surgeon who can deliver the results you’re looking for while addressing your specific concerns. Either way, I believe you’re a great candidate for a transformative outcome!

Sincerely,
Dr. Katzen

Hello and thank you for your question. From the pictures you have provided, you have striae (stretchmarks) present throughout your lower and mid abdomen and extending into your flanks. There is a severe amount of excess skin and subcutaneous fat present diffusely throughout your trunk- from your abdomen into your flanks and extending into your back. This is asymmetric in distribution. There are skin folds across your lower abdomen extending to your posterior flanks, and you also have multiple folds asymmetrically present throughout your mid and upper back. Based on all this, you would benefit from an abdominoplasty (tummy tuck) and 360 liposuction, with staged upper back lift, to best help improve your abdominal/trunk contour.
The difference between a "standard" and "extended" tummy tuck is just how far your incision extends to the side, and this is based on how much excess skin and fat needs to be removed to produce an aesthetic contour. They are essentially the same procedure- the goal is improved body contour at the expense of scars, so this is important to keep in mind throughout the process. In your case, the scar would extend around to your sides.
The reason I said abdominoplasty instead of circumferential belt lipectomy ("lower body lift") is because the excess skin in your back is located more in your mid/upper back, not as much in your lower back.
Liposuction would definitely provide additional benefit for you, particularly to the contour of your flanks and back, and can help improve the notable asymmetries present. Keep in mind that for you, given that you have excess skin on your mid/upper back which is not addressed with the 360 liposuction or the abdominoplasty procedures, and which will most likely become more noticeable and even appear deflated after liposuction, you would most likely need another procedure to address your excess mid/upper back skin at some point in the future in order to further improve your overall trunk contour. This would most likely consist of a staged upper back lift- the incision can be hidden in your bra line. A benefit of staging these procedures, is you can do further revision liposuction at that time, to correct any asymmetries or to provide further improved contour overall.
With all that said, it is always difficult to provide tentative surgical recommendations, as there is only so much information to be gained from any photos and descriptions provided. I recommend for you to come see me or another plastic surgeon for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) for your specific case. I hope this helps!
Best wishes,
Dr. Donald Groves
Plastic Surgeon

Dear Imaginative982259,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. 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

You need the lower body lift, and liposuction all your back and the waist, to Remove the extra skin and give you the best result

Thank you for your questions dear Imaginative982259.
Based on your front pictures you qualify for an extended tummy tuck with muscle repair, my recommendation is to lose weight before your procedure due to the amount of visceral fat you can have, that will guarantee you better results and a flat tummy as I believe you are looking for.

Good luck in your journey!

The lower body lift, or circumferential tummy tuck is designed to address excess skin on the front as well as the back. An in person evaluation is best, but from the posted photos it doesn't appear you have significant skin laxity in the back. You should be fine with an extended tummy tuck with liposuction for added contouring. I've included a video I hope you find helpful.

You only posted one front view photo and no side views. Based only on the one photo, an extended tuck should work well for you.

An extended tummy tuck can go by different names or terminology. That wraps around to the backside is generally considered an extended tummy tuck, and if the skin excision goes all the way around the procedure is either called a circumferential tummy tuck or lower body lift. The extent of skin excision should be based on the extent of skin laxity. Individuals who have skin laxity that continues towards the backside generally benefit by having a more extensive skin excision, leaving them with a longer scar but improved contour that continues not only on the front, but also on the sides and back. Generally speaking plastic surgeons will err on the side of under resection rather than over resection.
A failure of extending the procedure to incorporate skin laxity on the sides or backside leaves an insufficient skin excision with imperfect body contour with the development of skin folds called dog ears.
Extending a tummy tuck is a fairly major deviation to the primary procedures. Doing so requires repositioning the patient during general anesthesia. This may seem trivial, but is in fact complex, and can take a significant amount of time and effort. Moving a patient during general anesthesia typically takes six people and can take 30 or more minutes. My personal recommendation is to go with the provider who recommends the more extensive procedure. Patient should always be careful in choosing providers based on having in person consultations during which time I encourage patient to ask providers to open up your portfolio and show you their entire collection of previous patients who had similar body characteristics and had the recommended procedure. An experienced plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. Extended tummy tucks are not nearly as common as standard tummy tucks, but a sufficiently experienced Plastic surgeon should have ample documentation of previously done cases of patients who have similar body characteristics.
In regards to your assessment regarding a tummy tuck it is important to recognize what the procedure treats and what it doesn’t. There are four tissue variables that determine what the abdomen looks like. In other words, if somebody doesn’t like the way their belly looks It is always because of one or more of four different tissue variables.
The four different tissue variables that determine what the abdomen looks like our abdominal skin laxity typically due to previous pregnancies or weight loss, excess, subcutaneous fat, muscle separation from previous pregnancy, and lastly, excess visceral or intra-abdominal fat.
Based on your pictures, your abdomen bulges significantly. This is most likely due to a combination of both muscle, separation and excess visceral fat. It’s important to differentiate visceral fat from muscle, separation because individuals who have excess visceral fat are not ideal candidate for a tummy tuck.
To differentiate visceral fat from muscle separation, consider laying on your back and seeing if your abdomen goes completely flat. If it does, then the bulging of the abdomen is more likely due to muscle, separation and not visceral fat. If your abdomen still bulges while you’re laying on your back then this indicates that visceral fat is most likely a significant component of why your abdomen looks the way it does.
Individuals who have excess visceral fat, should seriously consider weight loss before having a tummy tuck. Tummy tuck results on individuals who have excess visceral fat will often be less than optimal, creating bulging of the upper abdomen.
Differentiating different tissue components on someone’s abdomen is fairly straightforward, but missing individuals who have access to visceral fat and recognizing the inherent limitation of the procedure is sometimes overseen.
A thorough consultation should have a minimum at least recognize and assess visceral fat as a component in regards to somebody’s candidacy for a tummy tuck.
Visceral fat, can only be reduced by weight, loss and individuals who have excess visceral fat, are often displeased and disappointed with tummy tuck outcomes.
This is one of the most common missed variables in regards to assessing patient’s candidacy for this procedure.
I suggest patients have multiple in person consultations just like you did. There’s no correct number of consultations needed to find the right provider. The more consultations you have the more likely you are to get an accurate assessment, a good understanding of your candidacy for the procedure and better understanding of what treatment options can, and cannot deliver.
Judge tummy tuck results based on who gets the most natural looking belly button with a low set scars that follows the anatomic contours, naturally and evenly on both sides, leaving the torso, looking, balanced, appropriate and attractive from all angles, including from behind.
Understanding your own candidacy for the procedure is critical in understanding what the procedure can, and cannot deliver. Rather than being disappointed after surgery with a still bulging abdomen it’s far better to accept the inherent limitation of the procedures, and either address visceral fat before scheduling surgery or realize the inherent limitations this condition imposes.
The ability to make an accurate assessment based on pictures alone is inherently limited. I am in no way, stating that you’re not a good candidate for a tummy tuck. Your abdomen does appear to have a visceral fat component, which mandates at least addressing this aspect of your candidacy.
An extended tummy tuck is probably in your favor, whether it’s called, wraparound, extended, or body lift.
Look at correlating before, and after pictures, displayed by providers to get a clear understanding of what the procedure incorporates. You should have a clear understanding of exactly how far the scar will go, and to what extent skin excision will be done in the hands of each provider. I suggest taking this conversation as far as asking specifically if they plan on turning you or repositioning you during surgery.
Good luck,
Mats Hagstrom MD

I almost never recommend 360 lower body lift. Patients have fewer complications with tummy tuck. Combing these two procedures will require a hospital stay and most likely have complications with the lower body lift.