Will an extended tummy tuck be the right procedure for me or will I need a body and back lift? (photos)

Thank you for your inquiry! After significant weight loss, skin does not go anywhere, it would have to be surgically removed. We would love to sit down with you in person and discuss your concerns and your options. Schedule a consultation with a Board-Certified Plastic Surgeon to assist you in reaching your goals.

Thank you for your photographs and congratulations on your weight loss. Your best contour will come with a lower body lift. I have found that with only a lower body lift, some of my patients back rolls flatten, and improve. This may be particularly true if you incorporate a Fleur de Les pattern on the front of your abdomen, although the trade-off is that you have a vertical incision on your abdomen, in addition to your transverse incision. Another option to dealing with the loose back skin, if you are also considering an arm lift and a breast lift is to incorporate an extended arm lift which runs down the side of your chest and blends in with the breast lift pattern. This markedly helps to reduce the excess skin on the back, again with a trade-off of an incision line down your lateral chest, which blends with the arm incision and the breast lift incision. Best wishes.

Based on your photos and the vector of excess of skin you have: vertical al horizontal (second photo) you will be a great candidate for Lower Body Lift Fleur de Lis 7 procedures associated: 360 and vertical skin resection, muscle repair to achieve a smaller waist, mons lift, outer thigh lift, real buttocks lift, liposuction and fat grafting to buttocks and hip dips, liposuction to upper and lower back and most likely you will be candidate in the future for Uoerr Body Lift: Breast lift and back lift. You have no idea of the huge improvement on your body contouring after the back lift specifically the positive impact on the waistline.
Be encouraged.
Dr. Cardenas

Hi Zee01,

Thank you for your question regarding the best surgical approach following your significant weight loss. Congratulations on your impressive weight loss journey!

Based on your history and photos, the ideal approach for achieving the best aesthetic result involves a combination of procedures, typically done in stages. Here's what you should consider:

A 360 circumferential lower body lift would be your best first step. This procedure includes:

Tummy tuck
Pubic lift/reduction
Hip lift/reduction
Buttock lift/reduction
Rectus abdominis or rectus diastasis plication
Relocation of the belly button
This comprehensive approach addresses excess skin and fat around your abdomen, hips, and buttocks, providing a more balanced and contoured appearance.

Following the lower body lift, a 360 circumferential upper body lift can be considered a few months later. This typically includes:

Horizontal torsoplasty (back lift)
Anchor breast lift (with or without implants)
Arm lift/reduction
During a horizontal torsoplasty, an incision is made across the back to remove a butterfly-shaped area of skin and fat, resulting in a flatter back. This procedure may be essential if you have significant back rolls and loose skin that cannot be adequately addressed by liposuction alone.

Liposuction, while effective for fat removal, might not be the best option for you due to the excess skin resulting from your weight loss. Liposuction alone could lead to rolls of loose skin without significantly improving your overall contour.

Another option to consider is a vertical torsoplasty. This involves removing a large elliptical area of skin and fat from the armpit to the upper hip, resulting in a scar from your armpit to your hip. However, this procedure is less common, and finding a specialist might require some research. Due to blood supply considerations, it is best performed several months after the upper body lift.

Regarding an extended tummy tuck, this procedure would primarily address your abdominal area but might not significantly improve your hips or buttocks. If these areas are of concern, a 360 circumferential lower body lift would provide a more comprehensive solution.

I recommend consulting with a board-certified plastic surgeon who has extensive experience with post-weight loss body contouring. This will help you determine the best surgical plan tailored to your needs and goals.

Good luck, and I hope this provides clarity regarding your surgical options.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS

Dear Zee01,
it is hard to tell for sure without an examination. Based on your photos, it looks like you have loose skin so you will probably need back lift too. 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

As with many weight loss patients, you exhibit the characteristics of loose upper and lower body skin. You shape is good. When you squeeze the skin together, this would require an inverted T excision. For me, the scar is excessive if not needed.I would approach you condition in 2 procedures.Initially do the removal of excess abdominal skin via a lower abdominoplasty scar. I don't believe you need a 360 degree belt lipectomy. The upper back skin cannot be removed at the same time as it would potentially impair healing of the abdominoplasty due to disrupted blood supply.The upper back removal of skin can be performed with a bra line scar 6 months after the abdominoplasty procedure. I typically due this in combination with a breast lift procedure.Hope this helps.

Congratulations on your weight loss journey! Thank you for your pictures and question.

It's important to understand the reconstruction needed in your case. You'll probably need more than one surgery to achieve the goal you want. As you mentioned, every surgery involves a scar, I understand most patients want to avoid it, but the course of action depends on your personal preferences, think of what would bother you more, the excess skin or the scar?

I would suggest starting with an extended or 360 Tummy Tuck.

If you're willing to travel, Surgeons in the Dominican Republic have experience and very high standard of excellence when it comes to plastic surgery. I'm positive you can get what you're looking for.

You'll need that posterior upper body lift. No manipulation you do in the front of your body will change that. Whether you do an extended tummy tuck, or what you really need, a lower body lift, you'll need a fleur de lys component in the front, a vertical scar from pubis to chest and posible inframammary extension.

Thank you for the question and including the funny pictures. From what I can see in your pictures, I would recommend a FDL tummy tuck (Fluer De Lis) This is a tummy tuck with a vertical scar down the middle of your abdomen. Or, my [reference is to perform a full tummy tuck, followed at a later time by 2 shorter vertical scars on your sides. These are muck less conspicuous and give even better tightening.

Regarding the loose skin of your upper back, there is no question that a BraStrap Upper body lift will give you the most tightening. But, again, the scar is not well liked. As an alternative, I would do an Axillary Upper Body Lift. This is a procedure that involves a scar in your armpit that extends down to the crease under your breast. This will remove the majority of the excess skin of your back, but not as much as the Bra Strap Scar approach.

There is excessive skin sagging in your abdomen, waist, back, and hips. A 360 body lift is recommended to address the looseness in the abdomen, waist, and hips. However, this procedure will not correct the sagging skin on your back. A separate back lift will be needed to address the excess skin in that area.