Body lift vs. panniculectomy vs tummy tuck vs. fleur de lis? (Photo)

Question

Hi! Looking to see what the best procedure would be. I have lost about 100 lbs and have a TON of extra skin. My main concern is my stomach and that roll on my bum. I do like my waist and my hips, though. I don't want my ab muscles to be worked on, but that may change. I workout everyday and I power lift 3x a week so I'm not sure work on my muscles will be necessary. I am also looking @ my back and wondering if a Fleur de lis will help smoothen it out? Thanks in advance for your help :)

Stefan Mark Szczerba, MD · Answer

Hi Congratulations on that weight loss!!  In my practice, I base the decision on muscle work more on whether you've had kids rather than on how much weight loss you have had or how much exercise you do.  From what I can see, you need muscle work to get your best result!  I would also recommend liposuction of your back rather than a Fleur de Lis pattern of skin excision.  You can also consider rounding out your backside by fat grafting the fat removed from your waist into your buttocks.  Best Wishes!!

J. Timothy Katzen, MD, FACS · Answer

HI Natasha, Thank you for your question regarding whether you should have a body lift, panniculectomy, tummy tuck or fleur-de-lis procedure after 100 pound weight loss. Since you said in your history that your  "main concern is my stomach and that roll on my bum", therefore the tummy tuck, panniculectomy, and fleur-de-lis will do nothing for your buttock. Since your hips and your buttocks bother you, and your pictures show excess skin and fat of your hips and your buttocks, I would strongly suggest the 360 circumferential lower body lift. During the 360 circumferential lower body lift, excess skin and fat of the abdomen, hips, and upper buttocks are removed. This leads to a nice, tight flat abdomen, hips, and buttocks. The hips will be more shapely and the buttocks will be raised.  In your setting, the panniculectomy, tummy tuck, and fleur-de-lis would not provide any of these advantages. The 360 circumferential lower body lift is a very common procedure for patients that have lost at least 100 pounds or more. I hope I have answered your questions regarding whether to undergo a 360 circumferential lower body lift, panniculectomy, tummy tuck, or fleur-de-lis procedure. Good luck!  Please seek an experienced, board-certified plastic surgery with significant experience in 360 circumferential lower body lift.   If you have any questions, please contact my office. Thank you.

Jeffrey E. Schreiber, MD, FACS · Answer

Congratulations on your amazing weight loss!  It appears as though you could get excellent results with a circumferential tummy tuck with an upper back lift.  I could give you a better answer during a consultation, but those procedures allow me to contour the entire torso.
Thank you for your question!
Dr. Schreiber, Baltimore plastic surgeon

Carmina Cardenas, MD · Answer

You already have a beautiful body shape and a great body foundation, so your result must be astonishing.You have developed saggy skin on abdomen, a bit on sides, lovehandles and definitely your buttocks have become flaccid. The Pure Tummy Tuck will not be enough to enhance, because that means only skin resection.You will be a great candidate for the LBL to do skin removal, skin tightening but also Lifting of pubic, sides. lovehandles and Buttocks. I would also add liposuction to waist and lovehandles to sculpt the area and harvest fat to transfer to buttocks. I will do recommend a Muscle repair because your abdomen is protruding because your muscle is loose and at the same time will help to create a smaller waist.Be encouraged.Dr/ Cardenas

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  Congratulations on your weight loss.  Based on your photograph, you are a candidate for all three procedures.  One good option could a tummy tuck with liposuction and back liposuction.  This can be done
through a low incision, all completely below the bikini line.  The belly button can be designed to look
natural and have no scars on the exterior. 
 Make sure you specifically
look at before and after pictures of real patients who have had this
surgery performed by your surgeon and evaluate their results.  The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Manuel Ventura Gonzalez, MD · Answer

Thank you for your question, after analyzing the photos you sent my recommendation is for you to undergo a tummy tuck in the abdomen area to remove excessive skin, a complete liposuction of the back in order to extract the fat located in that area and then to place said fat in your buttocks, if your health allows it these three procedures can be performed in a first intervention.
These procedures would help to improve your appearance immediately, and the use of the belt will help you to lose weight afterwards. After performing these procedures you can determine which other areas of your body need improvement, good luck.

Paul C. Dillon, MD · Answer

It seems like a combination of liposuction and skin excision may work well for you. The abdomen will definitely respond to liposuction as well as the waist. In addition, liposuction around the top of the buttocks may help contour the buttocks also. The liposuction of the abdomen will decrease inches.  Ultimately, you may want to consider a tummy tuck (that may sound scary, but it is very effective).  I think your end result will be pleasing to you.  I hope this helps.

Amira Sanki, MBBS Hons, FRACS, PhD · Answer

You are truly brave for losing 100 lbs! I would recommend an extended tummy tuck (incision extends three quarters round your body) or a body lift (incision extends all the way around your body) to deal with your excess skin. A FDL tummy tuck will always give you a tighter result, but it comes at the enormous cost of a huge, unsightly scar that runs vertically down the front of your abdomen. This scar does not heal as well as the lower underpant line scar of other abodminoplasties. The alternative technique to deal with your mid back rolls is a braline lift.

Kim Taylor, FRACS · Answer

I believe your best result will be with a bodylift.  This will improve your abdomen & remove the roll above your bottom. None of the mentioned procedures will improve your upper back rolls.  It is most likely that you would need a second procedure (at least 3 months later) to remove the excess tissue from your upper back (upper back lift).  I don't believe liposuction alone or the body lift will improve this area.Seek a consultation with a surgeon experienced in massive weight loss procedures.  It is common that planned multiple procedures are required.All the best

Rachel Streu, MD, FACS · Answer

Natasha!Congratulations on your impressive weight loss accomplishments! Once your weight loss has stabilized, an assessment by a board certified plastic surgeon who does a fair amount of body contouring cases per year is in order. At this consultation, a comprehensive plan of the best surgical approach to meet your particular needs and desires will be outlined. In addition to this, all risks and complications of body contouring procedures should be reviewed.Abdominal contouring using a vertical scar and a horizontal scar can typically improve the waistline contour in the front and the back. This is the fleur de lis abdominoplasty procedure. Plication (or tightening) of your abdominal muscles may be recommended to further improve your contour. Best of luck on your journey!

Body lift vs. panniculectomy vs tummy tuck vs. fleur de lis? (Photo)

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