Too much visceral fat for Tummy tuck???? (photos)

Question

I'm worried I have too much visceral fat to have a good result with a full tummy tuck. With lipo can I expect a more defined waist? I do not want to look thick with a flat stomach... I'm also scared if I have too much visceral fat, my surgeon won't have enough skin to pull and I will end up with a vertical scar in addition to my TT scar... Lastly, I would also like higher rounder smaller breast ... I'd love your opinions... Thanks doctors!!!!

Jerome Edelstein, MD · Answer

Hello,Thank you for your question and photos. It is good to recognise that there are limitations regarding type and location of fat prior to surgery. Visceral fat must be reduced with diet and exercise. I recommend that patients get as close to their ideal weight as possible and stable there before planning surgery.Having said that, it appears that a reasonable amount of your excess abdominal fat is outside the abdominal cavity and could be reduced with liposuction. You likely have enough skin excess to warrant a full tummy tuck and muscle tightening would help to slim your waistline. An in-person consultation is the best way to determine your options and best planning for optimal results.All the best

David R. Alfonso, MD, FACS · Answer

Your abdomen looks like you would have a good result after your surgery. Even if you have some prominent visceral fat the muscle tightening should help with flattening the area.  The lipo will help to thin out the outer fat layer

Karol A. Gutowski, MD, FACS · Answer

Based on your pictures, you would have a nice result with a combined lipo-abdominoplasty. Consider a non-drain tummy tuck with a Rapid Recovery program. The breasts can be addressed at the same time. See link below for examples.

Kahlil Andrews, MD · Answer

Excellent question! To start, yes, you should be seen in person in order to have the most accurate diagnosis. Judging solely on the images, you would be a great candidate for a standard Tummy Tuck. No vertical scar should be necessary if the closure is done with the bed flexed. We always perform liposuction of the hip and flanks and often in the anterior abdomen as well- definitely defines the waist. Additionally, Wide Abdominoplasty Rectus Plication will flatten your contour to help address the fullness created by the visceral fat. A small breast reduction can be done in conjunction with the Tummy Tuck, and we recommend that you consider a small amount of fat grafting to the superior pole for upper pole fullness. Good luck with your procedure & don’t hesitate to reach out should you have additional questions or concerns!

Owen Reid, MD · Answer

That's an excellent question. Visceral fat is something that can not be treated and when present it takes away from the aesthetic outcome. A consultation is required before a definitive answer can be given. Specifically, I would like to know if you have been pregnant, how your abdomen looks when lying supine and whether or not there is a significant muscle separation (rectus diastasis).Based on your photos, I expect you would benefit from a full tummy tuck with liposuction. If you do end up with a vertical scar, I think it would be very small . . . not something that would detract from the final result. Trying too hard to avoid the vertical scar can lead to too much tension or too short a distance between the lower transverse incision and belly button. Higher, rounder, smaller breasts might certainly be the result of a carefully planned breast reduction that removes tissue from the lower and outer breast areas. Whether these two procedures should be combined is something you would have to discuss with your surgeon.

Ravi Somayazula, DO · Answer

I would recommend being seen in person to be examined and to further discuss your goals and expectations. Based on the pictures you have provided, it would seem that you would be a good candidate for a tummy tuck and a breast lift with or without implants. I am assuming your BMI which takes into account your height and weight is 30 or less and your weight has been stable for at least 3 months.   Based on your body habitus, I am quite confident that a T scar will likely NOT be required, however, an in person examination would be helpful to know for sure. In general no surgeon can absolutely guarantee that a T scar will not be present when you wake up, so it is important for you to understand that there might be a scar. Most women are accepting of the T scar rather than a high riding horizontal scar that would be more visible above your underwear etc. ,which would be the only way to make sure you did not have a T scar. I also recommend seeing a board certified plastic surgeon who perfoms many breast and body procedures.  I typically perform liposuction of the flanks and lower back as well during my tummy tuck procedures.Best wishes,Dr. Ravi Somayazula

Tom J. Pousti, MD · Answer

Thank you for the question and pictures. Despite good intentions, online consultants are not in the best position to provide you with meaningful advice. Much will depend on physical examination when it comes to determining the location of  any adipose tissue present. For the benefit of other patients  wondering about "visceral fat":  the tummy tuck operation does not address visceral fat;  this fatty tissue is located around the intraperitoneal organs.  The tummy tuck operation serves to remove loose/redundant skin and reapproximate abdominal wall muscles that may have spread with weight gain/loss and/or pregnancies.  Generally speaking, the “ideal” patient for tummy tuck surgery is one who has completed pregnancies, is psycho socially/emotionally/financially stable, has an excellent social support system surrounding him/her, is capable of arranging enough recovery time, does not smoke and who has reached a long-term stable weight. I would suggest that you meet with well experienced board-certified plastic surgeons who can demonstrate lots of experience achieving the types of outcomes you will be pleased with.  After physical examination, and possibly with the help of visual aids such as before/after photographs, your plastic surgeon will be able to communicate what you can expect with the tummy tuck operation in your case. Best wishes.

Too much visceral fat for Tummy tuck???? (photos)

Answers (7)

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