Loose skin after gastric sleeve surgery - Am I a tummy tuck candidate? (Photos)

Question

I had gastric sleeve surgery over a year ago and have been at a stable weight for four months. I recently had a breast lift and augmentation, but would like to take care of the loose skin on my stomach in the future. Is a tummy tuck my best option? Is there another procedure I should consider instead?

Garrett Wegerif, MD · Answer

Congratulations on your weight loss&mdash;that’s a big accomplishment!
 Based on your concerns, I do think a tummy tuck would be the best option for you. You have enough loose skin that less invasive treatments wouldn’t give you the result you’re looking for. A tummy tuck (with or without drains) would remove that excess skin, tighten your abdominal muscles, and create a flatter, smoother contour. It would also improve the appearance around your belly button, getting rid of the loose, “hooded” skin and giving it a more natural shape. 
I hope this helps, and best of luck as you continue your journey!

Wayne I. Yamahata, MD · Answer

Your limited photos suggest that you are a good candidate for a standard tummy tuck. After a major weight loss many patients would benefit further by a more extended procedure. As your photos do not show the lower abdomen or sides, the value of these procedures cannot be opined.

Daniel Barrett, MD · Answer

Dear Peaceful740072,

based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. Flanks liposuction would give you a better shape. I would suggest you to consult a board-certified plastic surgeon because only after a thorough examination you will get more information and recommendations.

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

J. Timothy Katzen, MD, FACS · Answer

Hi Peaceful740072, Thank you for your question regarding loose skin after gastric sleeve surgery and whether you are a tummy tuck candidate.  Congratulations on your weight loss.  Thank you for your history and your pictures.  First, we should analyze your pictures to determine the best procedure.  You have mild to moderate cutis pleonasmus (excess skin), mild dermatocholosis (loose skin), moderate rectus abdominis diastasis (stretched midline muscle), and mild stria (stretch marks).  Your most significant tissue issue is muscle weakness.  Rectus abdominis weakness and distention is why abdomen projects on lateral view and when you  strain.  Due to your weight gain, the rectus abdominis muscles were stretched.  After weight loss, the rectus muscles contracted, but could not contract all they way.  This is why your rectus muscles are weak.  Therefore, the most important surgical intervention is rectus muscle plication. Rectus muscle plication involve imbricating (bringing the edges together) with permanent sutures.  Therefore, most plastic surgeons would suggest that the best surgery for you would be a tummy tuck (abdominoplasty), extended tummy tuck, or lower body lift.  A tummy tuck takes about 3 to 4 hours to complete under general anesthesia.  General anesthesia is required to relax the rectus abdominis muscles to be plicated.    Plan on a 2 to 3-week recovery.  Usually, drains stay in place for 7 to 10 days.   If you have any more questions regarding tummy tucks, abdominoplasties or abdominal liposuction, contact an experienced plastic surgeon who deals with significant weight loss patients. Since the tummy tuck surgeries is a big procedure, please seek an experienced, board-certified plastic surgeon with significant experience in performing tummy tucks.  Do your research.   If you cannot find an experienced tummy tuck plastic surgeon in your neighborhood, consider traveling out of state.  Sincerely, Dr. Katzen, MD, MBA, FACS, FICS. ( Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

Muge Sevindik, MD · Answer

First of all, thank you for your question. Yes, with a full tummy tuck, the excess skin above your belly button would also be tightened, giving us the opportunity to create a flatter, fitter, and more contoured abdomen. However, if you prefer a shorter procedure, a faster recovery, and you are not particularly bothered by the skin above your belly button, a mini tummy tuck may also be a suitable option for you.

Leila Kasrai, MD, FRCSC · Answer

Congratulations on your weight loss. To achieve the most dramatic and predictable results, a full tummy tuck would probably be your most suitable option.

Laura Roider, MD · Answer

Based on your photos, I would recommend a standard tummy tuck with liposuction and diastasis repair. This allows us to remove any residual fat (especially over the hips/flanks) and tighten the abdominal wall while removing the excess/loose skin.

Ira H. Rex III, MD · Answer

From your photographs, it seems that you are and excellent candidate for a tummy tuck.  I anticipate that you would achieve a very nice result! A consultation with a board certified plastic surgeon would probably give you an excellent idea of what you could expect.

Gary M. Horndeski, MD · Answer

You appear to be an excellent candidate for a tummy tuck.  This will excise excess skin and fat and tighten the skin envelope.  The scar lies low near the pubic bone and extends out to the flanks.

Best Wishes,

Gary Horndeski, M.D.

Jeffrey M. Darrow, MD · Answer

Thank you for your photos. Your first decision would be to decide if your loose skin that bothers you is only on your abdomen or goes circumferentially around your body. Loose skin of the abdomen is addressed very well with an abdominoplasty/tummy tuck. Loose skin around the entire trunk is best treated with a lower body lift.  Your next step would be to have a detailed consultation and physical examination with a board certified plastic surgeon who could determine the degree of laxity and the extent of laxity. This helps determine whether a mini tummy tuck, regular tummy tuck or an extended tummy tuck would address your concerns and give you your optimal result.  A tummy tuck procedure typically takes approximately two hours with a 2 to 3 week recovery period. Best wishes.

Loose skin after gastric sleeve surgery - Am I a tummy tuck candidate? (Photos)

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