Need tummy tuck to address asymmetry - 240lb, BMI 36 (photos)

Thank you for your question regarding what to do with your tummy to address the asymmetry, being 240 pounds with a BMI of 36. Thank you also for your question regarding what to do with your abdomen and upper skin folds. The way I see it there are three issues. It would be ideal if you could lose more weight. That will eliminate more fat and lead to a better outcome. However if you cannot lose any more weight I would suggest surgical options. There are two areas of concern. First, your abdomen and the skin rolls that you are holding underneath the brawl line. In regards to your tummy, I would suggest a horizontal tummy tuck which means the incision is placed in a horizontal fashion and the tummy is flattened. Excess skin inside of the abdomen is permanently removed and the pubic region is raised, reduced, and the abdominal muscles are placated and flattened. The skin rolls that you hold underneath the bra are not necessarily your abdomen. They are your torso. These can be removed with a torsoplasty. During a torsoplasty, an incision is made across the back to eliminate those roles of fat on your back. That incision would be then carried out underneath your breast and the rolls that you are gripping in the first picture are permanently eliminated. If you cannot deal with a vertical scar across your back, I understand. If you cannot deal with that scar then I would suggest a vertical torsoplasty with an incision from the armpit down the side of your chest. The incision would then extend past those skin rolls perhaps even to the waist to eliminate those rolls in a vertical fashion. Therefore, in my conclusion, you need a horizontal abdominoplasty or tummy tuck as well as either a horizontal torsoplasty(ideal) or a vertical torsoplasty. I hope this helps to answer a question regarding what to do with your tummy tuck to address asymmetry. Thank you and good luck.

Sincerely, Dr. Katzen. (“Verified” 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 and RealSelf Hall of Fame.)

It is recommended for you to first reach your goal weight before considering a tummy tuck. This will give your surgeon the opportunity to maximize your results. You mentioned that you do not want a fleur de lis incision, but it is the best way to address the loose skin. A back lift can best improve the excess fat and skin on the back.

Thank you for your questions and photos. From your photos, you would be a good candidate for a tummy tuck with liposuction. A tummy tuck will address excess skin & repair of the abdominal muscle. The abdominal wall can be weakened after pregnancy and (or) significant weight gain & loss. By repairing the muscle, not only does the appearance of your abdominal area improve, but your core strength as well. The repair of the muscle will cinch your waist like an inner corset, which will accentuate your curves. Liposuction will remove excess fat from unwanted areas with some skin retraction. Your expectations and health will dictate the best procedure(s) for you. I suggest a consultation with a board certified plastic surgeon to go over the options that best address your goals. Best of luck!

Dhaval Patel MD
Double Board Certified Plastic Surgeon
Chicago
South Barrington
Oakbrook
Orland Park

Dear One in aMilli,
generally speaking, you want to reach your goal weight before you consider a tummy tuck, otherwise your results will be suboptimal if you continue to lose weight after the surgery. 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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Congrats on the weight loss! No, a regular TT won't address those rolls. I don't even think a flour de lis will. You wounld need a separate excision along your upper back which could be incorporated into a brachioplasty (see extended brachioplasty).