The skin on my mid section still has significant laxity. Did my doctor mess up my Body Lift surgery?

Congratulations on your massive weight loss. In addition, congratulations on undergoing a 360 lower body lift. Thank you for your pictures. A more informative picture of your abdomen, would be a picture of your abdomen while standing straight.  I imagine your abdomen is flat when you are standing.  If your abdomen is not flat when you are standing, then you may be a candidate for a 360 lower body lift revision.  If the skin and fat can be pinched horizontally or parallel with your belt line, then you may need a revision by resecting  skin and fat removed through your bodylift incision. If however your abdominal skin and fat can be pinched only in a vertical fashion or perpendicular to your belt line, then I would suggest an incision from your sternum to your pubic region. This is often called a vertical abdominoplasty or tummy tuck.  Typically, after a 360 lower body lift, if there is excess upper abdominal fat I perform this vertical abdominoplasty.   I do not believe liposuction alone will significantly improve your condition.

It is not possible to say your surgeon messed up.  I like to give them the benefit of the doubt.  What I am curious about is how tight it looked at 1-2 weeks.  Every patient that I see with massive weight loss (MWL) gets informed that they may need a secondary surgery to retighten the loose skin.  When you put on significant weight you damage the skin and the elasticity is lost.  At the time of your initial surgery this will get pulled tight but it often relaxes.  A secondary surgery to retighten should not be seen as a failure in this setting but rather a consequence of the weight gain.  It is a simple fix and one I would encourage you to discuss with your surgeon as you will be way happier with the result after.  Incidentally, it is not likely (but not impossible) to happen again.  I don't think that any amount of exercise will ever correct the problem on its own.Rodger Shortt, MDPlastic Surgeon Oakville

     This is really difficult to evaluate without seeing pictures of you standing up or examining you in person.  It is also helpful to see preoperative photographs as well.Kenneth Hughes, MDLos Angeles, CA

Thank you for your question.I tell all my weight loss patients that recurrence or persistence of laxity is the rule and not the exception. This is normal. It is not realistic to expect the body skin to be completely snug and tight at all times after a body lift.  The skin has lost its elasticity and will inevitably sag some after the swelling of surgery goes away.It can be improved upon by going back a second time to get more but this is not the fault of the surgeon. This happens predictably.  Knowing the possibility of a second procedure on the front end, makes it not a surprise on the back end.



To be sure, see two or more board
certified and experienced plastic surgeons in your area for a full and complete
evaluation.



I hope this helps.

It appears from your photos -- if these are in fact your post-operative Tummy Tuck photos-----that the lift leaves a little to be desired. I would like to see this roll of skin and fat completely removed and a much flatter abdomen.

From
your photographs it appears that you still have excess abdominal skin.  This is very difficult to get rid of with
only exercise, and liposuctioning of this area will exacerbate the sagging
skin.  I would recommend that you speak
with your plastic surgeon again to discuss a revision abdominoplasty.  If he or she is not willing to help you, then
I recommend that you consult with a board certified plastic surgeon to help
you.

I would think your plastic surgeon would respect your assessment that some more skin could be removed. I do not believe liposuction or exercise would be sufficient in this case to get your abdomen flat.

If these are your recent post operative photos then you obviously have redundant abdominal skin and fat. This can be removed by a repeat abdominalplasty (tummy tuck)Since you already had a lower body lift you may have lost weight since the surgery which could account for the loose skin. Unfortunately when you do a body lift you can not get both the abdominal skin and the back skin as tight as you can when you do them separately. That is why I do a tummy tuck first and a lateral thigh and buttock lift 6-12 months later. When you do the tummy tuck by itself you can bend the patient over and pull the skin much tighter than when you do a lower body lift. Unfortunately liposuction, exercise and diet will not tighten the skin.