Failed tummy tuck. What would you suggest to fix this? (Photo)

Question

Hi, I had a tummy tuck surgery in November 2020 and it is fine when I sit but when I stand and bend it is very bad. I need a surgeons opinion if it should be a reverse abdominalplasty or it should be tummy tuck or a fleur de lis. I lost weight 1 stone (new medication for migraine) between the tummy tuck and now and the surgeon never did muscle repair apparently my muscles looked ok even though I lost 77kg so now I’m left with the stomach skin. Please could you tell me what you would all suggest?

Daniel Barrett, MD · Answer

Dear Sensible47230,
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

Leyla Arvas, MD · Answer

Hi, its better to make a consultation and decide after that. But in my opinion after loosing weight your skin get loose. May be you can ask your tummy tuck surgeon what to do. I think that second tummy tuck needed, but for technique, deciding after a consultation is better.

Connie Hiers, MD, FACS · Answer

Your photos are not totally clear with clothing blocking some of the view. I would suggest going back to your surgeon and discussing your concerns.

Mats Hagstrom, MD (license on probation) · Answer

With that much weight loss you have lots of skin laxity.

It’s a little hard to make an accurate assessment based on a real self post.

Ideally we need before and after pictures and standard pictures showing the front, side and back in the standing neutral position with pictures taken about 8 feet apart by someone else or using the timer on your camera.

When patients have significant skin laxity from weight loss it is both in a horizontal and vertical direction.

Typically the most important thing is extending the tummy tuck to the backside for a extended or wraparound tummy tuck. Adding a vertical component with a fleur-de-lis incision leaves an ugly scar which should try to be avoided.

With that much weight loss you may simply have skin laxity in different body positions because the horizontal skin laxity is an addressed with a tummy tuck without a vertical scar.

Likewise a reverse tummy tuck leaves a pretty undesirables car. If scars don’t bother you then either one of those procedures may be appropriate but the decision needs to be made after an accurate assessment which requires an examination.

Patients who have not had previous pregnancies do not have muscle separation and do not need muscle tightening as a general statement.

Obesity typically does not create muscle separation.

Muscle tightening serves to make an even greater mismatch between the smaller body and the larger skin envelope and is not typically indicated in patients who only have weight loss without a history of previous pregnancies.

Your result looks excellent. Everyone is going to have skin bulges in a sitting position and with a 70+ kilo weight loss a normal  full tummy tuck is not going to get rid of all your skin laxity.

Follow up with your provider or schedule more in person consultations for the other local board-certified plastic surgeons.

To me your results looks excellent for someone who has lost that much weight.

Always post or bring before and after pictures from previous surgical procedures.

If you don’t have before pictures then ask your surgeon to forward the ones they took.

Best,

Mats Hagstrom MD

Failed tummy tuck. What would you suggest to fix this? (Photo)

Answers (4)

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