40 year old man, Asian descent. Lipo and Renuvion 5 years ago. Will I benefit from a tummy tuck or further weight loss? (photo)

Dear Improvement2019,

congrats on the weight loss! 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.

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

Hello, and thank you for your question regarding whether you would benefit more from further weight loss or a tummy tuck. Given your age and history of previous liposuction, it’s likely that most of the fat from your abdomen has already been permanently removed. Because of this, further weight loss likely won’t result in much additional change to the appearance of your abdomen. In cases like yours, most experienced, board-certified plastic surgeons would agree that a tummy tuck—or abdominoplasty—would be more effective than trying to lose more weight.

During a tummy tuck, the abdominal muscles (specifically, the rectus abdominis) are tightened to help flatten and firm the abdominal wall. Next, the excess abdominal skin and fat are removed, and finally, a new belly button is created. Since you've already had liposuction and the fat has been permanently eliminated, there’s little remaining fat to target with further liposuction or weight loss. However, what you do have is loose, excess skin—and that’s exactly what an abdominoplasty is designed to correct. For that reason, a tummy tuck would provide you with the most significant aesthetic improvement at this point.

If you have additional questions about procedures like the panniculectomy, extended lower body lift, 360 circumferential lower body lift, belt lipectomy, or belt abdominoplasty, please reach out to an experienced plastic surgeon. These are major procedures, and it’s essential to choose a surgeon who is board-certified and has extensive experience in body contouring after massive weight loss. Make sure they’ve performed at least 100 of your desired procedures and can show you before-and-after photos of their work. Be sure to read patient reviews on platforms like RealSelf, and if you’re unable to find a qualified specialist in your area, consider traveling to get the results you deserve.

Sincerely,
Dr. Katzen
(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, International College of Surgery, and American Board of Metabolic and Bariatric 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.)

The single photo shows some fullness between the pubic region and the belly button. It is difficult to know whether this represents an excess of fat, skin or both. If fat, liposuction can thin the fat to reduce the appearance of fullness. If it is more of a skin excess, you can have a procedure that just removes an area of skin above the pubic area which will flatten that area of fullness above. I often do this in the office with local anesthesia which is extremely effective for this type of procedure and allows you to avoid the costs of an operating room and anesthesiologist.

I think a full or traditional abdominoplasty would be more than you need considering the appearance of the abdominal wall above the belly button. Best of luck.