I lost a lot of weight (from morbidly obese 2 anorexic in 6 weeks) 20 years ago. I have tried two lipos and didn't help much but to make my stomach look horrible, skewed, and damaged. The skin around from under my chest to above my genitals and flanks are super lose. I exercise a lot and am 105kgs at 1.9m (but quite muscly too) - so overweight but not much. The lose skin is upsetting. Do I do a normal or extended TT? In an extended TT, does the patient get flipped over?
Is Extended Tummy Tuck the Best Way to Go? (photo)
Doctor Answers 15
Extended Tummy Tuck?
The situation you describe happens very frequently. Liposuction is often performed as an alternative to tummy tuck because the incisions are so much smaller with liposuction. The problem is that liposuction is designed only to remove extra fat and not to remove extra skin. Tummy tucks on the other hand are designed to remove extra skin in addition to the extra fat. Patients like your self who have lost a lot of weight are usually better served by a tummy tuck than liposuction because it will get rid of that loose skin that appears to be bothering you in the pictures.
Your question of whether or not you should have an "extended" tummy tuck or a standard one depends upon how your surgeon defines "extended". For some surgeons this means simply extending your tummy tuck incision out on to the hips a little further than standard. This would help you with the skin in the hips area. For other surgeons, an "extended" tummy tuck includes an incision that goes all the way around your waist to the back. I would need to examine your extra skin in the hip area to give you a definitive answer but based on the pictures you have submitted, I do not think you need to have a tummy tuck extended all the way around to the back. Best of luck.
Physical Exam Is Important
We frequently see women who have concerns about the appearance of their abdomen. Many of these women present because of the effects of pregnancy, massive weight loss, over eating, or lack of exercise. Most of them have tried diet and exercise and despite this, have been unable to solve their problem. When redundant abdominal tissue is present, abdominoplasty surgery is usually always indicated. It’s important to realize that this procedure needs to be tailored to meet the patient’s specific needs.
In your case it’s virtually impossible to make a specific recommendation without performing a physical examination. However, it is safe to say that your pictures demonstrate a significant amount of loose saggy skin and that some type of abdominoplasty will be necessary to correct the problem.
The specific surgical approach will depend upon the physical exam. If the roll of redundant abdominal skin extends posteriorly into the flank area an extended abdominoplasty is probably indicated. In some cases where the roll extends into the back, correction of the problem may even require circumferential abdominoplasty.
If you’re considering abdominoplasty surgery, consultation with a board certified plastic surgeon is appropriate. This surgeon should be able to formulate a treatment plan that addresses your anatomic findings and achieves your aesthetic goals.
Tummy Tuck would be best
It appears that you have a significant amount of excess skin, which liposuction does not affect. An extended tummy tuck will remove more of the excess skin and give you a better contour.
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Extended Tummy Tuck
If the skin laxity extends to the sides, then an extended tummy tuck may be appropriate. I only extend the scar as long as the skn laxity is an issue.
An Extended tummy tuck might be the correct procedure for you.
An extended tummy tuck would be a nice option for what you are seeking. The extended allows removal of the loose skin on your sides by extending the incision, whereas a normal tummy tuck has a more limited incision. It depends how far along the sides, toward your back the incision would need to go to decide if you would be turned on the operating table. This is best determined at consultation and is difficult to ascertain through pictures. Both techniques will give you the additional benefit of muscle tightening, although your muscles appear to be rather tight to begin with! Most importantly find a board certified plastic surgeon that you feel comfortable with and has experience with extended tummy tucks. Good luck!
The more laxity that you have the longer the incision will be for optimal correction
Thank your for the question and the photos. There is not right or wrong answer. Simply put the best result will be the proper and full correction of all of the laxity of your waist. The amout of laxity will determine the length of the incision. An extended tummy tuck is essentially just and incision that is made as long as possible without flipping the patient over onto their front.
All the best,
Dr Remus Repta
Extended Tummy Tuck the Best Way to Go?
I think your best bet is a circumferential lift, some times called a belt lipectomy, which is a tummy tuck with extension all the way around the back. There really is no alternative way to get the excess flank and back skin off along with the tummy tuck.
Thanks and best wishes.
Ultimate Tummy Tuck
I recommend a new technique called Ultimate Tummy Tuck. Using this technique, it is possible to restore the strength to your abdominal wall by reinforcing the fascia with mesh. This will help you lose weight and maintain the reduced weight. Since you have already lost a large amount, it would be best to prevent it from returning. The incisions are the same as the standard incisions and extensions are not necessary. There are recent articles published in Plastic and Reconstructive Journal describing Abdominoplasty with Mesh Reinforcement.
Gary Horndeski, M.D.
Extended abdominoplasty is indicated when there is signifcant horizontal as well as vertical skin laxity.
The pictures are a bit difficult to judge, but I really don't think an extended abdominoplasty is indicated in this case.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.