70, fit, BMI 21, tummy tuck & past lipo, I don't know if I should have muscle tightening? (Photos)

Hello @Firstkitty, thank you for your question. To make an informed recommendation, more information is needed. A consultation is vital to establishing a surgical plan that meets your needs, meets your expectations, and takes into account what is possible. Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS),International Federation for Adipose Therapeutics and Science” Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP)

Thank you for your question about getting a tummy tuck after having liposuction in the past. Age should not be a barrier to plastic surgery, and you seem to be in good health based on the information and pictures.
Before proceeding, a thorough evaluation of your health is essential, including blood tests, an EKG, and a chest x-ray. Assuming you are medically healthy, a tummy tuck with muscle tightening (muscle plication) is possible, which can address your concerns about the abdominal wall and excess skin.
Your previous liposuction should not be a major issue for experienced plastic surgeons. The tummy tuck procedure can remove some skin, and a scar will remain near the previous belly button site. Alternatively, you may consider a floating belly button procedure.
Ultimately, most of the tummy tuck results come from the muscle repair, so if the abdominal wall and excess skin bother you, a tummy tuck could be a suitable solution.
Best of luck in your decision-making process!
Sincerely,

Hello, previous liposuction should not cause any difficulty whatsoever especially after 20 years. Your plastic surgeon should be able to tell you if there is any portion of the fat layer that is inconsistent as this might be noticeable after surgery, but unlikely to occur. Your photos show that you are pretty flat on the upper portion of your abdominal wall but most patients will have a muscle separation that can also be tightened during the surgery. Best of luck.

Hello!

Your contour and your laxity in below your umbilicus indicates you are a great candidate for an abdominoplasty- a surgeon well versed in secondary surgery should be able to minimize any issues from your liposuction surgery. Any procedure causes scar tissue- you scar on the inside just like you scar on the outside. Many surgeons are reluctant to operate on prior liposuction candidates for fear of not being unable to discern the proper tissue planes to dissect as well as any residual deformity from your liposuction after the abdominoplasty.

Be SURE to see a surgeon well versed in secondary surgery such as this.

I hope this helps

Based on the photos you appear to be an excellent candidate for a tummy tuck. The muscle tightening would help the cosmetic result but does cause pain and increased downtime.

Thank you for your question. You are a candidate for a tummy tuck with muscle repair. The main consideration is old liposuction-related fibrosis, which can limit how smoothly the upper flap redrapes and slightly increase the risks of contour irregularity and seroma. However, this is manageable with careful adhesion release and preservation of vascular planes. Muscle repair will be performed if a true diastasis is confirmed during your examination (or ultrasound). Set expectations for a "flatter and smoother" appearance, not perfectly taut, due to age-related skin elasticity and scarring. During your consultation with a board-certified surgeon, he will confirm diastasis, map tethering, plan the incision and flap strategy, and decide whether to add limited liposuction.

Hello, thank you for your photos and questions. Your concerns are very understandable, especially given your health-conscious background and your doctor's comments. Liposuction, especially if done years ago and multiple times, can cause scar tissue to form in the deeper fat and connective tissue layers. However, based off your photos I would suggest you have a Tummy Tuck with repair to the muscle wall to get a better result and smoother look of the abdomen. Best of Luck!

Thanks for your question! You do have scar tissue from the liposuction, but I do think you can still get a nice result with a tummy tuck. Based on your photos, I would say yes to the diastasis repair. Good luck!

Thank you for providing this background — your question touches on an important but often overlooked detail in abdominal surgery planning.
Having liposuction 20 years ago can indeed leave behind scar tissue (fibrosis) beneath the skin. This fibrotic layer may reduce skin elasticity and make it harder for your surgeon to achieve even tightening or smooth contouring during a tummy tuck. It’s not uncommon, but it does add some complexity to the procedure.
Your surgeon is likely being transparent about managing expectations: • Skin may not redrape as smoothly as in someone without prior liposuction. • Some firmness or contour irregularities might remain despite a technically sound surgery.
That said, plastic surgeons routinely work with post-lipo scar tissue, especially in secondary or complex cases. It doesn’t automatically disqualify you as a candidate — it just means more meticulous dissection and realistic expectations about the final result.
Regarding muscle tightening (rectus plication), this depends on your abdominal wall tone. If your core muscles have separated (diastasis recti), tightening may enhance both function and appearance. However, if you’ve never been pregnant and have a strong core at BMI 21, your surgeon may determine that plication isn’t necessary — or only needed minimally.
You’re not alone in this scenario, and many patients with similar backgrounds go on to have successful results. A second opinion can help clarify if your current plan is the best fit.
— Op. Dr. Güray Yeşiladalı | Vanity Cosmetic Surgery Hospital

Thank you for your question and photos. I have performed many tummy tucks on women who previously had liposuction to their abdomens. Many women have poor results following liposuction, and a tummy tuck will release the scar tissue. This will improve your contour, and significantly smooth many irregularities caused by liposuction. This is a fairly common problem that can be corrected with a tummy tucki.