Should I be disappointed yet? Will a revision help? (Photo)

I am 48 years old , no children , lost about 125 pounds. 4 weeks post op with no muscle repair Ps said not needed. I am still a little swollen, more swollen than during week one) said she left fat for fat transfer to breasts reconstruction due to cancer)There is still so much loose skin while sitting and especially when bending over, pubic mound also seems huge. When lipo is done it will look worse. If a revision is possible and necessary cost will be another factor

Doctor Answers 10

1 month post op, some advices:

Thank you very much for sharing your concerns with us. At this point (1months post-po) the swelling is normal. To reduce it, I recommend you perform daily lymphatic drainage massage therapy over the abdomen and wear a postoperative girdle from thigh to the breasts. If the fter six months post-op, I recommend you send us your photos again, to give you more information about how we can solve this problem. Kind regards, Dr. Emmanuel Mallol Cotes.-

Dominican Republic Plastic Surgeon
4.7 out of 5 stars 147 reviews

Post-Op Swelling

Swelling can persist for several months and will gradually improve and will look better at three months, six months, and even one year. Frequently the pubic area and the scrotal and penis area for men can become very swollen and discolored during the first two weeks due to gravity as this is the lowest area for swelling to accumulate.The only thing to keep any eye out for is the remaining loose skin, and I think that after some more given time for full healing this would be a good discussion with your surgeon if you are unhappy with the results. I wish you all the best!

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 94 reviews

Post op

give it 6 months before contemplating revision.  normal to be more swollen now.   I always do a muscle tightening. I look at it as if you had a 125 lb pregnancy. rhe other thing is that you did not lose weight in only one dimension ... you may need a vertical scar to remove extra skin

Jonathan Saunders, MD
Newark Plastic Surgeon
4.7 out of 5 stars 59 reviews

Redo tummy tuck

Dear bklyn,                                                                                                                                                               Thanks for submitting your pictures and sorry for your disappointment. From observing your pictures, I would have recommended originally, to tighten the muscles as well. That would have prevented the pubic protrusion, given you  narrower waists and most likely would have helped you to lose additional weight, since the muscle tightening would have reduced the amount of food that you can eat and your sense of hunger. 6-8 weeks after the tummy tuck or later, you can have liposuction of the hips, waists, flanks, abdomen, lower chest and pubic area. That procedure will thin down dramatically your skin and tighten it noticeably. However, the procedure has to be done by an expert who will make multiple entry incision to remove as many fat cells as possible and as evenly as possible. Otherwise the fat can come back and the skin will not be tightened optimally.                                                                                                  So, you will have to think it over carefully, whether you want to redo the tummy tuck (wait at least 3 months) or just do liposuction.                                                                                                                                  Always, consult with experienced board certified plastic surgeons, who operate in accredited surgery center for your safety. Most importantly, check the before and after pictures, to make sure that they are numerous, consistent and attractive  . Also, check the reviews on 'RealSelf' for ratings and positive experience reports.                                                 Best of luck,                                                                         Dr Widder

Disappointed yet? Will a revision help? (Photo)

thank you for the question and the photos. It is difficult to answer your question without examining you. However from looking at the photos provided you may benefit from a vertical excision of this sagging skin that you have. People who have lost as much weight as you have sometimes require a Fleur de lis abdominoplasty. It is best to discuss this with your board-certified plastic surgeon. Good luck.

The choice is yours

You definitely appear to have some abdominal skin laxity and may want extra skin removed in the future. Please, keep in mind that after such a large weight loss and based on possible medical circumstances, your surgeon may have had a good reason to be conservative performing the procedure. That is something to discuss with him, as he can explain his approach best. For now, let yourself heal properly. That should be your priority. The fact that you are more swollen now than a week after the surgery concerns me a bit. A seroma (a fluid collection under your flap) may be causing it and should be removed. This would be more common in someone with a large weight loss. Your surgeon can examine you and let you know, if one is present. Serial aspirations with a needle resolves it in most instances. It is not a painful process.

Nicholas Nikolov, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 5 reviews

Before pictures would have been helpful

I guess you had a lot of improvements based on the amount of weight loss but the results do not meet your expectation. You can have revision but it will involve vertical incision to remove the excess skin. Please discuss your concerns with your surgeon. 

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.7 out of 5 stars 110 reviews

Should I be disappointed yet? Will a revision help?

Thank you for sharing your questions and photographs and I am sorry that your current results have not been what you anticipated. It is difficult to judge your photographs without a before image but it appears that you have obtained a nice result after tummy tuck surgery.  It is not clear what discussion you had with your surgeon about your desired results and anticipated staging of procedures, but with the excess tissue of your abdomen the only way to address this would be through a revision procedure that includes a vertical incision from your breast bone, around your navel, and to your current tummy tuck incision to remove the horizontal skin excess that your pictures demonstrate.  Allow your current results to mature until the skin has returned to normal (about 6 months) before entertaining the need for the next step of your body contouring. Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 38 reviews

Should I be disappointed yet? Will a revision help?

My first issue is after 3 postings no before photo posted so we can compare the early result obtained???? I bet it is a marked improvement. So my guess is your expectations might be unrealistic? Please post a before photo.....

Massive weight loss patients

Hello.  Thank you for your sharing your question and photos.  Massive weight loss patients often have a lot of sagging skin. For that reason a good plan of surgery should be done in order to resect as much as possible of tissue.   Maybe in the future you'll need a revision to resect the excess of skin. Consult with a certified plastic surgeon in your area.  Best of luck. 

Derby Sang Caputo, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 58 reviews

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.