What caused pockets of skin on love handles? Should I get a revision? (photos)

Question

7/31/21 surgery. Looked good post op for several months. Never have quit wearing the shapewear garment even. But 8 months & $12k later, I can’t even tell..

Raffy Karamanoukian, MD, FACS · Answer

Abdominoplasty scars can be quite complex, ranging from the simple hypertrophic scar to a multiplane inflamed keloid. Pigmentation, discoloration, chronic inflammation, scar visibility can all occur in the short term. We begin each treatment with combination therapy using Yellow broadband BBL, Vbeam, fractional erbium, intralesional IIT, and scar modulation. Start with a combination of Plato's Scar Serum massaged twice daily after one week of epithelialization followed by Luminase/Exfolase. Scar consultation and revision may be recommended.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Zoran Potparic, MD · Answer

Unfortunately, we occasionally see similar delayed result of poor skin laxity after extended TT in patient who had significant weight loss; their skin is stretched and elasticity is minimal. Although result may look good immediately after surgery, it does not last for a long time in particular if there is a lot of residual fat deposits. Performing aggressive liposuction before TT may be good way to avoid this. In your case, both liposuction and revision of TT (including vertical skin removal ??) may be needed. Good luck.

Daniel Barrett, MD · Answer

Dear TexanAF,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

From your photos it appears you would benefit from further skin excision and liposuction of the hips and flanks.  This should help improve the overall contour.  See a board certified plastic surgeon to discuss your options.

Douglas Taranow, DO, FACOS · Answer

It appears that you need revision aggressive liposuction of your flanks/lower back.  The anterior abdomen would look significantly better with a Fleur-de-lis abdominoplasty.
Dr. Taranow

Mats Hagstrom, MD (license on probation) · Answer

It’s difficult to make an assessment based on the information presented.

We typically rely on standard before and after pictures. If you don’t have the ones your surgeon took then you should ask them to forward those.

The one thing that stands out is your full length midline incision in your before picture.

Was that scar excised as part of your tummy tuck?

If it wasn’t than that probably explains most of the issues regarding the outcome.

A midline full length scar is going to have no pliability and behave like a string. The unscarred tissue around it will be flexible with lots of elasticity.

Normally during a full tummy tuck anywhere between six and 10 inches of skin of the lower abdomen are typically removed.

If there’s a rigid scar that isn’t removed and that scar will inhibit how much skin can be removed during the procedure.

If your midline scar was not redone or excised as part of your procedure and that is probably the main culprit.

If it was taken out and redone then you’ll need to have a few in person consultations which you probably will need regardless to get a good assessment about your outcome.

For a quality second opinion consultation be prepared with all your before and after pictures and a copy of your operative report. These are all part of your medical record that you can get from your current provider by simply requesting.

Bring those with you and let another plastic surgeon do an assessment with an examination and review of the operative report and pictures and you should get a much better understanding of why your results look the way they do.

With limited information we can’t really give you a quality assessment and without an assessment it’s hard to give a good recommendation.

Good luck,

Mats Hagstrom MD

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