Tummy tuck, FDL, LBL and loose skin remaining - will a revision fix this? (Photos)

Thank you for your pictures and questions. Often times, skin that has been stretched from weight gain tends to be of poor quality and more prone to stretching over time. Not sure how long ago you had the surgery, but even if the skin was tight after surgery, it can tend to loosen more over time. In addition, any loss of additional weight after surgery will often result in a return of some of the laxity. Unfortunately gravity, age, and time never stop. That being said, I do think that some revisions in the areas you have shown would create significant improvement and an overall better result. Make sure you consult with a board certified plastic surgeon with experience with massive weight loss body contouring procedures.
Best of luck!
Dallas Buchanan, MD
VIVIFY plastic surgery
Tampa, FL

After body contouring surgery, it is very common for the skin to be initially relatively tight and then have some degree of relaxation, as the skin has lost some of its strength and elasticity. If your surgeon tries to make the initial repair very tight, there is a risk of poor wound healing, and this is not a good option. Revising your areas of loose skin should help improve your already good result.

Dear Forceful4906,

I understand your concern. However, without a proper assessment, it would be difficult to determine what is 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

Unfortunately, in your photographs you have not shown your breasts. There is a breast lift technique called The Bellesoma Method that will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. This technique also pulls up the upper abdominal skin and will help with the excess abdominal skin. You would also benefit from scar revisions.

Best Wishes,

Gary Horndeski, M.D.

Yes. There is skin redundancy and laxity of the lower abdomen, The abdominal wall can be tightened below the umbilicus, the lower excess abdominal skin removed appropriately, and a reverse tummy tuck to tighten the upper abdomen could be done at the same time, if necessary, or as a later secondary procedure. Since you already have a midline scar, the umbilicus could be freed and the flap dissected as in a primary tummy tuck, pulled down, and any residual umbilical donor-site hole sutured in the midline in continuity with the fleur-de-lis scar. The decision would be made in an in-person consultation to see what might work best.

Congratulations on your impressive weight loss! From the photo it does appear you could achieve better results with further contouring. An examination is needed to determine if liposuction alone would be adequate or if a revision to the tummy tuck is recommended. See a board certified plastic surgeon to learn more.

Based on your post of photos, I recommend an impersonal virtual consultation to discuss revision that is needed. Expect fee to arrange from $10,000-$25,000. Again, best of virtual consult with.