70 pound weight loss - would smart lipo help or would a tummy tuck be necessary? (Photos)

Question

31 year old female, 5’3, 142 pounds, no children, recent 70 pound weight loss. I am close to my goal weight. However, my abdomen has been stubborn when it comes to fat loss. I carry my weight in my midsection. I have been incorporating more ab exercises into my regimen, without much success. Would smartlipo be an option or would that just make my skin looser once the fat is removed? I don’t want to look worse and regret it. I have read there is some skin tightening benefit, but I’m unsure if it would be enough. The downtime, recovery, and large scar from a tummy tuck isn’t ideal. But if SmartLipo isn’t the best plan, I’d rather wait until I can take time off work and recover from a tummy tuck. I have seen that once recovered and healed there is some scar tattooing available if I am concerned about the tummy tuck scar appearance if I go that route. Thank you for any guidance!

Finny George, MD · Answer

Hi, thank you for sharing your question. Liposuction alone will not treat the skin laxity. If you wish to achieve the optimal results and remove the excess skin, a tummy tuck procedure is best.

Warren Schutte, MD · Answer

Congratulations on your weight loss. I would highly recommend putting your investment into a laterally hip extended abdominoplasty. This will correct all skin laxity and allow for muscle repair.

Vasileios Vasilakis, MD, FACS · Answer

Hello,
Thank you for the question. Congratulations on your weight loss! You will not be able to exercise loose skin. You will need to address this surgically through an extended tummy tuck or a body lift (360 tuck).
I wish you the best. 
Vasileios Vasilakis, MD, FACSDouble Board Certified Plastic SurgeonHouston, TX.

Paul M. Parker, MD, FACS · Answer

Congratulations on your weight loss journey! You must feel like a different person. The loose skin you have can only be effectively removed with a tummy tuck. Any type of liposuction alone would remove some of your fatty tissue beneath the skin and exacerbate your sagging skin. Find an experienced board certified plastic surgeon near you who does a lot of tummy tucks. We typically conceal the scars beneath revealing clothing and close the incisions very carefully so the scars heal quite well--certainly a positive trade for removing all that loose skin. Good luck!

Jacob Carlson, MD · Answer

Congratulations on your significant weight loss - that is no small feat. With the amount of loose skin and degree of skin laxity that appears in the pictures your submitted, I think you are going to get a far superior result with a tummy tuck than with any skin tightening modality that is available. Liposuction is great at removing fat from the body, but it doesn't do much to help the skin contract back down afterwards. Even if you were to add a skin tightening procedure (e.g. Bodytite, J-plasma), it would not tighten the skin enough to compensate for the weight that you have lost and/or the fat that is removed with liposuction.

Daniel Barrett, MD · Answer

Dear heatherlane05,

based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. Flanks liposuction would give you a better shape. I would suggest you to consult a board-certified plastic surgeon because only after a thorough examination you will get more information and recommendations.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Ramiro Morales, Jr., MD · Answer

Thank you for your pictures and questions.  Congratulations on your 70 lbs weight loss.  As for your abdomen, SMART lipo would not be a good idea at all.  The majority of your issue on your abdomen is significant skin excess that would only be correctable with a tummy tuck. As I tell my patients, just like your clothing didn't shrink after the weight loss neither did your skin.
 Do not fall for other modalities that promise to fully tighten your skin because it won't work and could make things worse.  Be sure to see a Board-Certified PS for your consultation.

Ira H. Rex III, MD · Answer

From your photographs, it seems you are not even a candidate for smart lipo.  Probably your best way to proceed is to see a board certified plastic surgeon.  After an appropriate exam, I think a tummy tuck would be recommended, and you could expect a very nice result.  Good luck with things.

Harry T. Haramis, MD, FACS · Answer

Unfortunately, after massive weight loss loose skin can be a concern and persist after Smart Lipo.

Extended tummy tuck would give best results for your entire abdomen and waist. Sometimes, muscle repair is not necessary which would shorten recovery time.

An exam and consultation with a plastic surgeon is recommended to confirm this as well as further discuss your best options and expectations.

Steven S. Carp, MD · Answer

Based on the photo and history of significant weight loss, a tummy tuck is the best option.  Any type of liposuction alone will not address the skin issue .  I see many patients that take the short cut with liposuction from another provider, who are unhappy and then have the additional expense of a tummy tuck to address the skin issue, and the diastasis.

70 pound weight loss - would smart lipo help or would a tummy tuck be necessary? (Photos)

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