Hanging Skin 4 Months Post-Tummy Tuck

I think you prabably received the wrong operation - you clearly have global horizontal and vertical abdominal skin laxity- your TT only treated the laxity in the 'up-down' direction, and not the laxity in the 'side-to-side' direction. A Fleur de Lis abdominoplasty results in a horizontal scar (which you have) and a vertical scar (which you need). I would have recommended a Fleur de Lis patterned tummy tuck.

The most common reason is that there is inadequate removal of skin. You usually have to wait six to nine months to see the final result. At that time, one can easily excise more skin in the supra pubic area if needed. To prevent this from occurring, it is prudent at the initial operative procedure if performing a full tummy tuck to remove as much of the skin from the supra pubic area to the umbilicus so that it is somewhat tight upon closure with the patient flexed. The patient will be able to walk without being flexed in about 3 - 4 weeks.

Your surgery is likely the best that your plastic surgeon could do at the time.  He was likely looking out for what was best for you but it does appear that you'll be needing a more aggressive second procedure to re-tighten.  Stick with your board certified plastic surgeon (or switch to one) as he will know what the proper steps to correct things are and at a second stage your tissues will tolerate the procedure easier.  Good luck

IT is not really fair to assess the results of a tummy tuck by bending 90 degrees at the waist and expecting it to be tight. This doesn't even happen in an 18 year old. Having said that the problem is that your skin was removed using a horizontal incision to conceal the scar and you have so much skin that could be removed with vergtical incision which can leave an undesireable and visible scar. The choice is up to you.

If you only had a baby four months ago, it is probably too early to consider abdominoplasty. If you are 20 years old and plan on having additional children, I would wait on having a tummy tuck until you have all your children.

Regarding: "Hanging Skin 4 Months Post-Tummy Tuck
I had a full tummy tuck 4 months ago. I have had 4 c-sections, a hysterectomy, and lost 150 lbs in the last 5 years. Leaving a lot of excess skin. However, after a full TT I expected to have all the hanging skin removed. I still have two pouches one on either side of my belly button and when I bend forward I have several inches of hanging skin. Is this normal and what should I do about this I am not satisfied."

Everything in life is PERSPECTIVE. I don't think you had realistic expectations of what a standard (horizontal scar) Full Tummy Tuck can do. Plastic Surgery is similar to golf and Poker in that we have to play the ball from where it lands and play the hand dealt to us. Your surgeon did an admirable job for you. Judging by where you started, you have a VERY nice result with a flat tummy where the excess skin is visible only when you bend over.

Yes- the result could have been flatter if he significantly prolonged the operation by adding a vertical midline scar which would preclude you from wearing certain fashions. But, the fact is we do it uncommonly and only after making sure our patients are aware of the permanency of the scar.

Further flattening at the cost of such as scar can be done as soon as you are ready.

Dr. Peter Aldea

Thanks for the posted photo series. A very conservative TT to say the least. Revision is in your future plans I assume? From MIAMI Dr. Darryl J. Blinski

You appear to have had a tremendous improvement in your abdominal contour and should be quite pleased.  You should expect some skin relaxation in the months after your surgery and certainly loose skin when you bend forward at the waist. You may benefit from a revision with skin resection and tightening in the vertical dimension, however this will leave you with a vertical midline scar. That is the trade off.

Even after a  tummy tuck you can not expect the skin to be so tight that you can bounce a quarter off of it especialy when your skin has poor elasticity. Be that as it may, you may wan tot combine a vertical excision to narrow the wasit, because the expansion you underwent is in all dimensions as evidenced by your post-op result 

Perhaps your plastic surgeon was trying to avoid a large vertical scar and gave you a lower abdominal scar.  In any case, the loose skin is from the very large amount of skin you had following your weight loss.  If you to be very tight, then a vertical scar is what you will need.