I have excess skin on my stomach. Would a Tummy Tuck without Liposuction or muscle repair give me the results I want? (photo)

I have excess skin on my tummy. Would I get decent results by just removing skin, with no lipo & no muscle repair? Before answering, please consider: 1) I don't expect to wear a bikini, ever; 2) I don't like when the tummy is strangely flat and all curves lipo'd away. I prefer full hips & small waist; 3) I don't want to spend $10-12,000 to look slightly better than I do now -- and in HI, that's how much I've been quoted for tummy tuck w/out muscle repair. Is it really "go full tuck or go home"?

Doctor Answers 4

Modified Tummy Tucks can work well

Thanks for your photo.  The excess skin is noted and your subcutaneous fat layer is appropriate for your torso.  So, a modfied tummy tuck by skin resection only may be considered.  The muscle sutures are indicated if you are found to have any ventral hernias or diastasis (separation) of the rectus muscles, but I cannot determine this by your photo alone without an examination.  If your muscle wall is intact and healthy, I expect your results from a skin resection tuck will be much smoother, but the degree of improvement can only be determine by further discussion with your surgeon regarding your goals.  

Modified Tummy Tucks can work well

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Thanks for your photo.  The excess skin is noted and your subcutaneous fat layer is appropriate for your torso.  So, a modfied tummy tuck by skin resection only may be considered.  The muscle sutures are indicated if you are found to have any ventral hernias or diastasis (separation) of the rectus muscles, but I cannot determine this by your photo alone without an examination.  If your muscle wall is intact and healthy, I expect your results from a skin resection tuck will be much smoother, but the degree of improvement can only be determine by further discussion with your surgeon regarding your goals.  

Dear Islegirl, Thank you for your question.

Abdominoplasty removes excess fat and skin and, in most cases, restores weakened or separated muscles creating an abdominal profile that is smoother and firmer. From your pictures it is not possible to determine how much your muscles have separated. This would be determined by physical examination. Even if the muscles are not separated, usually after child birth or as we age, they become weakened. The muscle repair helps to obtain a flatter surface to redrape the skin, therefore allowing a better result with more skin removed. It will also help give you a more defined and smaller waist, which is one of your desires. Think of it as an internal corset allowing for a firmer abdominal core.
A tummy tuck cannot correct stretch marks, although these may be removed or somewhat improved if they are located on the areas of excess skin that will be excised. Any below the umbilicus will be removed.
Liposuction does remove unwanted fat in most cases, but it is also used to help sculpt the contour of your body, rather than” lipo the curves away.”

My advice to you would be to have an evaluation for the muscle weakness, and consider it an important aspect of the abdominoplasty. It is important to understand expectations and outcomes associated with all aspects of the procedure before making a decision.

Sincerely,
Christine Blaine

Dear Islegirl, Thank you for your question.

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Abdominoplasty removes excess fat and skin and, in most cases, restores weakened or separated muscles creating an abdominal profile that is smoother and firmer. From your pictures it is not possible to determine how much your muscles have separated. This would be determined by physical examination. Even if the muscles are not separated, usually after child birth or as we age, they become weakened. The muscle repair helps to obtain a flatter surface to redrape the skin, therefore allowing a better result with more skin removed. It will also help give you a more defined and smaller waist, which is one of your desires. Think of it as an internal corset allowing for a firmer abdominal core.
A tummy tuck cannot correct stretch marks, although these may be removed or somewhat improved if they are located on the areas of excess skin that will be excised. Any below the umbilicus will be removed.
Liposuction does remove unwanted fat in most cases, but it is also used to help sculpt the contour of your body, rather than” lipo the curves away.”

My advice to you would be to have an evaluation for the muscle weakness, and consider it an important aspect of the abdominoplasty. It is important to understand expectations and outcomes associated with all aspects of the procedure before making a decision.

Sincerely,
Christine Blaine

Would A Modified Tummy Tuck Without Liposuction & Muscle Repair Be An Appropriate Alternative To A Full Tummy Tuck For Me?

When considering a tummy tuck, especially with the photograph you kindly allowed us to see, it's not really "go full tuck or go home", but rather "do it right, get the full benefit from the tummy tuck, or don't waste your time or money".

Tummy tucks are a mixed reconstructive/cosmetic procedure.  The tummy tuck, if done correctly, improves the appearance of your abdomen, but also repairing the muscles of the abdomen, decreases low back pain experienced by many post pregnancy women especially as they enter the mature years.  Multiple pregnancies lead to a problem with urinary incontinence, you laugh you pee, you cough you pee.  By pulling the vulva up which is part of a well done tummy tuck, you improve the angle of the urethra, therefore decreasing stress incontinence. 

Abdominal muscle repair not only decreases the abdominal girth, but also improves posture and gives the post operative patient an overall sense of having control over one's abdominal muscles (core). 

As far as liposuction is concerned, I personally break the abdominoplasty surgery into two pieces, first doing a full tummy tuck as tightly as possible without complications, and then secondarily after 3 months, do a no charge liposuction of abdomen which is, of course, optional to the patient.  I have also found that liposuction of the muffin tops or hips is an absolutely essential part of the primary abdominoplasty. 

I am not quite sure why you feel your money will lead to only a slightly better appearance.  I believe that if you check out the before and after pictures on the websites of the Board Certified plastic surgeons in Hawaii, you will find some truly incredible transformations. 

I highly recommend you seek a few more consultations from Board Certified plastic surgeons in Hawaii.

Would A Modified Tummy Tuck Without Liposuction & Muscle Repair Be An Appropriate Alternative To A Full Tummy Tuck For Me?

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When considering a tummy tuck, especially with the photograph you kindly allowed us to see, it's not really "go full tuck or go home", but rather "do it right, get the full benefit from the tummy tuck, or don't waste your time or money".

Tummy tucks are a mixed reconstructive/cosmetic procedure.  The tummy tuck, if done correctly, improves the appearance of your abdomen, but also repairing the muscles of the abdomen, decreases low back pain experienced by many post pregnancy women especially as they enter the mature years.  Multiple pregnancies lead to a problem with urinary incontinence, you laugh you pee, you cough you pee.  By pulling the vulva up which is part of a well done tummy tuck, you improve the angle of the urethra, therefore decreasing stress incontinence. 

Abdominal muscle repair not only decreases the abdominal girth, but also improves posture and gives the post operative patient an overall sense of having control over one's abdominal muscles (core). 

As far as liposuction is concerned, I personally break the abdominoplasty surgery into two pieces, first doing a full tummy tuck as tightly as possible without complications, and then secondarily after 3 months, do a no charge liposuction of abdomen which is, of course, optional to the patient.  I have also found that liposuction of the muffin tops or hips is an absolutely essential part of the primary abdominoplasty. 

I am not quite sure why you feel your money will lead to only a slightly better appearance.  I believe that if you check out the before and after pictures on the websites of the Board Certified plastic surgeons in Hawaii, you will find some truly incredible transformations. 

I highly recommend you seek a few more consultations from Board Certified plastic surgeons in Hawaii.

Tummy Tuck

Dear Islegirl,


Thank you for your question. 

Based on your photographs, skin removal is an important component of surgery that would improve your abdominal appearance.  In my opinion, the majority of skin between the mons pubis and belly button needs to be removed.  Although the loose skin is your primary concern, you would benefit from the other procedures you mention: liposuction and muscle repair.

Muscle repair will flatten the underlying abdominal wall, allowing for more skin removal.  The maximal removal of skin is essential for the best result in your case and the muscle repair will help accomplish this.  Imagine stretching skin over a bulging surface vs. a flat surface.  More skin can be stretched over the flat surface, which will allow a surgeon to remove more skin.  Muscle repair will bring in your waist.  Muscle repair will give you the best cosmetic result as it will result in a flat tummy and it can be done without looking "strangely flat".

We place the incision as low as possible so that the scar is the most hidden.  The problems I see with tummy tucks done by other surgeons is that the scar is placed too high, which makes it very obvious and visible.  Even if you do not wear a bikini, it is still best to have a low scar.  If the scar is kept low, there will be a discrepancy between the thickness of the edge skin which is pulled down to the position of the eventual scar and the skin in the pubic area and the skin above the front of your thighs.  This creates an unnatural step off of thick skin joined to thin skin.  To avoid this, I perform liposuction of the abdominal skin to make it thin enough so that this does not happen.

It would be my advice to you that if the best surgery is done correctly, you will have the best result and this can give you a very natural appearance.  It always costs more to perform an inferior surgery which results in a subsequent revision that you would pay for.  You can maintain and accentuate your curves with a properly planned and performed surgery.  I strongly believe that just removing skin from your abdomen wouldn't be in your best interest.

Sincerely,

Shim Ching, MD

Tummy Tuck

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Dear Islegirl,


Thank you for your question. 

Based on your photographs, skin removal is an important component of surgery that would improve your abdominal appearance.  In my opinion, the majority of skin between the mons pubis and belly button needs to be removed.  Although the loose skin is your primary concern, you would benefit from the other procedures you mention: liposuction and muscle repair.

Muscle repair will flatten the underlying abdominal wall, allowing for more skin removal.  The maximal removal of skin is essential for the best result in your case and the muscle repair will help accomplish this.  Imagine stretching skin over a bulging surface vs. a flat surface.  More skin can be stretched over the flat surface, which will allow a surgeon to remove more skin.  Muscle repair will bring in your waist.  Muscle repair will give you the best cosmetic result as it will result in a flat tummy and it can be done without looking "strangely flat".

We place the incision as low as possible so that the scar is the most hidden.  The problems I see with tummy tucks done by other surgeons is that the scar is placed too high, which makes it very obvious and visible.  Even if you do not wear a bikini, it is still best to have a low scar.  If the scar is kept low, there will be a discrepancy between the thickness of the edge skin which is pulled down to the position of the eventual scar and the skin in the pubic area and the skin above the front of your thighs.  This creates an unnatural step off of thick skin joined to thin skin.  To avoid this, I perform liposuction of the abdominal skin to make it thin enough so that this does not happen.

It would be my advice to you that if the best surgery is done correctly, you will have the best result and this can give you a very natural appearance.  It always costs more to perform an inferior surgery which results in a subsequent revision that you would pay for.  You can maintain and accentuate your curves with a properly planned and performed surgery.  I strongly believe that just removing skin from your abdomen wouldn't be in your best interest.

Sincerely,

Shim Ching, MD

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.