How Do Other Patients Finally Decide to Get Tummy Tucks? I'm Having a Hard Time.

Question

Ever since I had my twins almost 5 years ago I've toyed with the idea of a tummy tuck. I can't decide whether the benefits outweigh the risks. I am generally happy with my figure when I'm in clothes but without it's another story. I can't bear to let my husband touch my tummy and am very self conscious of it. The day I delivered the twins I weighed 198lbs and now I'm 125lbs, I'm 5ft 4in. I have stretch marks below my belly button but only a couple around the top of BB. What should I do? Thanks!

Robert Heck, MD, FACS · Answer

Tummy tuck surgery is very safe and is one of my favorite surgeries to perfrom. The results can be phenomenal when the right patient is chosen. Based on your photos, you are an ideal candidate for this surgery. No amount of working out or exercise is going to get rid of the loose skin or stretch marks. This can only be acheived with a tummy tuck.

Paul Gill, MD · Answer

Thank you for your question and this is a very common struggle for many women, when it comes to weighing the pros and cons of an elective surgical procedure.   This is a personal and family decision.   We find many women decide to proceed when their children are at an age of self sufficiency, they have enough family help, and the skin or muscle laxity persists despite diet and exercise.   I wish you all the best. Dr. Gill

Steven Turkeltaub, MD · Answer

Thanks for the excellent photos - they are very helpful. They clearly demonstrate that you would be an excellent candidate for a tummy tuck. Mentally, it sounds like that is your issue (this is very common). If you are healthy and when performed by a reputable board certified plastic surgeon, you should expect fairly low significant risks and a nice improvement (of course, there are no guarantees in anything).

	You should consult with one or more board certified plastic surgeons in your area who could explain the procedure in detail including outlining the risks and expectations and generally put it all into perspective. This should be very helpful for you. Your husband may be able to help you out on this as well.

Herluf G. Lund, Jr, MD · Answer

Dear Caldo, First, you are to be congratulated for your dedication to getting your weight back down after having your twins but somethings will not respond to diet and exercise and will require surgery to correct. The loose skin with stretch marks and the muscle separation(diastasis) are best corrected with an abdominoplasty(tummy tuck) and from your photos, you are a good candidate for this procedure and should get a very good result. Your concern about being vain and selfish for considering an abdominoplasty is very common given that many women feel they must sacrifice their desires and needs for the family and others. Clearly though from your question, your displeasure with your appearance is affecting your self-image and also impacting how you are interacting with your spouse. If you are not comfortable with yourself, then it will affect your marital relationship and there is no need for that given that we can correct the problems that are behind your worries. Please see a Board-Certified Plastic Surgeon for a consultation and bring your husband with you. Ask if you can speak to previous patients who have had a tummy tuck and how it impacted their feelings and relationship. They can also address your worries about the safety and recovery issues. I think you will be more comfortable in proceeding. Good Luck, Herluf Lund MD-father of twins!

Stephen Delia, MD · Answer

Patients with mostly skin excess and spreading apart of the abdominal muscles represent the best candidates for tummy tuck surgery. This is in contrast to patients who are obese and have more of a rounded protuberant shape with more intraabdominal fat. You appear to be in the former group and may be a good candidate for a tummy tuck. Seek out a board-certified plastic surgeon in your area for complete evaluation if you are interested.

Darryl J. Blinski, MD · Answer

Based only on the posted photos I agree a full tummy tuck or abdominalplasty is a very good option. Seek in person evaluations from boarded PSs in your area.

Tom J. Pousti, MD · Answer

Thank you for the question and for sending your pictures. You are an excellent candidate for abdominoplasty surgery  assuming you're not planning on having any more children. You have done an excellent job dropping weight and it is clear that you take good care of yourself.

	However, despite your best efforts, the twin pregnancy has stretched the abdominal wall muscles and the overlying skin to the point where no amount of exercise or dieting will improve your situation. The abdominoplasty procedure will remove the excess skin and and &ldquo;reconstruct&rdquo; the abdominal wall musculature. Again, based on your pictures you should have an excellent result.

	The downside of the procedure is the low transverse scar (which can be hidden in undergarments or swimming suit),  a scar around the umbilicus, possibly a short vertical scar, and a month-long recovery process.

	Make sure you seek consultation with a well experienced board-certified plastic surgeon.

	Best wishes.

John Whitt, MD (retired) · Answer

As you have suggested, you must always weigh the benefits and risks with any elective surgical procedure. Ypu certainly appear to be a very good candidate for a tummy tuck. I cannot provide the risks in your particular situation as I have not examined you andf am unaware of your history (smoking, for example, would significantly increase your risks for problems). Only you can decide when the beneits outweigh the risks.

David N. Hing, MD (retired) · Answer

You are and excellent candidate for the abdominoplasty operation.

	You have:

	1) Loose skin in a vertical dimension from the belly button to the pubic are

	2) Laxity in your rectus abdominis muscles- twin babies can push the normally vertical rectus muscles to the side and allow the abdominal contents to push outwards in a standing position

	3) Fatty tissue as padding in the lower part of your abdomen

	 

	The abdominoplasty (tummy tuck) can remove the extra skin and fat in the lower abdomen and allow tightening of the rectus muscles back to their midline, vertical orientation.

	 

	A one to one consultation with a board certified plastic surgeon is the next step to verifying your surgical option.

	 

	Good Luck!

Ronald V. DeMars, MD (Retired) · Answer

Your concern regarding risk versus benefit of a tummy tuck is very common. What you have not voiced but may be your concern is what if your "vanity" over your abdomen causes you to have surgery and something happens and your family is left without a Mom. This is a very real concern on women's part but without a thorough consultation with an experienced surgeon you probably don't have a good handle on how many patients have an exciting change in their life from the surgery and how few ever have any serious complications. "Vanity" is defined as an overly preoccupied concern about less than important physical problems. Your abdominal changes will never affect your health but it sounds like they are seriously interfering with your marital relations. There is no vanity in wanting to feel better about yourself and if you do go ahead and get the surgery I bet you wind up saying, like so many of my patients, "why did I wait so long?". Get a consultation for a full abdominoplasty with muscle repair with several surgeons and find one you are comfortable with and then reevaluate your concerns.

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