Is a revision possible? What options would I have? (Photo)

Question

This is how I am left after a TT with MR and lipo 360. When I lay flat the skin on my abdomen is tight however, when I stand up or bend over the skin is still loose. I have a bulge on both sides of my belly button when I stand or sit. I have never been completely flat since surgery and the bulges have always been there. I just want to know options, if any, on a revision. My original surgeon said this was normal so I am also looking for a new surgeon and second opinions. I am 7 months post op.

Zoran Potparic, MD · Answer

It is not rare to see patient with similar problem after TT and liposuction. This is in particular the case if patient has very loose, stretched skin with minimal elasticity (after weight loss, multiple pregnancies) which starts sagging several months after surgery. Liposuction itself undermines blood supply of the skin flap, so when done together with abdominoplasty, it is usually very conservative, in particular around skin flap edges (lower abdomen, above scar). You should wait  one year for condition to settle and deformity to present in full form before undergoing more aggressive liposuction and scar revision (lower scar position). Good luck.

Gerald Minniti, MD, FACS · Answer

Your result is very common due to most surgeon's misprioritization of 'getting the hole' out ( the hole in the skin where it used to be attached to your belly button) versus what should really be prioritized: getting the scar low enough to look good. good news is that with a little liposuction and a revision of just the lower belly skin, you can have a lower and less conspicuous scar.

George Marosan, MD · Answer

Thank you for your question and photos. Based on these photos, you have lots of fat on your abdomen, since this was not thinned out during your surgery. Cannot address the muscle repair, since that would need to be an in person examination/evaluation. If  the MR is intact, I would do VASER lipo 360 degrees and possibly lowering your high abdominoplasty scar.
See a board certified plastic surgeon for evaluation. Good luck. See attached web reference.

Ronald J. Edelson, MD · Answer

There is still plenty of loose skin that can be removed with a revision. Your original surgeon is correct however. Many patients do experience further stretching if skin after a tummy tuck. A revision for this reason is not at all
Uncommon.

Daniel Barrett, MD · Answer

Dear realagent20,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went 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

Douglas Taranow, DO, FACOS · Answer

Based solely on your photos, it appears that you have excess fat of the front of your belly which is not addressed with the liposuction of your sides and lower back.  The front of the belly is not usually liposuctioned at the time of an abdominoplasty to avoid injuring the blood supply to the flap.  
You would require an examination to assess your skin laxity before commenting on abdominal liposuction (again).

Best wishes,

Dr. T

Mats Hagstrom, MD (license on probation) · Answer

I will refrain from playing Monday morning quarterback.

If you want us to make an assessment on the outcome of a procedure then you need to post proper before and after pictures. If you don’t have the before pictures your surgeon took before the procedure then ask them to forward those so you can post them.

A tummy tuck it’s only going to deal with skin laxity in a vertical direction. Patients with severe skin laxity may need skin reduction in both vertical and horizontal direction which would require a fleur-de-lis design giving you a vertical scar from your sternum to your pubic area.

It all depends how much skin laxity someone has to start with. I’m guessing this is a pretty big change from what you look like before your procedure.

At this point your option is to convert this to a fleur-de-lis pattern which personally I think leaves a pretty ugly scar.

It’s hard to say from the picture if this could be improved from a revision leaving you with a similar designed incision pattern.

Consider re-posting with proper before and after pictures.

Best, Mats Hagstrom MD

Is a revision possible? What options would I have? (Photo)

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