Would Bodytite combined with Morpheus8 or a tummy tuck be better for sagging abdominal skin? (photos)

Dear Tough,
So... it's most likely the consensus of the PS community here will advise that you will have a much better result with a skin excision/tummy tuck.  They are correct.  However, I have seen fair to moderate skin tightening with bodytite/morpheus.  It may be "worth a go" to see how much improvement you might get if you are "on the fence."  Hope this helps and good luck!  

You need a formal evaluation by a licensed plastic surgeon and expert in abdominal surgery to determine what is best for you and your goals.The key to a successful tummy tuck (or abdominoplasty) is to address the multiple layers that are damaged with pregnancies or weight fluctuations. For most patients I will perform internal rectus muscle plication to flatten and tighten the abdominal wall while creating a better waistline. The excess abdominal skin and fat is then excised and tightened, leaving a low, discreet transverse scar. Keeping this scar as low as possible is important so my patients can wear normal bikinis and low-cut jeans. For many patients, I will use liposuction as an adjunctive procedure to further refine the torso.
To accelerate recovery and reduce the risk of complications, I spend extra time placing progressive tension sutures to tack the abdominal tissues down to the abdominal wall and eliminate space for fluid to collect. I also use a medication called Exparel that is a local anesthetic that releases over a 3-day period; by injecting this carefully in the surgical areas, particularly where the muscle is tightened, I am able to dramatically reduce the immediate discomfort associated with abdominoplasties.
Ideal candidates for this procedure are women who have had children or experienced extreme weight loss and were left with excess skin. During the evaluation, we will discuss your needs and identify the best abdominoplasty technique for you.
I suggest consulting with a board-certified plastic surgeon and expert in body contouring. - Dr. Cohen

Hello. Great question. Thank you for your question. Based on your images, you will better benefit from a full tummy tuck procedure. Please schedule a consultation with a board certified plastic surgeon for a detailed surgical plan to achieve your desired results.

Dear Tough8988,
It is hard to tell for sure without an examination, but 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. 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

Although energy-baed devices can help, the degree of laxity you have is not going to be improved without surgical excision of the skin.  I would meet with a Board Certified Plastic Surgeon and discuss options that will help you achieve the most optimal result.I hope that helps and wish you the very best!Warmest regards,-Gregory A Buford MD FACS PCEOBoard Certified Plastic Surgeon and Published Author

I have been so unimpressed by non invasive or minimally invasive methods for skin tightening that I wouldn’t even waste the money.  These techniques are aimed at people like you who want to try something to avoid surgery.  But they really go very little in my opinion and you need a full tummy tuck?

Concerns about the appearance of the abdomen are very common among patients consulting with a plastic surgeon. Just like every patient is different…so too is every abdomen. Different problems require different solutions. Your board certified plastic surgeon is uniquely trained to identify the problems as well as the appropriate solution.
The abdomen is commonly addressed via liposuction or abdominoplasty (“tummy – tuck”). Which procedure is best is dependent upon the source of the problem. 
Excess fat deposits underneath the skin can be addressed via liposuction. Liposuction will not address any other issues and may worsen the situation if there are other factors at play (such as skin excess and muscle laxity, see below)
Commonly patients concerns are centered around issues of excess skin as well as fat. A third factor, which is often overlooked by most patients is abdominal wall muscle laxity (typically seen in post partum mommies).  The tummy tuck, also known as abdominoplasty is a surgical procedure designed to eliminate excess skin and fat and tighten the muscles in the abdominal wall to create a smoother and slimmer contour. The tummy tuck is designed to target areas of the abdomen that have not responded to diet and exercise, making it particularly popular among people that have a lot of loose or sagging skin around the abdominal area due to significant weight loss, as well as women with excess skin and stretched abdominal muscles following pregnancy and childbirth. RF skin tightening represents a newer approach to skin laxity. BodyTite combined with Morpheus8 can provide a significant tightening effect. While impressive, this does not compare to the more complete abdominal rehabilitation of an excisional procedure such as a tummy tuck..
Based on your photos, you would likely benefit most from a formal abdominoplasty in conjunction with liposuction for waistline contouring. However, if you are unwilling to consider this an an option BodyTite and Morpheus8 is a less invasive option.
As always discuss your concerns with a board certified plastic surgeon (ABPS).
Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons
RealSelf Verified Member
RealSelf Top 100
RealSelf Hall of Fame

Thank you for sharing your excellent question and photographs.  Because of the degree of stretch marks and the amount of skin/muscle laxity I think you would be a better surgical candidate with a tummy tuck rather than Bodytite/Morpheus8.  Hope this helps.

Hi, thanks for sharing your concern and photos with us!
Looking at your photos I might say that you´ll be a great candidate to get an entire back, waist and flanks liposuction, with BBL, and tummy tuck, this is because all the extra skin located in this areas plus your abdominal muscle needs to be repaired.
Before all this, of course, you need to get a complete medical evaluation and laboratory exams to check everything is fine. Also please try to find a board certified plastic surgeon, remember that your safety, always, is going to be first.
Have a great day! 
Dr. JPG

Thank you for the question and pictures. In my practice, I would only offer you the full tummy tuck operation; any "noninvasive" procedure or lesser operation would not end up with an outcome that you or I would be pleased with. Generally speaking, the “ideal” patient for tummy tuck surgery is one who has completed pregnancies, is psycho socially/emotionally/financially stable, has an excellent social support system surrounding him/her, is capable of arranging enough recovery time, does not smoke and who has reached a long-term stable weight.
 
The vast majority of patients who have had children and/or weight gain/loss benefit from muscle plication during tummy tuck surgery. Muscle laxity is usually easy easily determined with physical examination prior to surgery. The separation is also easily visualized during surgery.  Again, omitting this part of the procedure will potentially leave patients with continued abdominal wall laxity and, in my opinion, a less than optimal result.
If/when the time is right, seek consultation with board-certified plastic surgeons who can demonstrate significant experience helping patients achieve the types of outcomes you would be pleased with.   Best wishes.