Is an extended tummy tuck to remove flank tissue very so close to a belt Lipectomy, that you might as well go all the way?

    These questions are difficult to answer without an exam or pictures from various angles.  I only make the scar as long as absolutely necessary.  Auxiliary procedure such as liposuction and fat transfer sometimes produce a nice benefit as well.Kenneth Hughes, MDBeverly Hills, CA

Hi, thank you for posting your question. It is difficult to recommend the ideal option to you without a thorough evalulation. A variety of tummy tucks are available.
Patients who only need a tightening of the abdominal muscles or removal of a
small amount of skin may be best treated with a “mini-tuck.” Patients who have
undergone massive weight loss, on the other hand, will probably require more
extensive surgery.

An abdominoplasty is usually done under
general anesthesia. An incision is made along the lower abdomen at about the
pubic hair line, and another incision is made around the belly button which
stays attached to the muscle.

Mini-abdominoplasty tightens
the lower abdominal wall and skin below the umbilicus, belly button, only
(shortest scar).

Modified abdominoplasty addresses
conditions where just the muscle wall or just the abdominal skin requires
repair.

Standard abdominoplasty tightens
all of the abdominal wall skin and muscles above and below the belly button.
The scar can be altered or lowered to be hidden by most panty lines and bathing
suits. (Standard scar).

Extended abdominoplasty tightens
the abdomen and the flanks or sides (longest scar extending around the flanks
onto lower back.)

A general anesthetic is most common, although mini-tucks may be done
with local anesthetic and intravenous sedation. A standard abdominoplasty is
generally an outpatient procedure, but extended abdominoplasty may require a
short hospitalization of 1–2 days. I advise you to seek a face to face evaluation from a board certified plastic surgeon. Your concerns and questions will be best answered at that time. Best Wishes to you!#tummytuckoptions  #personalevaluation #boardcertifiedplasticsurgeon

Thank you for your question.  A consultation would help determine which of the following procedures is the right one for you:1)  Traditional tummy tuck:  Reduces a great amount of skin laxity, tightens the abdominal wall muscles and keeps the incision hidden in the underwear line.2)  An extended tummy tuck:  Same as a tummy tuck, but helps to reduce more skin laxity around the flanks.3)  A corset tummy tuck:  Adds a vertical scar and breast fold scar, but reduces a significant amount of vertical skin laxity in addition to the horizontal skin laxity and creates the most hour-glass type figure.  Downside is more visible scar4)  A belt lipectomy helps lift the outer thighs and buttock in addition to the benefits of an extended tummy tuck.Options 3 and 4 usually have a significant amount of skin laxity that is being addressed.  I would recommend visiting with a board certified plastic surgeon who can spend time with you to explain the different options in more detail.

Hello, and thank-you for your question. I have reviewed the question and photos you submitted to Realself 19 days ago and see that you have some fat as well as excess fat in the photo of your back.  Liposuction will reduce the excess fat and the skin in this area generally bounces back fairly well. You do not appear to have a great deal of sagging of your buttocks or posterior thighs. I would not expect that extending the tummy-tuck incision will tighten the skin in this area too much. To tighten this area, a lower body lift is required. A lower body lift (tummy tuck combined with a posterior thigh and buttock lift) is a excellent option to dramatically improve the waistline and lift the buttocks when there is skin laxity and sagging buttocks. The improved contour of the waist and hips with a  lower body lift must be weighted against the longer operative time and scar.You can see results of lower body lifts in patients with similar concerns at the link below

when I examine patients for tummy tuck, I divide them into three groups: those with a small amount of skin and loose muscle below the belly button (mini tuck), those with laxity of the abdominal muscles from the breast bone down to the pubis with excess fat and excess skin from hip to hip( standard tummy tuck) and those with excess fat and skin extending just passed the lateral hip(extended tummy tuck). I will perform lower body lifts usually on patients who lost significant weight and have excess skin circumferentially. In addition they've lost volume in their buttocks and I can take a flap of skin and fat in the upper buttocks/lower back, remove the skin and flip the fat over onto the buttocks in order to enhance the buttocks with the patient's own fat.

Thanks for your question.The options for abdominal contour can range from liposuction, mini-TT, full TT, extended TT, and body lift.It will depend on your body's need. Without seeing you in-person, I cannot assess your need/goal and give you a meaningful surgical plan.Please consult a board-certified plastic surgeon to learn about your options.

An extended tummy tuck elongates the transverse incision when there is
excess skin extending laterally. It helps to contour the waist in some
patients when needed. Liposuction is commonly performed in the waist
and flanks.  A circumferential body lift is essentially 3 procedures in one: extended tummy tuck +
waist/lateral thigh lift + buttock lift (with the option of buttock
augmentation).   To determine which procedure is better for you requires an in-person physical exam.    Generally speaking, if you have laxity or loose skin in your lateral thighs, posterior flanks and/or need reshaping of your buttocks, then a circumferential body lift will likely be better for you.  However, if your concerns are primarily in the front of your tummy, perhaps an extended tummy tuck with lipo of your waist/flanks may be better.  Please see a board certified PS to learn more about your options.  Best wishes,Dr. BasuHouston, TX

A total wrap around body lift is really only needed in those patients that have significant buttock sagging. Otherwise an extended tummy tuck will suffice for loose skin in the flanks.