Abdominoplasty or just excess skin removal? Length of scar? How would recovery affect my active lifestyle long term? (Photos)

Thank you for your questions and photos. In my opinion you have two good choices to better contour your abdomen. The first option is a mini-tummy tuck where only the lower abdominal skin below the belly button is removed. A mini tummy tuck does not address the skin of the upper abdomen above the belly button. This procedure is done through a scar slightly longer than a c-section scar but not extending hip to hip. A good candidate for this procedure is someone who has loose skin below the belly button, tight skin above the belly button and good muscles without separation. This procedure can be combined with liposuction of the upper abdomen or flanks if there is some excess fat in these locations. The second choice is a full tummy tuck which can also be combined with liposuction of the flanks to better accentuate an hourglass figure. A full tummy tuck requires a longer scar as well as a scar around the belly button. In this procedure the underling muscles and fascia are often tightened as well. Consultation with a board certified plastic surgeon with experience in tummy tucks is strongly recommended to see exactly which procedure is best for you based on your exam and goals. Best wishes! 

Thank you for your question and photos. Your photos show loose skin and protrusion of your lower abdomen. You are an excellent candidate for a tummy tuck procedure with plication of your lower abdominal muscles and fascia. This will remove excess skin and flatten your contour.  At the same time, liposuction can be done to your hips and flanks.

Based on your pictures, you appear to have more of a loose skin problem than excess fatty tissue. Liposuction will really not improve your abdomen, but could be used to contour your hip area. With an abdominoplasty, the length of the scar is determined by the amount of loose skin. The more loose skin present and the higher up the loose skin is on your abdomen, the longer the scar needs to be to ensure that you have no excess skin postoperatively. A shorter incision can always be made, but it often compromises your result leaving you with loose skin after surgery. If you do not have diastasis, the rectus muscles don't have to be plicated during the procedure.

Thank you for your question. There are various types of abdominoplasty procedures for patients to choose from. Each one is designed to treat a specific set of needs.  In consultation with a qualified plastic surgeon, the choice of procedure will be made based on your anatomic features and desired outcome.  While all tummy tucks have in common that they tighten the abdominal skin, there are two key differences between the various procedures. The incision lengths vary depending on the amount of skin to be excised, and the abdominal muscles may be tightened if they have excess laxity.For you Mini Tummy Tuck would be a good option.  This uses a relatively short incision in the same area of your C-section.  Since you don't need much skin resection, you could avoid the incision around the belly button.  Most importantly, this would give access to the abdominal wall so that a good muscle repair (placation) can be performed.  Healing after a tummy tuck is usually pretty straight forward.  There is a process of swelling and bruising that peaks at 3 days after surgery and then undergoes the first stage of major resolution in the first 2 weeks after surgery.  The lateer phase of healing takes place over the 2-3 months after surgery where everything really settles and softens.  It is after this time that we are getting close to the final result, though this varies patient to patient. That said, you definitely have to choose your surgeon correctly and make sure that he/she has the training and experience to meet your goals with absolute safety.  Best is a Board Certified Plastic Surgeon with specialized expertise in this procedure.

A short-scar tummy tuck is right for patients who have loose skin, residual fat, and drooping muscle tissue in the abdominal area. It’s an excellent choice for those patients who are excited by the idea of attaining the results of a full tummy tuck but do not want a long curving abdominal scar after the procedure. Following six weeks of recovery you could return to CrossFit and powerlift, gradually building up to your regimen prior to the TT.Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

Your issue is excess skin so the only option is excision either with a tummy tuck or mini tummy tuck.  You first have to be fine with the scar which would basically be from hip to hip.  Based on your photos, skin excision, leaving a very low scar, with liposuction would be a good option.  This would not correct any issues with excess skin in the upper abdomen but would correct the pouch you have when you bend over.  

tksh10.  You have done a lot on your own to get your pre-pregnancy body back with diet and exercise! Liposuction of your abdomen with Mini-Tummytuck if muscle plication not needed should work for you. Scar is shorter than full Tummytuck scar, somewhat longer than C-section scar. Be sure to consult with a board certified plastic surgeon. Good luck!

Hello and thank you for your question. Based on your
photographs and pregnancy history, you are a great candidate for a tummy tuck with liposuction.  This can be done through a low and short
incision, all completely below the bikini line. 
The belly button can be designed to look natural and have no scars on
the exterior.   Your muscles can also be
plicated resulting in a flat abdomen. 
Make sure you specifically look at before and after pictures of
real patients who have had this surgery performed by your surgeon and evaluate
their results.  The most important aspect is to find a surgeon you are
comfortable with. I recommend that you seek consultation with a qualified
board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

A skin excision is part of a tummy tuck and the more skin you want removed (and have a better result), the longer the scar will be. 

From the photos you probably could get by with a simple skin excision and some liposuction to enhance your waist. A mini tummy tuck would undermine the lower abdominal skin and tighten the lower rectus muscles. The “Tummy Tuck” undermines the upper and lower abdominal skin, tightens the full length of the rectus muscles, repositions the umbilical opening and removes the excess abdominal skin. Liposuction is frequently done with all of the procedures. 
The length of the scar depends on the amount of skin removed. However, the position of the scar also impacts patient satisfaction and we try to place it as low as possible. A  consultation would provide an accurate assessment and evaluation of your options. Thanks for your question.