Lipo 360 gone wild. Thoughts? Is this fixable? (Photo)

Question

2 years PO. and this is what I am left with. I've done 110 sessions of lymphatic massages, RF, cavitation, wood ...you name it I've done it. I should've been advised to get a tummy tuck. I'm at that point of getting one. However, I've consulted with 5 plastic surgeons and each have vastly different feedback ranging from 100% fixable to not fixable(triangle of death/not enough skin/too much skin/fibrosis/not fibrosis, scar tissue/not scar tissue). Thoughts?

Daniel Barrett, MD · Answer

Dear Butterfly2U,

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. Flanks liposuction would give you a better shape. 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

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question and for sharing your concerns. I'm sorry you weren't told about the excess skin that would be left behind after your 360 lipo. Based on your photos and history, I believe your abdomen is fixable with an extended tummy tuck. While I understand your feedback may be confusing, I want to address some of the key concerns.

It’s common for patients with prior liposuction to develop scar tissue and adhesions, which can make the skin appear irregular or tethered. During an extended tummy tuck, I would release these adhesions and scar tissue to allow the remaining skin to be re-draped more evenly. This process is particularly important in cases like yours to optimize the results and achieve smoother contours. Additionally, the procedure would involve removing a good amount of excess skin, which should further enhance the overall result.

While every patient is different, and the degree of improvement depends on factors like skin elasticity and existing scar tissue, I do believe you have the potential for significant improvement. It’s crucial to consult with a board-certified plastic surgeon who has experience in complex revision cases and can tailor the surgical plan to address your unique anatomy.

Good luck with your journey, and I hope this helps to answer your question.

Sincerely,
Dr. Katzen

John Michael Thomassen, MD · Answer

I would recommend an abdominoplasty with no further liposuction.  This would allow muscle plication to flatten your profile and excision of excess skin to smooth out the dimples from the prior liposuction.

Eric Swanson, MD · Answer

You are correct. You would have been better served with a tummy tuck and avoided all those other procedures and expense. You are still a candidate. Yes, you are at higher risk for complications such as skin loss.

Gary M. Horndeski, MD · Answer

You have excess skin. However, if the skin has been damaged from all the treatments you have had, it may not stretch as much as normal skin would. So, it is possible that undergoing a tummy tuck you may end up with a high riding scar. Another possibility for you to consider would be a breast lift. There is a technique called The Bellesoma Method, which lifts the breasts higher and lifts the upper abdomen and may take care of the upper abdominal skin. This may eliminate the need for a full tummy tuck and you may only need a mini tummy tuck.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Joel Patrick Maier, MD · Answer

This is definitely fixable. If fact, managing your skin is the next logical step after liposuction. There are good options for rejuvenating your tummy. The first question is if you have noticeable diastasis, meaning a bulge in-between your six-pack muscles when you do a sit up or plank type of action. Your muscles look flat in your photo so this is likely not a major issue in decision making. Assuming so, the I would recommend some liposuction (not a major part of the procedure) with skin excision and umbilical transposition. This is a tummy tuck type of skin excision excluding the muscle tightening. This can be done with an oral cocktail for sedation and local tumescent anesthesia, so you never go "under". There are no drains with resumption of activity as tolerated. There is an overall lower complication rate and down time compared to a traditional tummy tuck. On caveat is that you may have a vertical scar if your umbilical opening does not stretch down to your horizontal scar below the bikini line; but still, I think it would be a good "trade-off" to rejuvenate your tummy. This is a great option for many women out there. Having said that, if your muscles need tightening, then proceed with a tummy tuck. Either way, I would not hesitate in proceeding so you can take the next step in rejuvenating your tummy..An in-person exam by an experienced body plastic surgeon will help guide you in your decision. Thank you, I hope this helps.

Carmina Cardenas, MD · Answer

Impossible to determine based on photos your degree of fibrosis, besides what is observed on your photos and it is important because that will determine how mobile is your skin. 
I consider you have two vectors of excess of skin: width and length, so I consider you will be a great candid For a Tummy Tuck Fleur de Lis (vertical incisión) with muscle repair to achieve a flatter abdomen, tapered waist and smoother abdominal skin. 
Your results will be super nice, just the surface of your skin will continue being lumpy but tighten. 
Be encouraged 
Dr. Cardenas

Shlomo Widder, MD · Answer

Dear Butterfly,
   Thanks for posting your pictures and sorry for poor outcome. From observing your pictures, abdominal skin and muscle laxity is obvious, so indeed you should have been recommended to have tummy tuck. In any event, you are a good candidate for tummy tuck surgery, which will give you flat stomach, tight skin, improved posture , nice waists and flat pubic area. It appears that you have enough skin laxity of the upper abdomen to allow the belly button hole to reach the pubic bone. In worst scenario, if the upper abdomen skin can't stretch due to the previous lipo surgery,  you might end up with a small vertical scar at the lower abdomen. Your total abdominal improvement is definitely worth such a compromise.
    Always consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly . check the before and after pictures in the photo gallery, to make sure that they are numerous, consistent and attractive as mentioned above.
                   Best of luck,
                                       Dr Widder
                            widderplasticsurgery.com

Arif Eroglu, MD · Answer

Hello,This is the result of Liposuction performed on a patient who should have undergone a classic tummy tuck. In patients around 50 years old with loose skin and weakened abdominal muscles, Liposuction should absolutely not be performed. When Liposuction is done on an unsuitable patient like this, the fibrosis that develops causes a decrease in the elasticity of the upper abdomen, which appears very loose, and makes it more difficult to perform a tummy tuck. Additionally, since your belly button is positioned higher, more skin will need to be removed during the tummy tuck, which will further complicate the procedure. However, there is no other surgery that can solve your problems besides a tummy tuck. I would recommend Vaser liposuction to release the fibrosis in the upper abdomen as much as possible, followed by Lipoabdominoplasty.

Finny George, MD · Answer

Hi, thank you for sharing your question. It is likely that this is fixable but will require an in person evaluation to determine the exact location of the laxity and how much scar tissue is tethering the skin.