Skin only tummy tuck with local anesthesia? (Photo)

Question

Im 41 years old,5'5" and 160lbs. Lost 100+ lbs about 14 years ago via gastric bypass surgery. Not until recently did my loose stomach skin bother me. I live in the land of plastic surgery yet im having a heck of a time researching a Dr. that would preform a skin only tummy tuck. I do not need muscle repair..I do not need lipo. I do not need perfection..lol. just need this nasty loose skin to be cut away. PREFERABLY under local anesthesia.

J. Timothy Katzen, MD, FACS · Answer

Hello gentle 259841,
Thank you for your question about undergoing a skin-only tummy tuck under local anesthesia, and congratulations on your significant weight loss. Based on your history and photos, it sounds like you're a candidate for abdominoplasty.
Given that muscle plication (tightening of the abdominal muscles) does not appear to be necessary in your case, a skin-only tummy tuck could potentially be performed under local anesthesia. This approach may be less common and can be slightly uncomfortable, but it is technically feasible.
However, it's important to note that most plastic surgeons typically recommend general anesthesia for a tummy tuck. This is due to the duration and extent of the procedure, which, in your case, is expected to take around four hours. General anesthesia ensures patient comfort and immobility during the surgery, which can be crucial for the precision and success of the procedure.
Suppose you choose to proceed under local anesthesia. In that case, it's vital to understand the implications, including the possibility of discomfort during the procedure and the importance of having an experienced surgical team.
The surgery would likely be outpatient, allowing you to return home the same day. Postoperative care is crucial, and you should plan for minimal activity for the next 2 to 3 weeks to ensure proper healing.
I recommend discussing these options thoroughly with a board-certified plastic surgeon. They can provide detailed information on the pros and cons of local versus general anesthesia for your specific case and help you make an informed decision.
Good luck with your decision and your surgery. I hope this information has been helpful to you.
Sincerely,
Dr. Katzen

Robert Colgrove, Jr., MD · Answer

Based on your photos, it looks like you would be a candidate for skin removal only if that is what you desire. However, I do not recommed doing the surgery under local anesthesia. The amount of local anesthetic needed to perform the surgery could lead to lidocaine toxicity.

Chet Mays, MD · Answer

Thank you for your inquiry and congratulations on your weight loss!  You have a lot of skin that would need to be removed.  This would not be recommended under local anesthesia. We would love to help you reach your goals.  Schedule a consultation with a Board-Certified Plastic Surgeon!

Daniel Barrett, MD · Answer

Dear Gentle259841,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Mohammed Asif, MD · Answer

Hi,
Congratulations on losing the weight. You can certainly get panniculectomy which would remove your skin only. This would need general anesthesia and you will need vertical and horizontal incisions to remove all the excess skin. You will so need new belly button position as well. I hope this helps. Good luck.

Joel Patrick Maier, MD · Answer

Yes, it is possible to have a skin only tummy tuck and it can be done with local tumescent anesthesia and oral sedation. No drains needed and down time is very reasonable. You’ll notice the vertical rims of skin when bending over, and this will likely require a vertical scar (fleur-de-lis) technique to completely tighten the skin. Thanks for the inquiry.

Leila Kasrai, MD, FRCSC · Answer

Congratulations on losing the weight and keeping it off. It is common for stubborn fat to be attached to loose skin, which is probably one of the reasons why skin-only tummy tucks are rare. However, they are certainly not impossible to do. However, chances are, the procedure would be performed under general anesthesia.

Arif Eroglu, MD · Answer

Hello; you have intense cracks and sagging in your upper abdomen and lower abdomen areas. You need for a Full Tummy Tuck. It simply removes skin from the lower abdomen; it provides for a better view than your current situation; but, you will get the best results with tummy tuck. I don't know; why you desire for it; to be done with local anesthesia; but, of course, it is possible to do it with local anesthesia. However, since the area is wide and long; for this type of operation, it is necessary to use for large amounts of local anesthetic. Local anesthetic agents, dose-dependently; you should know that; it may cause for problems; such as cardiotoxicity and nephrotoxicity.

Gary M. Horndeski, MD · Answer

The problem with local anesthesia is that you have a large area that needs to be injected and this may exceed the safe amount of local anesthetic that can be used. The number is 15 mg per kilogram of weight of Lidocaine with epinephrine. It would take a sufficient amount of anesthesia to do your entire abdomen. I recommend you do this under general anesthesia instead.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Harry T. Haramis, MD, FACS · Answer

Unfortunately, after massive weight loss some stubborn areas, notably, the abdomen can persist, out of proportion.

In my experience, extremely lax skin up and down as well as side to side would benefit from a fleur de lis (modified T) tummy tuck. It can be done without liposuction.

A traditional tummy tuck will remove the excess skin vertically, but your waist will not be defined and still hang when bend over. It’s like wearing a XXXL shirt and tucking it in waistband- it’s still too large around.

I wouldn’t recommend local for ski only tummy tuck as there is a lot of pulling and need for cautery, etc.

An exam and consultation with a plastic surgeon who performs these procedures is recommended to confirm you are a candidate as well as discuss your options and expectations.

Skin only tummy tuck with local anesthesia? (Photo)

Answers (16)

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