Do I Need A Tummy Tuck? How Many Liters Of Fat Do You Think I Have (This is For Liposuction)? (Photos)

Thank you for your question. You may be a candidate for an abdominoplasty with a low-positioned scar because you have a lower abdominal pooch that includes skin laxity and may be a muscle separation. After previous liposuction and scarring (mild fibrosis), standard lipo may struggle to smooth the tissue, so combining abdominoplasty with VASER Lipo 360 can further refine your waistline and enhance your overall result since you don’t want ab etching. An in-person consultation with a surgeon experienced in revision lipo and tummy tucks will help confirm the surgical plan.

I understand that in your case, 4K liposculpture with J-Plasma technology would provide excellent results, achieving a flat abdomen and defined waist without the need for a tummy tuck.

Thanks for sharing your photos—you’re clearly in great shape, with very little excess fat overall. What stands out most are the contour irregularities from the previous liposuction and some excess skin. There also appears to be a bit of lower abdominal muscle separation from pregnancy, which could be contributing to the persistent pooch.

Liposuction alone probably wouldn’t be enough to fully address everything. For a more complete and lasting result, a tummy tuck (abdominoplasty) with a low-placed scar and a floating belly button technique would be a strong option. Since the belly button sits high—and given your tall frame—it could be moved down about 2 inches without appearing out of place. This allows for full muscle repair, skin tightening, and a smoother lower abdomen.

Liposuction could also help refine the flanks. When performed with a drainless technique, the use of sequential tension sutures helps keep the scar low and in the right position as healing progresses.

-DrB

Thank you for sharing your story — your commitment to fitness, healthy living, and self-care is inspiring. After everything you’ve managed over the years, it's completely understandable to want your abdominal area to reflect the level of effort and discipline you’ve put in.
Here’s how your situation breaks down:
- You’re athletic, at a healthy weight, and maintain a consistent workout routine.- You’ve had previous liposuction, but the results were unsatisfying, with some residual lower abdominal fullness and mild fibrosis.- You’re not interested in ab etching — just a flat, lean, naturally contoured midsection.
So, what might help?If your skin is tight, and the remaining issue is mainly fat and fibrotic tissue, a high-definition VASER Lipo 360 could be a great option. It can break down fibrosis, sculpt the waistline, and address residual pockets more precisely than traditional lipo.
However, if there is any skin laxity, especially in the lower abdomen (common after lipo and time), a mini tummy tuck combined with lipo might give a cleaner, flatter result. This would remove excess skin and potentially reinforce the lower abdominal wall.
Important considerations:A mini tummy tuck addresses loose skin below the belly button, but won’t significantly affect skin or muscle above it.
VASER Lipo works well when skin quality is good and underlying muscles are intact — which, in your case, may be true given your fitness level and pregnancy history (just one, over two decades ago).
For mild fibrosis, VASER can help soften and remodel tissue, especially when paired with lymphatic massage post-op.
What’s next?A detailed, in-person consultation with a board-certified plastic surgeon who specializes in revision body contouring will help clarify which route will give you the lean, defined result you're after — and finally put that stubborn pooch behind you.
— Güray Yeşiladalı, MD

Thank You for your query. You look pretty good and Vaser Liposuction in the lower part of your abdomen may be all you need. You can get some non surgical skin tightening with, J-plasma or Thermitight as well, if needed. Please find an experienced board certified Plastic surgeon who can examine you and help you with all your concerns. All the best!

Dear Seabee80,
it is hard to tell for sure without an examination. Based on your photos, it looks like you don't have much loose skin. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. 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

Your issues include abdominal wall laxity, abdominal skin excess, especially around the bellybutton, residual excess fat in the abdomen, hips and flanks, and irregularities in surface contour of your abdomen. Liposuction can mitigate excess fat and potentially improve irregularities in fatty tissue thickness. Devices like Vaser can help remove fat, and Renuvion can tighten the attachments of the skin to the deeper layers, but no device can tighten skin. The only way of getting what you want is to have an expert perform revision liposuction on your torso and a very low scar abdominoplasty. The reason I qualify the tummy tuck as 'very low scar' is because that is essential to having an essentially invisible scar. And contrary to many of my colleagues, you 'have enough skin'.

You have contour irregularities from the Sone Bello procedure. You will need the skin repositioned. I am not sure you have enough redundant skin to do a full tummy tuck. Unfortunately, you have not shown us your breasts. There is a breast lift technique called The Bellesoma Method which lifts the breasts and also lifts the upper abdominal skin and may be able to take care of the contour irregularities. The inferior abdomen can be taken care of by a mini tummy tuck.

Best Wishes,

Gary Horndeski, M.D.

I am sorry to hear about your experience in the past! correcting issues from poorly performed liposuction can be challenging. Trying to treat this with liposuction alone is unlikely to give you a result that you are happy with. Due to the degree of irregularities that extend along the length of the abdomen (including above the belly button), and tummy tuck would be recommended. You may be a candidate for a hybrid tummy tuck with an umbilical float given the modest skin laxity that you appear to have in your photos. this would avoid an incision around the belly button while still allowing for a diastasis repair. This could be combined with liposuction in your flanks and lower back to further address your waist contour.
Sean Fisher MD Aesthetic Plastic SurgeonSeattle, WA

Thank you for the detailed history and photos. Given your excellent skin tone, overall fitness, and localized fat distribution, VASER Lipo 360 appears to be a very suitable option for enhancing contour and eliminating the lower abdominal pooch. It can also help address the mild fibrosis from your previous procedure.
A mini tummy tuck could be considered if there’s lower abdominal skin laxity or muscle separation, but based on your current appearance, liposuction alone may be sufficient, without the need for skin excision or a full tummy tuck.
In terms of volume, you may have approximately 2 to 3 liters of removable fat distributed across the abdomen, waist, and flanks — but this will be confirmed during an in-person assessment.