I lost 95 pounds and feel great, but my stomach is not flat. What do you recommend: tuck, lipo or skin tightening? (Photo)

Question

Im not good with pain and i work a lot so what will be my best option

Dhaval M. Patel, MD · Answer

Thank you for your question and photos! 
A tummy tuck will address excess skin & repair of the abdominal muscle. The abdominal wall can be weakened after pregnancy and (or) significant weight gain & loss. By repairing the muscle, not only does the appearance of your abdominal area improve, but your core strength as well. The repair of the muscle will cinch your waist like an inner corset, which will accentuate your curves. Liposuction will remove excess fat from unwanted areas with some skin retraction. Your expectations and health will dictate the best procedure(s) for you. I suggest a consultation with a board certified plastic surgeon to go over the options that best address your goals. 
Best of luck!

Dhaval Patel MD 
Double Board Certified Plastic Surgeon

Chicago 
South Barrington 
Oakbrook 
Orland Park

Leila Kasrai, MD, FRCSC · Answer

Congratulations on your weight loss! You appear to have loose skin, which would make a tummy tuck the most suitable option. This would remove the excess fat and repair abdominal muscle separation (if necessary) while also tightening the loose skin you have. While the procedure may be more invasive than liposuction and require some time off from work, you won’t be left with loose, saggy skin or a “muffin top”.

Martin Jugenburg, MD · Answer

Liposuction and skin tightening will not fix loose skin. A tummy tuck is the only option to remove loose skin

Gary M. Horndeski, MD · Answer

The technique I recommend is abdominoplasty with mesh reinforcement. The mesh creates a more flatter stomach by compressing the abdominal wall resulting in early satiety and helps maintain a reduced weight. You may need a circumferential lift. This can be done in 2 stages doing the anterior portion first and then the posterior portion.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Gregory Lakin, MD · Answer

Congratulations on your weight loss! You look like you would be a good candidate for a tummy tuck with some selected areas of liposuction to add definition. Good luck!

Carmina Cardenas, MD · Answer

It is wonder what you have achieved after weight loss!!! 
You have developed a severe degree of saggy skin and nothing conservative will tighten your skin besides a Tummy Tuck. 
Be encouraged you will look wonderful after all and finally you will show your great muscles.
Dr. Cárdenas

Dana Goldberg, MD · Answer

You don’t mention if you’ve had kids or if you have muscle weakness, but it doesn’t look like it from your photos.

I offer some patients a “skin only” tummy tuck. The extra skin is removed, so the scar is the same as a full tummy tuck (low abdomen and around the belly button). But if you don’t tighten the muscle, there is less post op pain and fewer restrictions after surgery. I usually use drains and require 2-3 weeks of reduced activity after surgery.

If you’re not good with pain, you could consider exparel. It’s an injectable pain medication used during surgery that makes the incision numb for up to three days.

Josh Olson, MD · Answer

Great job on the weight loss. Tummy tuck would be your best option but muscle repair is not necessary so the pain won’t be near as bad as a traditional tummy tuck. Don’t waste your money on skin tightening in my opinion. Good luck

Daniel Barrett, MD · Answer

Dear will k,
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

Robert M. Tornambe, MD · Answer

Congratulations on your weight loss, you should be proud of this accomplishment! 
It appears from your photos that full tummy tuck would be needed to complete your transformation as stretched and redundant skin present after massive weight loss will not contract. Skin tightening procedures alone would have little effect in your case and would be a waste of time and money.
Even though you have issues with pain control, there are excellent pain medication protocols now that do not involve opioids but are highly effective. 
Recovery usually involves a week away from work unless you work from home and then you may be able to get back sooner. Consult with a board-certified plastic surgeon in our area to explore the best options for you. Good luck.