Tummy Tuck or Body Lift? (Photo)

Question

I'm a 36-year-old man who has lost 110 pounds over the past two years. I'm now considering gynecomastia surgery and a tummy tuck to address excess skin. The plastic surgeon I've chosen has proposed two options for the torso: a traditional tummy tuck with liposuction on the back flanks (his recommendation), or body lift. I'm looking for a second opinion on which direction I should take. My main concern is making sure my back and sides match my front as best as possible.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question and congratulations on your impressive 110-pound weight loss! This kind of weight loss often leaves behind excess skin that does not contract well, making it essential to choose the right procedure for your needs.

In your case, given your history of significant weight loss, a 360 circumferential lower body lift would likely provide better results than a traditional tummy tuck with liposuction. The reason is that your skin has already been stretched, and while liposuction can remove excess fat, it won’t adequately address the loose skin that remains, particularly around your back, hips, and buttocks. A lower body lift will remove excess skin and fat from the abdomen, hips, and lower back while also lifting the buttocks, giving you a more balanced and even contour all around your torso.

The 360 body lift addresses not just the front of the abdomen, but the sides and back, ensuring that your entire midsection and lower body look consistent. A tummy tuck, even with liposuction, won’t provide this comprehensive result, especially for patients like you who have undergone massive weight loss.

In many cases, the gynecomastia surgery can be combined with the body lift, which would streamline your recovery process. The lower body lift typically takes around six hours under general anesthesia, and you should plan for about a two to three week recovery. You will likely need drains for about seven to ten days depending on fluid output.

I hope this helps you make a more informed decision, and I wish you the best in your surgical journey.

Sincerely,
Dr. Katzen

Ira H. Rex III, MD · Answer

The answer to this is largely dependent on the expectations of the patient.  From your photograph, it seems you would have an extremely nice result from just a tummy tuck.  The body lift makes this a much larger operation, which comes with larger risks.  Good luck with your decision.

Larry C. Leverett, MD, FACS · Answer

The distinction between the two procedures depends on the condition of your lateral thighs and buttocks, both of which are covered in the photos submitted. With that much weight loss, it is  highly likely that a simple tummy tuck and lipo will be insufficient because the left over skin laxity is circumferential both vertically and horizontally which makes the body lift more reasonable... even without seeing representative photos. However, I have seen several patients whose thighs and buttocks look great after massive weight loss and those patients do well with smaller procedures.

Daniel Barrett, MD · Answer

Dear Brave427239,

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

Arif Eroglu, MD · Answer

Hello
The sagging and skin folds on the abdomen are short on the right side of the waist, but extend all the way to the back on the left side. Therefore, I would recommend a body lift instead of a tummy tuck. If only a tummy tuck is performed, the patient should be aware that the skin fold extending from the waist to the back on the left side will remain.

Luis Suarez, MD · Answer

Due to your previous weight loss, the ideal procedures according to the pictures would be a circular tummy, tuck, a gynecomastia, and definitely a torsoplasty this will ensure that the area fully improved, otherwise if they just did liposuction because of the weight loss, the skin doesn’t retract as well and doing liposuction without skin removal. Can give you the opposite result that you’re looking for, it would be the same case for the tummy tuck the lower back, skin removal is what would need to be done in order to get the best results.

Ryan Endress, MD · Answer

Good morning! This is a very common scenario. A traditional abdominoplasty with lipo will address the front, obviously, and get out some of the fat laterally and around the back to whatever degree can be reached with you lying on your back. This helps with some volume and contouring laterally, but if there are concerns about the lateral thigh, buttocks, and lower back then a circumferential body lift with lipo will yield superior results. It is hard to say with shorts on in the picture. Downside is additional cost and slightly longer recovery, but upside is huge.

Jose Perez-Gurri, MD, FACS · Answer

Congratulations on your weight loss. I would recommend an extended abdominal lipectomy with repair of the rectus diastasis. The extended procedure will remove the excess amount of "apron" skin that curves around the side and unto the back region. I don't feel a body lift is necessary. Liposuction of the flanks can be of benefit. Just remember that you have lots of flaccidity of the skin following your weight loss journey. Good luck, Doc PG

Moises Salama, MD · Answer

Thanks for your question. Based on your pictures, you seem to be a good candidate for a tummy tuck with liposuction.  I recommend you schedule a consult with a board certified plastic surgeon. Hope this helps. Take care, Dr. Moises Salama, board certified plastic surgeon.

Chet Mays, MD · Answer

Thank you for your inquiry!  Without seeing you in person and being able to feel how much skin laxity there is, it is hard to determine which would get the best outcome.    Schedule a consult with a Board-Certified Plastic Surgeon to help you reach your goals.

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