Loose skin around belly 2.5 years after last child was born. Is this worth a tummy tuck? (Photos)

Question

I ama 33 year old female. 5’5” height and 125lbs in weight. I gained a large amount of weight with both pregnancies getting up to 205lbs with each. My last child was born 2.5 years ago and I am now left with a lot of loose skin around my belly. The pictures show me standing straight vs hunching over. I’ve already been weight training 5 days a week for some time to try to “fill in” the space with muscle but it’s not helping. Does this require a tummy tuck to fix? Are there any milder operations that would help?

Gulcin Nujen Cardak, MD, FEBOPRAS · Answer

Hi, I see that after your pregnancies you were able to lose weight and train your muscles. But unfortunately skin can’t be trained. You have excess skin and if it’s bothering you, tummy tuck is your solution. There are no other ways to get rid of the excess skin.

Leila Kasrai, MD, FRCSC · Answer

There will always be some loose skin when hunching over, as without it you wouldn’t be able to stand straight up. However, there is some last skin in the first photo as well, and this could be tightened with a tummy tuck. Depending on the amount of loose skin you have and its location, a mini tummy tuck may be sufficient. This would target the area below your belly button only.

Eric Swanson, MD · Answer

Congratulations on getting into such great shape. No question, abdominoplasty is the treatment you need to correct your skin excess, and also your diastasis recti. It is important to keep the incision low, within the bikini line. Some surgeons know how to do this; others do not. Check photos from your surgeon (they should show the scar). Other options (energy treatments, Coolsculpting, mini-tummy tuck) will not get the job done and will be a waste of your time and money.

Donovan Rosas, MD · Answer

Concerns about the appearance of the abdomen are very common among patients consulting with a plastic surgeon. Just like every patient is different…so too is every abdomen. Different problems require different solutions. Your board certified plastic surgeon is uniquely trained to identify the problems as well as the appropriate solution.

These areas are commonly addressed via liposuction or abdominoplasty (“tummy – tuck”). Which procedure is best is dependent upon the source of the problem. Excess fat deposits underneath the skin can be addressed via liposuction. However, commonly patients concerns are centered around issues of excess skin as well as fat. A third factor, which is often overlooked by most patients is abdominal wall muscle laxity (typically seen in post partum mommies).  Despite the commonly held misconception, neither liposuction nor tummy tuck is intended as a weight loss tool nor is it a solution for stretch marks on the stomach.

The tummy tuck, also known as abdominoplasty is a surgical procedure designed to eliminate excess skin and fat and tighten the muscles in the abdominal wall to create a smoother and slimmer contour. The tummy tuck is designed to target areas of the abdomen that have not responded to diet and exercise, making it particularly popular among people that have a lot of loose or sagging skin around the abdominal area due to significant weight loss, as well as women with excess skin and stretched abdominal muscles following pregnancy and childbirth. Candidates for tummy tuck should be already at or near their ideal weight for optimal results. It is recommended to women that are planning on becoming pregnant to postpone the procedure until they are finished having children.

The procedure will typically take anywhere from two to three hours to complete under general anesthesia. An incision is made between the hip bones at the bikini line (easily camouflaged by most undergarments). There is typically an incision around the navel to elevate it to a higher position depending upon the amount of skin that needs to be excised. In many cases, liposuction may be performed as an adjunct at the same time to refine the results.

During the recovery period, the patient will need to wear a special support garment to help the abdominal area recover from the surgery. A small drain may also be placed in the area to remove excess fluid and to alleviate swelling. In most cases, patients are able to recover from the surgery within 4 weeks. In fact, many patients are able to return to work and other normal activities within two to four weeks, though strenuous activities and exercise will need to be postponed for four to six weeks.

Based upon your photos, you appear to be a reasonable candidate for an abdominoplasty.

To determine if you are a candidate for abdominoplasty or other body contouring procedures, consult with a board certified plastic surgeon.

Ozge Ergun, MD · Answer

Based on your description and images, a tummy tuck (abdominoplasty) would likely be the most effective option to address the excess skin and restore a smoother, more toned abdominal contour.
Despite your excellent efforts in the gym — loose or stretched abdominal skin will not respond to exercise alone, especially when the skin has been significantly stretched from past pregnancies and weight fluctuations. It allows for tightening of the abdominal muscles (diastasis recti repair), which often separate during pregnancy. It restores a flatter, firmer abdominal profile both when standing and bending, addressing the pouching or skin folds you may notice in different postures. You’re at a healthy, stable weight and already leading a fit lifestyle, which makes you an ideal candidate for a tummy tuck. This procedure will give you the physical results your hard work hasn’t been able to fully achieve due to the nature of post-pregnancy skin changes. I recommend consulting with a board-certified plastic surgeon who specializes in body contouring after pregnancy or weight loss.

Jeffrey M. Darrow, MD · Answer

Thank you for your photos. If your goal is to have the smoothest, flattest abdomen possible, then an abdominoplasty would be the best choice. This would allow maximal removal of the loose skin of your abdomen, as well as repairing your muscle diastasis, which is not going to repair itself in spite of all of your weight training exercises. It would help to smooth the skin below your belly button as well as above your belly button.  A mini tummy tuck would help to remove some of the loose skin below your belly button, but would not affect the skin above your belly button and you would not be able to fully repair your diastasis. There are a number of non-invasive, transcutaneous treatment treatments on the market that report to tighten the skin, but the results of most of these are relatively modest. They would also not have any effect on improving your diastasis.  A regular tummy tuck would address and correct all of the issues which you discussed. Discussed this with your plastic surgeon. Best wishes.

Ira H. Rex III, MD · Answer

From your photographs, it seems like you may be a very good candidate for a tummy tuck.  This is the only way to tighten up all of that loose skin.  You might need a small vertical incision toward the pubis if the bellybutton donor site does not stretch all of the way down to the end .  Good luck!

Daniel Barrett, MD · Answer

Dear AppleBerry1552,

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

Jose Leon, MD · Answer

Hello, thank you for the question and the pics, YES, you would greatly benefit from a tummy tuck with muscle repair ! I can't see your back, but probably also liposuction to your mis to lower back with the use of RF technology to tighten the skin and counter the effects of the weight loss

Camille Cash, MD · Answer

From the photos you are a great candidate for a tummy tuck.  This would remove the excess fat and skin as well as correct abdominal wall laxity.  The result would be a flatter, tighter tummy.  Visit with an experienced board certified plastic surgeon near you to learn more about the procedure.  I've included a video I hope you find helpful.