What procedures would you recommend? Or in what order? Loose skin? (Photo)

Question

2 kids, 25, 1 c section 7 yrs ago. I want everything done but I want to avoid a tummy tuck without loose skin, is that possible? If not, is a mini TT with a BBL possible? Should I go whole mommy makeover? The idea of a full tummy tuck scares me and if I have to decide between butt or boobs, I’m going boobs:/ also want 360 lipo. I am on about a $6000 just surgery budget in the southern states and open to more rounds for other things later

Ajaya Kashyap, MD · Answer

Thank you for your query. Your skin seems to be quite good and a tummy tuck may not be needed. A 360 Vaser Liposuction with breast and/or buttock augmentation will give you very good contours. Please find an experienced Board certified Plastic surgeon who can examine you and help you with all your concerns. All the best!

Chet Mays, MD · Answer

Greetings! There are a few issues going on in this picture, Full abdominoplasty with muscle repair is the best option based on photos for possible rectus diastasis " muscle separation" from pregnancies and c-section. There is intra-abdominal fat in the abdomen which is fat meant to protect organs, this layer of fat can't be liposuctioned it can only be lost with diet and exercise changes. Mini Abdominoplasty "mini tummy tuck are for those with minimal skin laxity and no muscle separation. Please feel free to schedule a consult to discuss your body goals. 
Mays Plastic Surgery

Daniel Barrett, MD · Answer

Dear Considerate357572,
it is hard to tell for sure without an examination. Based on your photos, it looks like you would need to reach goal weight prior to any procedure. And also, you will most likely need tummy tuck in order to get good results. 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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Mats Hagstrom, MD (license on probation) · Answer

You bring up many different surgical options.
I think you need to focus on what bothers you the most and what you’re trying to achieve.
Let’s start with the front of your abdomen.
There are four tissue variables that determine what the abdomen looks like.
 if somebody says they don’t like the way their belly looks then it is almost always because of one or more of these four tissue variables.
Understanding which tissue variable is contributing more to the problem determines which is the better procedure.
The four variables that determine what the abdomen looks like are the following.
1) Abdominal skin laxity, typically due to previous pregnancies or significant weight loss.
2) Excess subcutaneous fat.
3) Muscle separation from previous pregnancies.
4) excess visceral or intra-abdominal fat.
In regards to treatment options at tummy tuck primarily treats, pregnancy related changes, which are going to be skin laxity, and muscle separation.
Subcutaneous fat is the only variable treated by Liposuction.
Excess visceral or intra abdominal fat can only be reduced through weight loss.
In your case, I would say you have moderate abdominal skin laxity, moderate excess subcutaneous fat with significant bulging of your abdominal wall.
The bulging of your abdominal wall is due to muscle separation and access visceral fat.
Without producing the visceral fat, you’re not a good candidate for a full tummy tuck, which is your best surgical option if you want a flat tight abdomen.
 Differentiating muscle separation, and excess visceral fat can be somewhat tricky, but is key for understanding your candidacy for surgery.
Liposuction is not going to get you a flat abdomen may create slightly better in your waist line. 
The best outcome would come from first having significant weight loss followed by a full tummy tuck.
To make an assessment for a BBL we need to see your body from your neck to your knees.
Your pictures don’t include proper views of your buttocks or thighs.
Likewise, without seeing pictures of your breast, we can’t make an assessment regarding breast surgery.
I don’t know what local plastic surgical prices are like in your community but I think $6000 maybe insufficient to get quality work done.
My best recommendation is you start with the obvious which is weight loss if you want to look and feel better about yourself.
Weight loss is free And surgical outcomes are going to be limited unless you lose weight first try
I recommend you avoided temptation of making your own assessment or deciding what your best course of treatment is without having in person consultations with plastic surgeons in your community.
For now I suggest you focus on weight loss and schedule in person consultations with local plastic surgeons.
Best,
Mats Hagstrom MD

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