Creases/lumps - revision or tummy tuck? (photos)

Question

I was lean/muscular pre-lipo, but wanted to fix small amt of fat after 4 kids. Dr. said no upper abs or TT necessary. Had bellafill in July 1. Still have creases around belly button and a soft lump in upper abs. Also when I bend over, still seems like there's fat left. He said he took everything possible (under 1 L.) Do I need a TT after all? Lipo revision/upper abs done? I lift/workout a ton and I feel like I should look better than I do with lipo. I'm kind of embarrassed.

Alan Gonzalez, MD, FACS · Answer

Hello @lcp85, thank you for your question and showing your pictures. Exercise and weights improve muscle structure, but the quality of the skin depends on other factors, and in your case, flaccidity may be noticeable. In addition there are some post-Liposuction irregularities. I recommend using laser technology and TID in order to improve and regularize the tissue and generate more contraction in the skin. You can also opt for some non-surgical treatments such as Radiesse and Ulthera to gradually improve the skin. For a proper assessment I suggest you consult one or several board certified plastic surgeon for more information and options. Best wishes! Alan Gonzalez MD FACS

Tommaso Addona, MD · Answer

Thank you for your question.
Based on your photos, I believe that a mini abdominoplasty may leave you with the best possible aesthetic. While liposuction does an excellent job at removing excess fat in the body, you will be left with excess skin. A mini abdominoplasty will be able to remove the excess tissue between the umbilicus and the pubic region, create a youthful umbilicus, and repair your rectus muscles that may have separated during child bearing. This will leave you with a flatter, smoother contour to the abdomen. I also tend to liposuction the flanks in order to provide an hour glass figure. I recommend speaking to a board certified plastic surgeon to discuss your options.

Justin Yovino, MD, FACS · Answer

I think the only option that will tackle your issue is a tummy tuck. Removal of fat (liposuction) in those areas will only leave you more deflated and do nothing for the skin. A tummy tuck would elevated all of the skin and then re-drape it downwards to pull it all tight. The downside of a tummy tuck with you is the likelihood of a short vertical scar between your belly button and the pubic area. This vertical scar would come from the area where your belly button used to be in the skin that has been pulled downwards. Of course, there will also be a low transverse scar in the lower abdomen / pubic area and a scar around your current belly button. There are non-invasive options such as Morpheus 8 which can help tighten the skin but it's more of a subtle improvement and does not compare to a tummy tuck.

Daniel Barrett, MD · Answer

Dear lcp85,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Mats Hagstrom, MD (license on probation) · Answer

Everybody is going to form skin lines when they Flixster torso. If you had tight skin with a flexed tour so you wouldn’t be able to stand up straight.
All women develop some degree of abdominal skin laxity and muscle separation from term pregnancies though it affects some women far more than others.
Typically the treatment for pregnancy related changes as a full tummy tuck. Having children does not change your fat distribution.
Did you have a Bellafill injected on your abdomen?
To make a quality assessment we need to see proper before and after pictures. If you don’t have those then ask your provider to forward the ones your they took.
Is your provider an experienced board-certified plastic surgeon?
Consider having proper a second opinion consultations with other local board-certified plastic surgeons in your community. For a second opinion consultations patient should come well prepared bringing with them all before and after pictures and a copy of your operative report. These are all available from your current doctors office since they are part of your medical record. Just called her office and asked for copies of your medical records specifically your operative report and all pictures taken. 
If you want a tight flat abdomen then you’ll need a full tummy tuck.
In a standing position you robbed them and doesn’t look that bad. The truth is most plastic surgeons are not very good at doing liposuction.
Patience considering Liposuction should be extremely selective and interview numerous plastic surgeons before committing to having the procedure. Liposuction is permanent and irreversible. Correct and poorly done Liposuction is extremely difficult but often some improvements can be had. Considering that revision work is many times more difficult than primary liposuction and most plastic surgeons aren’t very good at even doing primary liposuction the need to find someone who is seriously talented in this procedure speaks for itself. 
During consultations ask each provider to show their entire collection of before and after pictures for the area you’re interested in. An experience provider should have no difficulty showing you at least 50 sets of before and after pictures of common procedures like abdominal liposuction. highly experienced surgeons will have hundreds or even thousands of before and after pictures of commonly performed procedures.
Being shown a handful of preselected pictures which most likely represent the best results of the providers career it is insufficient to get a clear understanding of what average results look like in the hands of each provider. being board-certified and plastic surgery with an overall good reputation is insufficient to confirm someone has mastered liposuction.
Correct and poorly done Liposuction results is extremely difficult. Treatment options include revision liposuction(doing more liposuctio in an attempt to even out the area) fat transfer to restore areas were too much fat was removed or converting the procedure to a skin tightening operation like a full tummy tuck.
All of these options have major inherent limitations.
I suggest first and foremost following up with your provider to see what he or she has to say then start scheduling second opinion consultations if you’re interested in trying to correct or improve upon the outcome.
Best,
Mats Hagstrom MD

Creases/lumps - revision or tummy tuck? (photos)

Answers (5)

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