What is my stomach type and do I need a tummy tuck? Can this be addressed with laser liposuction alone? (photos)

Question

This how my stomach looks at various weight points. I battled type 1 obesity most of my life. What stomach I have that give my stomach a slightly hang apron like appearance? Is A: Pannus? Panniculus Type 1? Abdominal flaccidity? Diastasis Recti? Can Laser Lipo address the issues or I wil have loose skin that I will nee a tummy tuck? What type of tummy tuck is recommend if I need such?

Thomas Wright, MD · Answer

Diana, thank you for sharing your photos.  From your photos I don't see any signs of abdominal flaccidity or diastasis recti. You appear to have normal torso and I would not describe the small roll on your lower abdomen as a pannus.  I think you are a good candidate for a good result with Laser Liposuction.  Wishing you the best.

Alan Gonzalez, MD, FACS · Answer

Hello @DianaJ89, thank you for your question. Yes for best result you need a Tummy tuck because there is an excess of skin. There are 4 factors that are taking into account when it comes to the abdomen shape: Lax skin, diastasis recti, fat under the skin and intra abdominal fat. The first two are treated with a tummy tuck and the latter with lipolysis made with liposuction. It is important that you have a consultation with a board certified specialist to determine a surgical plan according to your needs. Best wishes! Alan Gonzalez MD, FACS. Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science” Member (IFATS), Colombian Society of Plastic Surgery member (SCCP)

Sergio Sanchez-Bailon, MD · Answer

The best thing to give you a right answer is having a consultation, so a physical exam is done as well as the photos. Other thing must be assessed, is the medical history and the most important of those is if you have been pregnant, that is the main factor that causes a Diastasis Recti. In my experience the best results for a patients that's had a pregnancy is doing a Lipoabdominoplasty or Liposuction + Tummy tuck, so you can do the muscle repair, get rid of the extra skin and also the body contouring with the Liposuction. And if you have not been pregnant I would advice you have a Liposuction using technology to have the best results possible, that is using a Ultrasound instead of Laser (Vaser), Power Asissted Liposuction (Microaire), and a Radiofrequency technology (Renuvion-JPlasma or Inmode-Bodytite). Everything we have at our disposal to look for your best results.

Louis D. Cole, MD · Answer

Thank you for your question. By looking at your pictures, you seem to be a great candidate for laser liposuction done under tumescent anesthesia.. Although you have a bulge in your lower abdomen, it looks like you have a good skin quality and would respond well to fat removal and collagen stimulation. Good luck on your journey.

Darryl J. Blinski, MD · Answer

GREAT series of posted photos! You really think any type of liposuction can effectively address your abdominal issues? NO WAY! You need full TT with muscle plication and lipo of waist/flanks. Fee $8,000. Best to virtual consult with....

Mats Hagstrom, MD (license on probation) · Answer

Choosing the correct procedure should be based on having a clear understanding of what the underlying problem is. In other words, the first step in the process is to make an accurate diagnosis or assessment.
There are four variables that determine what someone’s abdomen looks like. Each of these four variables has its own way of being treated and determines what is the best procedure.
The Ford variables determine what someone’s abdomen looks like our abdominal scan laxity typically do to previous pregnancies for weight loss, excess, subcutaneous, fat, muscle separation from previous pregnancies, and lastly, access, visceral, or in the truck domino fat. 
A tummy tuck primarily treats, abdominal scan, laxity, and muscle separation from previous pregnancies. Liposuction reduces subcutaneous fat.
Excess visceral fat can only be reduced through weight loss. I’m all the information that you listed. What is not included, is a history of previous pregnancies or not. This is paramount in order to make a quality assessment. Muscle separation only happens from previous pregnancies.
Patients should also consider if future pregnancies are part of the picture and if so, patients should not have a tummy tuck until they’re done having children.
Liposuction will reduce subcutaneous fat, and I will do some extent mimic, successful, weight loss. It will not treat abdominal skin laxity, regardless of what form of Liposuction is used.
I suggest having multiple in person, consultations with local board-certified plastic surgeons in your community to get an accurate assessment and better understanding of treatment options.
There is significant variation in outcomes, depending on which surgeon you choose. For that reason, I recommend patients have multiple consultations to properly vent to each provider to find the best, most talented and most experienced provider for your needs.
This is true, regardless of what procedure you choose. Liposuction seems to have particularly large variation in scale among different providers.
During each consultation, ask each provider to open up their portfolio and show you their entire collection of before and after pictures for the procedure, you are interested in. As providers just show you examples of previous patients who had similar body characteristics to your own. For a reference and experience surgeon should have no difficulty showing you were at least 50 sets of before, and after pictures of commonly performed procedures, like abdominal liposuction, or tummy tucks.
Best,
Mats Hagstrom, MD

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