Full tummy tuck but no muscle repair? Donut lift only with implant? Please give me advice! (photos)

I have lost approx 120 lbs (diet & exercise took abt 5 yrs) 29 no kids. I had a consult with a very talented and respected PS. He said I did not need muscle repair and would remove my skin above the navel & excess fat. Also said I only needed a donut lift (w implant) bc my breast sagging isn't too bad. This was GREAT news to me bc of less scars on breasts & better recovery, but is this too good to be true?! I am seeing other PS but I really want to book with him. Any advice is appreciated.

Doctor Answers 13

Type of a Breast Lift with Mommy Makeover

The intentional result of a Breast Lift (#Mastopexy) is to improve the shape and position of the breast without reducing their size. It is used especially for breasts which sag or droop (#ptosis) as a result of aging, weight loss, pregnancy, or breastfeeding. However, many women report more satisfaction if an implant is used at the time of #mastopexy. The implants further shape their breasts, restoring superior fullness or volume which may be decreased over time.
In regards to implants alone, this is usually said to be mistake by patients reflecting back at the decision. Most breasts will look larger and more droopy with solely implants. They will sag more and sooner, due to the sudden and excess weight. At times it's possible for a “Snoopy” breast or double bubble to develop as a result. There are a variety of techniques for a #BreastLift. I prefer to use the short scar technique, “#lollipop scar” or “#donut lift” rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant scarring. Although the “anchor-shape” or inverted “T” incision is still more popular in the United States, it represents an older technique with extensive #scarring and a less optimal result in many cases.
It is imperative you select a plastic surgeon who is #board-certified and has a great deal of experience with breast #augmentation and the incision type, #implant placement, and implant type. Plastic surgeons who have specialized in breast surgery and cosmetic surgery are suitable to perform your breast augmentation. Aside from checking board-certification, it is suggested that you look at before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision.

Orange County Plastic Surgeon
5.0 out of 5 stars 94 reviews

Surgical options

If you are happy with the shape of your breast and only want to improve in size then a breast augmentation and full tummy tuck would address your areas of concern. As for the muscle repair, you are already there so might as well do it. Definitely seek out a board certified plastic surgeon in your area with an expertise in Body Contouring and Aesthetic Breast Surgery for a consultation. Be sure to express your expectations and goals to the surgeon your choose. Good luck, Dean Vistnes.

M. Dean Vistnes, MD
Bay Area Plastic Surgeon
5.0 out of 5 stars 40 reviews

Plenty of option

Good for you for losing the weight! You need to remove the excess skin through an abdominoplasty approach. I disagree with one of my colleagues who suggested liposuction, your excess skin will sag even worse and you will not be happy with this. Muscle repair is an option and will,yield a better result. Since you have to remove the excess skin and undoing up to the ribs to do this, why not repair the abdominal wall? It doesn't extend recovery that much. Your wall,laxity is not too bad so not doing it would not be a bad thing

it is hard to evaluate the breasts but I think an implant or fat transfer would make a nice change and a mastopexy would not be needed depending on how much volume you would add with a augmentation.

Michael S. Beckenstein, MD
Birmingham Plastic Surgeon
4.9 out of 5 stars 18 reviews

Full tummy tuck but no muscle repair? Donut lift only with implant? Please give me advice!

From your photos, I believe you would be a good candidate for a donut lift and breast augmentation.  With regard to the tummy tuck, it is difficult to say if you need a muscle repair or not.  However, if you have had a 120 lb weight loss and feel your abdomen looks substantially better when you "suck in your stomach" , you may want to consider the muscle repair.  best wishes, Dr. Lepore.

Vincent D. Lepore, MD
San Jose Plastic Surgeon
4.9 out of 5 stars 49 reviews

Full tummy tuck but no muscle repair? Donut lift only with implant? Please give me advice!

Thanks for the questions. But very hard even with posted photos to be sure if a mini or full TT is the correct option. Best to see a few of the over 80 boarded PSs in South Florida in person.. 

Full tummy tuck but no muscle repair? Donut lift only with implant? Please give me advice! (photos)

consider a liposculpture of the entire torso with fat injection into breast and butt with or without skin excision of these areas.

Ofer Rodriguez, DO
Miami Plastic Surgeon
5.0 out of 5 stars 2 reviews

Full tummy tuck but no muscle repair? Donut lift only with implant? Please give me advice!

Most patients will benefit from some degree of plication after massive weight loss.  The implant with lift is probably reasonable based upon the pictures.  I would search for the board certified plastic surgeon who you feel is most likely to give you the best results and who performs hundreds of these procedures each year. I would look at patient reviews as well as before and after photos on that surgeon's website.

Kenneth Hughes, MD

Los Angeles, CA

Good candidate for and abdominoplasty but probably breast augmentation only.

 I personally am not a fan of the donut breast lift except in very select patients. I think you get a good result with and abdominoplasty.  A breast augmentation alone should give a good result.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 32 reviews

Full tummy tuck but no muscle repair? Donut lift only with implant?

Congratulations on your weight loss! You appear to be a good candidate for abdominoplasty . Muscle tightening is performed on majority of my patients-- if indicated . Re/ breasts-- from the photos it appears that you are a candidate for mastopexy ( this will give you your perkiest breasts) and possible breast augmentation if you desire volume increase.

Full tummy tuck but no muscle repair? Donut lift only with implant? Please give me advice!

Thank you for the question and pictures. Good job with your significant weight loss!  As you know, the tummy tuck procedure typically involves plication  of the abdominal wall muscle that have spread during pregnancy or weight gain/loss.  IN MY OPINION, omitting  this part of the procedure for the vast majority of patients who present for consultation will  possibly or likely leave them with continued abdominal wall laxity and, in my  opinion, a less than optimal result.    Based on your history and photographs,  I think you will benefit from muscle plication as well as breast augmentation/“donut” mastopexy. Make your decisions carefully…  You may find the attached link, dedicated to patients who have experienced significant weight loss, helpful to you as you learn more.

Best wishes for an outcome that you will be very pleased with. .

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.