To make an assessment on the outcome of a plastic surgery procedure we always need to see proper before and after pictures. If you don’t have before and after pictures, then contact your surgeon and ask them to forward the pictures they took. Weight loss patients typically have diffuse skin laxity of their torso in both horizontal and vertical directions. The skin laxity is not focused on just the front of the abdomen And the more extensive tummy tuck is needed in order to deal with the diffuse skin laxity on your body from your successful weight loss. It would be helpful to know how many pounds weight fluctuations you’ve had at your maximum. To get more diffused skin tightening, you’ll need a wraparound tummy tuck, and may need to consider a fleur-de-lis pattern as well. This will add longer scars, which will most likely heal with the same hypertrophic nature. You do not have evidence of excess subcutaneous fat and Liposuction is not indicated. Weight loss patients need more skin surgery, and if there is any doubt, the procedure should be made more extensive rather than less. Weight loss patients don’t need liposuction they need extensive skin surgery. A tummy tuck, whether extended or regular will only tighten skin in a vertical direction. Patients will still be left with horizontal skin laxity, unless they had a vertical component with the fleur-de-lis incision. The fleur-de-lis pattern leaves a highly visible scar and isn’t for everyone. You have to balance, the desire to have tight skin versus highly visible scars. I recommend all patients have multiple in person consultations before scheduling, permanent, irreversible body contouring procedures. There’s no recommended correct number of consultations, but I suggest patient start by having at least five in person consultations before scheduling surgery. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of patients with similar body characteristics. Male tummy tucks are not as common as tummy tucks based on previous pregnancies, but a sufficiently experienced surgeon should have pictures of skin only male tummy tucks from successful weight loss patients. Look carefully at results, especially making note of the extent of surgery. Without knowing the conversation you had with your provider, it’s hard to be critical of the outcome. It’s also important to show before and after pictures when judging outcomes from cosmetic surgery procedures. Considering you will most likely need a more extensive procedure a second surgery may, in fact, be more involved in the primary procedure rather than a revision. In the end, choosing the correct procedure is a balancing act between patient candidacy, provider skill and experience, and balancing what you’re trying to achieve with what you’re willing to go through. Best, Mats Hagstrom, MD