Need Help and Its Uncomfortable(lower Hanging Belly Fat)? (photo)

Question

I'm 5'4", 246, 30 years old and as you see in the photos, I'm dealing with a lot of hanging skin. This I developed after a weight gain of 98 pounds with my last pregnancy due to complications. The heaviness of the fold is now uncomfortable and embarrassing. I'm trying to get down to 160 but I know this will only get worse. Any suggestions because its not comfortable and I can't lay on my stomach and have pain in that region a lot.

Richard J. Bruneteau, MD · Answer

There’s no question that being close to your ideal body
weight improves the results from tummy tuck surgery.It also decreases the potential for
complications with this type of surgical procedure.For these reasons, we prefer that patients be
within 10% of their ideal body weight at the time of surgery.Unfortunately,
reaching an ideal weight is easier said than done.The vast majority of patients are
unsuccessful at losing this additional weight.It’s also important to realize that even when patients are overweight,
they can potentially benefit from abdominoplasty.We therefore evaluate every patient on an
individual basis.In your
case, a temporizing maneuver might be helpful.Although it’s difficult to make a specific recommendation without a
physical examination, your history and pictures suggest that you might benefit
from an abdominal panniculectomy to remove your hanging skin.This procedure has the potential to
significantly improve the quality of your life.It may also facilitate further weight loss by improving exercise
tolerance. At some point, if further
weight loss occurs, you may be a good candidate for a formal abdominoplasty.It’s
important to consult a board certified plastic surgeon with experience in this
area.This surgeon can formulate a
treatment plan that addresses your anatomic findings and aesthetic goals.

Kenneth Hughes, MD · Answer

You may be a candidate for panniculectomy if you have rashes or infections underneath your hanging belly. In addition, you should be evaluated for hernia. See your plastic surgeon for more details and an exam.

Steven H. Williams, MD · Answer

Thanks for your question and congratulations on your weight loss, it is one of the hardest things we ask our patients to do.

	 

	You're right that as you lose weight you may notice more sagging skin.  You'll have a better cosmetic result if you can be as close to your ideal body weight as possible.  

	 

	Sometimes patients in our San Francisco area practice have staged procedures which can include liposuction to reduce existing fat followed by a tummy tuck some months later.  You may also consider a panniculectomy to remove the hanging skin you have now and have a tummy tuck at a later date when you've lost more weight.  The down side to this approach is having two surgeries instead of one.

	 

	I hope this helps.  We have before and after pictures of people who have had staged procedures, please take a look if you'd like.

Ellen A. Mahony, MD · Answer

Hello SassyNatty,

	Congratulations to you on your determination and continued success!

	At a rate of -18 lbs per month, you are making great headway and will get the best results from your future tummy tuck if you stick with your weight loss program and close in on your goal weight.  I think it makes sense to keep the tummy tuck as your goal and not do an intermediary step like a panniculectomy:  do it once and do it right.

	The good news for you is that you are seeing immediate results from your own efforts.  Here are some TIPS for you along the way:

	1.  If the loose skin is really annoying you...try wearing a girdle or spanx for added support and comfort, even at night

	2.  Be sure to enjoy a balanced diet and keep up your protein

	3.  Add  cardio and weight training to your program.  This will hasten your progress, keep up your energy and tone your muscles.

	* DO HAVE A MEDICAL EVALUATION IN ADVANCE OF ADDITIONAL EXERCISE TO ASSESS YOUR FITNESS BASELINE AND DETERMINE IF ANY OF YOUR ABDOMINAL DISCOMFORT COULD BE RELATED TO A HERNIA

	4. Decisions about more children?  It is best to hold off on tummy tuck surgery until you have completed your family, especially if tightening the muscles of the abdomen are part of the procedure.

	Best of luck to you!

	Thanks for asking, Dr Ellen

Robert Kearney, MD, FACS · Answer

Ultimately you will be a candidate for a tummy tuck. In the meantime you need to workout, build muscle and strengthen those abdominal wall muscles. When you carry those babies around for nine months they suck all the muscle mass off of you which is why it is hard to get back in shape. It might take you a year - having surgery in the short term would lead to a less than optimal result with a significant chance for redo surgery.

Gregory T. Lynam, MD · Answer

You appear to be a fair candidate for an extended tummy tuck procedure. please seek out a board certified plastic surgeon for consultation. Good Luck!

Jourdan Gottlieb, MD · Answer

Congratulations on your ongoing accomplishments. Although the amount of overhang may increase, the weight of the overhanging tissue will decrease some, and the symptoms should gradually improve. 

	Many medical supply shops will have trusses that can be worn to support the overhanging skin, but they don't work well for everyone. With some more time to go before reaching your weight it is worth a try.

	You will most certainly be an excellent candidate for a tummy tuck when you have reached your goal weight.

	When you ready for an in person consultation, RealSelf has listings of surgeons in your area. You should consider cross referencing the listings from the The American Society of Plastic Surgeons (plasticsurgery dot org). A listing in the ASPS website assures you that your surgeon is not only board certified,  but also is a member in good standing of the major plastic surgery organization in the U. S.

	Thank you for your question, best wishes.

Pablo Prichard, MD · Answer

Hello and thank you for  your question.

	I understand your frustrations and applaud you for being determined to lose weight.  Your ideal result will be only after you lose weight  down to your goal weight.  However, some ladies elect to have a 'panniculectomy' to remove just the skin and fat that is hanging below the belly button.  This motivates them to work out and lose more weight and eventually have the definitive abdominoplasty once they get to their goal weight.

	Best Wishes,

	Pablo Prichard, MD

Darryl J. Blinski, MD · Answer

You could be a candidate for an apronectomy of this excess skin/fat. But ONLY in person evaluations will see if your are a candidate. Most cases we would like to see some weight lose prior to any surgery.

Tracy Pfeifer, MD · Answer

Thank you for your question and for providing the photo.  It is great that you recognize that you need to lose weight.  It may be difficult with this much extra skin.  Some surgeons might consider performing your surgery prior to the weight loss, as you will then be better able to exercise and lose the weight.  I agree completely that you should be evaluated by a Board Certified plastic surgeon.  You can find out if you have a hernia, which may need to be addressed, and discuss your surgical options. 

	Tracy M. Pfeifer, MD, MS

Need Help and Its Uncomfortable(lower Hanging Belly Fat)? (photo)

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