Do I need a tummy tuck to remove loose skin and possible fibrosis? (Photos)

Question

Do I need a tummy tuck? I have some loose skin and I am not sure if I have fibrosis? I had lipo ten years ago and my stomach has since looked like this. I am thinking I need a tummy tuck when in reality all I want is a flat stomach. Im really hoping I can achive that with just liposuction & hopefully get rid of the fibrosis (i am not sure ehat to call it).

Leila Kasrai, MD, FRCSC · Answer

It appears that you have loose skin in the marked areas. For this reason, a tummy tuck would be suitable. Liposuction alone would not tighten this loose skin. During the surgery, your surgeon can also target any scar tissue that has developed.

J. Timothy Katzen, MD, FACS · Answer

Hello Teresa9413, Thank you for your question regarding whether you need a tummy tuck to remove loose skin and possible fibrosis. Thank you for your history and pictures. Most plastic surgeons would agree that you have fibrosis from your prior liposuction. Let's analyze your pictures. Three things can go anatomically wrong with the abdomen: skin, fat, and muscle. Let's examine each area individually with you. In the skin department, you have MILD cutis pleonasmus (excess skin), NO stria (stretch marks), and MILD dermatocholosis (loose skin). In the fat department, you have MILD lipodystrophy (excess fat). The lumps you see are scar tissue, not fat. In the muscle department, you have a distended abdomen and laxity of the rectus muscle. In your case you have rectus abdominis weakness, not rectus diastasis. Therefore, most plastic surgeons would suggest a tummy tuck rather than more liposuction. Liposuction could lead to more scarring in the fibrotic area. Most plastic surgeons would suggest that it would be safer to undergo a tummy tuck than undergo another liposuction and risk more unevenness and fibrosis. During your tummy tuck, the scar tissue (fibrosis) from the prior liposuction can be removed. Therefore, go with the tummy tuck. Tummy tucks take about 3 to 4 hours to complete and require general anesthesia. Usually, two drains are placed and are removed after 10 to 14 days. Most patients can return to activities of daily living after about two weeks. Most patients are able to return to their regular exercise routine after about six to eight weeks. Most plastic surgeons offer free virtual or in-office physical consultations. Therefore, explore what other plastic surgeons have to say. Good luck. I hope that I have answered your question regarding whether you need a tummy tuck to remove loose skin and possible fibrosis. If you have any more questions regarding tummy tucks, abdominoplasties, or abdominal liposuction, contact an experienced plastic surgeon. Since tummy tuck surgery is a big procedure, please seek an experienced, board-certified plastic surgeon who has significant experience performing tummy tucks. Do your research. If you cannot find an experienced tummy tuck plastic surgeon in your neighborhood, consider traveling out of state. Sincerely, Dr. Katzen, MD, MBA, FACS, FICS (Plastic Surgeon, President of the American Society of Bariatric Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

Kadir Berat Oyur, MD · Answer

Based on the photos, there appears to be mild skin laxity and contour irregularity that may be related to previous liposuction. If your goal is a flatter abdomen, liposuction alone is unlikely to address loose skin and may not improve fibrosis or contour deformities. You may be a better candidate for a tummy tuck, which can remove excess skin and improve abdominal contour more effectively. A physical examination is necessary to determine the extent of skin laxity and any underlying scar tissue before recommending the best treatment.

Joel Patrick Maier, MD · Answer

I think revision liposuction of the peri-umbilical area will help. It looks like a "doughnut" of fat remains around the umbilicus. You can also have your pubic area treated as well which will help your contour and likely meet your expectations. I do not thin you skin elasticity is a problem. I hope this helps. Thank you.

Mehmet Ozdemir, MD · Answer

Based on your photos, the contour concerns appear to be related to a combination of skin laxity and possible scar tissue or contour irregularities following previous liposuction. Liposuction alone is unlikely to flatten the abdomen if excess skin is present. A tummy tuck may provide the most predictable improvement, with scar tissue addressed as needed during surgery. An in-person examination is essential to determine the best treatment plan.

Gary M. Horndeski, MD · Answer

A tummy tuck can be performed.  However, it does not appear you have that much skin.  You may want to consider a mini tummy tuck.

Best Wishes,

Gary Horndeski, M.D.

John LoMonaco, MD, FACS · Answer

I see the areas you want improved.  If its scar tissue (fibrosis), residual fluid (pseudobursa) or loose skin, the best treatment is the same: andominoplasty with or without liposuction depending on your goals.  I syart with an ultrasound exam in the office and make a plan from there.  Best wishes from Texas !

Guray Yesiladali, MD, FEBOPRAS · Answer

The photos suggest skin looseness with some uneven contour around the umbilicus and lower abdomen. However, fibrosis, residual fat or scar-related tethering cannot be diagnosed reliably from images alone.
If the main issue is excess skin, further liposuction would not be expected to flatten the abdomen and could make the laxity more visible.
A tummy tuck would likely be the more effective option if skin removal and correction of previous liposuction changes are needed.
An in-person examination is necessary to assess the fat layer, skin quality, abdominal wall and any firm scar tissue before choosing the right approach.
I wish you clarity in understanding the cause of the irregularity and a result that gives you a smoother, flatter contour.
&mdash; Güray Yeşiladalı, MD

Yasemin Aydinli, MD · Answer

Whether liposuction alone can give you a flat stomach depends mostly on your skin quality and whether the bulge is fat or loose skin. If your skin still has good elasticity and the main issue is fat plus the firm fibrosis left from your previous lipo, then liposuction with a fibrosis release and an even-layer technique can improve the contour nicely. But if the skin is loose or the muscle is lax, liposuction will smooth the fat yet leave the skin hanging, which is where a tummy tuck becomes the better tool. The fibrosis itself can usually be softened or released during surgery. An in-person pinch-and-skin assessment is what determines which path actually gets you flat.

Semih Yildiz, MD, FEBOPRAS · Answer

The main issue visible in the photos is loose abdominal skin and some contour irregularity around the belly button and lower abdomen, but a photo cannot confirm whether this is fibrosis, residual fat, skin laxity, or scar-related tethering.

If the main problem is loose skin, more liposuction alone usually will not make the abdomen flatter and may even make looseness more noticeable. A tummy tuck is often the stronger option when skin needs to be removed and the abdominal wall or old liposuction changes need to be assessed. An in-person exam is needed to check skin quality, thickness of the fat layer, muscle separation, and any firm scar tissue before deciding between revision liposuction, scar release, energy-based tightening, or a tummy tuck.

Do I need a tummy tuck to remove loose skin and possible fibrosis? (Photos)

Answers (12)

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