Body and face proportions after tummy tuck?

Question

I am 33 yo 5'2" my prepregnancies weight was 115 lbs now I am 138 lbs. i am having a hard time losingg the weight, has some high risk pregnancies and now I am dealing with diabetes and hypothyroidism. I hate my midsection but something else i dont like is how round my face looks. I am considering a tummy tuck and lipo for my midsection (tummy and thigs) but i want to know if my face will look any different? Or would I look all disproportional a round chubby face with a nice shaped body?

Gary M. Horndeski, MD · Answer

Great question.Your face will not look any different after a TT or liposuction unless you loose weight. Loosing weight after pregnancy can be very difficult due to the stretching out of your fascia and other structures of your abdominal wall. I wrote a paper published in Plastic and Reconstructive Surgery journal a few years ago that explains this phenomenon in detail. Google it!  It also explains why women who are overweight or obese loose weight after a TT with mesh reinforcement. So, if you have tried loosing weight through diet and exercise, but failed, you may want to consider this procedure. You must be done with pregnancies in order to undergo this procedure since the mesh will not allow your abdomen to expand. The mesh acts like an internal girdle that keeps your tummy flat and gives you a feeling of being full allowing for weight loss to occur. Most of my patients who are overweight who have had this procedure experience a significant weight loss post op.Hope this helps.Kind regards,Gary Horndeski M.D.

Ajaya Kashyap, MD · Answer

Thankyou  for your question.It is important to understand that if you gain weight after liposuction it can go to other parts of the body, which could include the neck and the face. If, however yyou combine the liposuction  with a good diet and exercise regimen ( lose some weight  on your own) there should not be any increase in the face and neck fat. You will look better and would probably be able to control your diabetes better. All the best!

Vishnu Rumalla, MD · Answer

Thanks for your inquiry and interesting question.  It is impossible to for any of us to fully know if you will be unhappy with the proportion of our face to your body after a tummy tuck--because it is a very personal determination.  I always tell patients if you have any reservations or not willing to accept the risks with an elective cosmetic surgery procedure then you should not do it.  Make sure you choose a highly experienced plastic surgeon if you decide to have surgery who discusses your concern in advance.  Good Luck.

Austin Hayes, MD · Answer

It's a good question. It seems unlikely that your face would be out of proportion to your body. When preparing for any body contouring procedure it's best to reach your goal weight and make sure that your able to maintain it. In your situation it sounds like control of hypothyroidism and diabetes would help you achieve this goal.Being at your goal weight when you undergo surgery helps your surgeon obtain the best result, and gives the best chance to make the postoperative result long-lasting.Good luck with the process!

Jay Burns, MD · Answer

This is a great and important question. Most people don't think of this but I discuss this topic with all of my patients undergoing body contouring, especially those who are struggling with their weight. That includes most of us!There are three things I think all patients should consider regarding weight and cosmetic surgery.You will be both healthier and a better surgical candidate at your ideal weight. The best way to lose your weight is diet and exercise. However if that is not possible then consider the next two points.if you are having a skin tightening procedure such as tummy tuck then you will do better at your lowest weight so that the maximum skin can be removed and the contours will be more easily seen. if you are having a fat reduction surgery such as liposuction then you are best being honest with yourself and get to a weight you can maintain easily. If you diet down to a weight you can not maintain then when you gain your weight back after liposuction, you will gain it in places other than where you had the fat removed. So if you consider the points above, let me try to answer your question as best I can.  Everyone adds fat in certain areas preferentially. Some people get fat faces and some never put fat in their face. Some put fat in their lower body and some put it in their midsection. It appears that when you added your weight during pregnancy, you added it more evenly over your body and face. Fat is not something that is easily removed from your face safely, so contouring your body with a tummy tuck and lipo should have no effect on your facial fat unless you gain weight post operatively. If you gain weight in the future, your face may show the growth in an exaggerated form as the fat will not go as easily to your body where the work was done, but will go to your face. If you lose weight after your surgery, that would be ideal as your face would return to pre pregnancy form and such weight loss would only enhance the result of your surgery. If you stay the same weight then your body will look better and your face will look the same as it does right now. Hopefully these different scenarios will help you decide the best course of action. All the best.

Tom J. Pousti, MD · Answer

Thank you for the interesting/unusual question. I have not had patients report that they feel that their faces are disproportionate to their bodies after undergoing body contouring surgery.  My best suggestion: do your best to achieve your long-term stable weight prior to proceeding with any type of elective surgery. This may be challenging with the hypothyroidism… Make sure that the diabetes and hypothyroidism are well controlled. Then, it will be important for you to select your plastic surgeon carefully. Working together, you will come up with the best plan to achieve your goals. I hope this, and the attached link, helps. Best wishes.

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