Skin Removal, age 66, "apron" belly after pregnancies - Options? (photos)

I would recommend an extended tummy tuck with liposuction of the back. The fat from liposuction could be used to add fullness to your lower buttocks and help round that area out. There are other techniques out there such as a "belt lipectomy" aka bodylift or a "flankplasty" that would work well also however an in person exam and review of your priorities is really important to figure which of these options is the best plan for you. Liposuction of the inner thighs and an energy based treatment to help tighten skin could also be added. A second stage surgery 3-6 months later may be needed to optimize the outcome such as a thighlift. At that second stage, other touch up work could be done such as additional skin excision or liposuction. Best Wishes!!

Hello! Thank you for your question about what to do after significant weight loss and multiple pregnancies. I appreciate you sharing your history and photos.

Most plastic surgeons would agree that you are an excellent candidate for either an extended tummy tuck or, even better, a 360 circumferential lower body lift. Both procedures effectively remove excess abdominal skin and fat. An extended tummy tuck would involve plicating the rectus abdominis muscles to correct diastasis recti, lifting and reducing the pubic area, and repositioning the belly button for a more natural contour.

The 360 circumferential lower body lift addresses not only the abdomen but also the hips and buttocks. This procedure involves an incision starting at the top of the pubic area, extending over the hips, and connecting at the top of the buttocks. It offers the advantage of lifting and contouring the hips and buttocks, resulting in a flatter abdomen, elevated and reduced hips, and improved buttock shape. This procedure also helps minimize wrinkles on the lateral hips and buttocks.

Regarding your inner thighs, you have some excess skin and fat in the upper inner third of your thighs. A modified longitudinal vertical medial thigh lift would be the best approach for this area. This procedure typically involves liposuction of the inner thighs followed by an incision made from the groin partially down the inner thigh. The incision length is generally 4 to 6 inches, extending slightly beyond the excess skin to ensure smooth results.

Both the extended tummy tuck or 360 body lift can be combined with the vertical medial thigh lift, depending on your overall health and surgical plan. These procedures are performed under general anesthesia, and most surgeons agree that combining them is safe and effective for patients in good health.

While it would be ideal for your BMI to be below 30, many experienced plastic surgeons understand that this may not be realistic for everyone. Most would agree that you can proceed with these surgeries at your current weight of 170 pounds. To determine the best surgical plan for your specific needs, I recommend consulting with multiple board-certified plastic surgeons. Many offer free virtual consultations via Skype, Zoom, FaceTime, or WhatsApp, which can provide valuable insights.

Plan for a recovery period of at least 2 to 3 weeks after surgery, and you’ll likely need to wear compression garments for about 6 weeks. Good luck! I hope this information helps answer your questions regarding your options.

Sincerely,
Dr. Katzen