Would an extended tummy tuck help tighten the remaining skin and flanks? Can the bulge be corrected? (Photos)

Question

I am 38, have lost about 70 lbs and 10 months post-op from a tummy tuck, breast lift, and BBL done together by a high-profile board-certified surgeon. I originally wanted Lipo 360 and a dramatic BBL. I was advised I needed an abdominoplasty and I agreed but I preferred to stage my procedures. The surgeon recommended doing everything at once. At the last minute, I also added a breast lift. After four kids and weight loss, I know my skin lost elasticity, but I still expected a smoother, tighter result. I later learned I had a standard tummy tuck when I likely needed an extended one to remove flank skin. Only 300 cc of fat was transferred to each buttock, and my hips weren’t contoured despite my request for a curvier look. I’ve spent over $30,000 and traveled for surgery but still have loose skin, a bulge above my belly button, very boxy look, limited projection, and a crooked left breast. Loss of nipple sensation in left breast. My surgeon offered a revision with more lipo and fat grafting to the hips, but I feel a more extensive revision is needed. Would an extended tummy tuck help tighten the remaining skin and flanks? Can the bulge be corrected?

Sibel Atalay, MD · Answer

Thank you for sharing your journey so openly, it’s completely understandable to feel disappointed after putting so much trust, time, and investment into your transformation. After significant weight loss and multiple pregnancies, it’s very common for skin elasticity and tissue quality to vary, which can make achieving perfectly smooth or balanced results more challenging, especially when several procedures are performed together.
Based on visuals and what you described, it does sound like you may benefit from a revision abdominoplasty, potentially an extended tummy tuck, to address the residual loose skin and tissue around the flanks. An extended approach allows for more lateral skin tightening, which helps refine the waistline and create a smoother, more tapered contour.
The bulge above the belly button could be related to residual fat, laxity in the upper abdominal wall, or incomplete plication (muscle tightening) during your first surgery. These issues can often be improved during a revision by re-tightening the muscle layer and removing excess tissue.
As for your breast asymmetry and loss of sensation, those concerns can be assessed in detail during an in-person exam. Minor asymmetries and nipple changes can sometimes be refined with targeted revision, but it’s important to allow full healing before planning any surgical correction.
A thoughtful revision plan, possibly staged this time, could help restore balance and smoothness while improving definition in your waist and hips. I always recommend a comprehensive in-person evaluation with a board-certified plastic surgeon experienced in post–massive weight loss and revision body contouring. This allows for careful assessment of your remaining tissue, scar placement, and realistic options to achieve the refined, natural silhouette you originally envisioned.
Warm regards,Dr. Sibel Atalay, MDBoard-Certified Plastic Surgeon

Camille Cash, MD · Answer

Congratulations on your weight loss!  If you are still losing weight it is recommended to wait until you reach your goal before proceeding with further procedures.  From the submitted photos it appears a revision would be helpful.  The revision would repair separated muscle and remove excess fat and skin.  Liposuction could be added for further contouring.  See a board certified plastic surgeon near you to learn more.

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