Weight loss or lipo or revision?

Question

Hello, I had a tummy tuck with lipo July 2023. Prior to the procedure, I was told by 2 doctors to lose some weight as I was 179lbs at 5ft. Due to feeling depressed and obese, I continued my search. I found a doctor who stated that he could do the surgery without me doing the weight loss. Now 7 months post op, I am shaped like a ball and I look pregnant. My surgeon says it’s fine .I am unsure more weight loss or lipo or a revision? I am now 161 lbs. Thank you.

Ronald J. Edelson, MD · Answer

It’s unfortunate that you’re not happy with the result. Unfortunately many women after tummy tucks store fat inside the abdomen . Weight loss is the only answer

Steve Laverson, MD, FACS · Answer

To have a more narrow waist, flatter abdomen, and hourglass shape, a combination of weight loss, liposuction, and revision tummy tuck may be indicated.   The first of these measures should be continued weight loss.  If you are 5 feet tall, at 161 lbs your body mass index is 31.5, within obese category.  It's the Western diet, your hormones, and likely genetics causing your body to store every single extra calorie you eat.  Consider semaglutide, tirzepatide, 10xdiet.com, or another weight loss plan.  Find one you can do and stick with it until you lose the intra-abdominal fat and your body shape changes.  Abdominal skin will become loose.  At your ideal body weight, well done revision tummy tuck and liposuction will produce an amazing result.

Darryl J. Blinski, MD · Answer

The initial first two doctors were correct. Best results can be obtained in a tummy tuck surgery when patient is near an ideal weight. Your preop BMI was over 34, which classifies you in the obese category. Doing a tummy tuck at that higher rate limits the results to being obtained as you appear now. Even though you did have some weight loss with your BMI being a little over 3031 you still need to have at least a 15 to 20 pound weight loss before additional surgery should be anticipated. At this point I would recommend an abdominal ultrasound or MRI to see if the thickness of the subdermal fat above your muscles is substantial. If it is, then you might consider 360 Lipo as an answer, but with that  Operation you might have some laxative of the skin. Best to see virtually a second opinion consultation with a board-certified real plastic surgeon. Expect fees for 360 Lipo from 5000 to 10,000 thousand dollars. Good luck.

Mats Hagstrom, MD (license on probation) · Answer

There are four variables that determine what the abdomen looks like.
In other words, if somebody doesn’t like the way, their belly looks it is because of one or more of four different reasons.
The four variables that determine what the abdomen looks like are the following.
1) abdominal skin laxity typically due to previous pregnancies or significant weight loss.
2) excess subcutaneous fat.
3) muscle separation from previous pregnancies.
4) excess visceral or contra abdominal fat.
Skin laxity, and muscle separation are not contributing since you’ve already had a tummy tuck.
That leaves only excess subcutaneous fat and visceral fat as being due to potential culprit.
While both of them are made worse by obesity excess visceral fat is the number one reason patients have a bulging abdomen after a full tummy tuck.
The only way to reduce visceral fat is through weight loss and weight loss is what you need more surgery.
You don’t need more liposuction you need to lose weight.
 you may or may not be a good candidates for Liposuction but first and foremost you should lose weight.I think the two first plastic surgeons you spoke with served as good patient advocates.
The surgeon who did your procedure should’ve made a more accurate assessment and described the inherent limitations of doing the procedure without successful weight loss first.
Best,
Mats Hagstrom, MD

Weight loss or lipo or revision?

Answers (4)

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