Is this normal following huge weight loss and tummy tuck? (photo)

After losing around 250lbs naturally, I had surgery to remove skin. After a year post-op, I am all healed up, but I still have quite a bit of loose skin that rolls when I sit down. My surgeon - who I trust - says there's not much more he could do. He mentioned a vertical cut but did not recommend it. He doesn't believe there is enough skin he could get to warrant the long incision. He says my skin elasticity is unfortunately, that poor. Does this look normal for my post-op situation?

Doctor Answers 4

After massive weight loss

hello. interesting question. I would recommend to do  another surgery. patients with  massive weight loss  usually needs more of one reconstructive procedure to achieve their goals.

Dominican Republic Plastic Surgeon
4.5 out of 5 stars 384 reviews

Is this normal following huge weight loss and tummy tuck?

   Actually, these results are very good, and I would have to say I would not recommend a vertical incision either.

Kenneth Hughes, MD

Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 482 reviews

More Surgery?

Recurrent skin laxity after surgery is a problem with massive weight loss patients such as yourself. What we know is that the larger the swing in your BMI from your high weight down to your plateau weight, the less elasticity the skin will have. With a 250 lb weight loss recurrent skin stretch is not unusual. I see your skin laxity when you sit and lean forward but your surgeon can only remove as much skin as he can with you in the upright position as you can't live your life bent forward. Anyone, no matter their situation, will have loose skin on their abdomen if they sit and leant forward. If your surgeon feels he has done what he can do and you are not happy, seek out another Board Certified Plastic Surgeon with experience with post weight loss cases and get a second opinion. There is no harm in doing that and it will answer your questions. Good luck and congratulations on such a significant, postivie life change!

Lee E. Corbett, MD
Louisville Plastic Surgeon
4.8 out of 5 stars 24 reviews

You Could Benefit from a Vertical Tummy Tuck

Congratulations on your massive weight loss. You should certainly be proud of yourself. Also, congratulations on undergoing reconstructive surgery.

In regards to your pictures in history I would recommend further surgery. I would recommend a vertical abdominoplasty. The vertical abdominoplasty or tummy tuck is achieved by making an incision from the bottom of the sternum ( middle of the chest) to the pubic region. I often extend the incision into the pubic region to reduce excess skin and fat in that area also.

The vertical tummy tuck or abdominoplasty pulls skin from the sides of the abdomen together centrally. The horizontal tummy tuck or abdominoplasty which you had, pulls the abdomen down. Often the vertical abdominoplasty is done in conjunction with the horizontal abdominoplasty, resulting in an inverted T abdominoplasty. However, it is not uncommon to delay the vertical incision to see if a patient really needs it. From your pictures, history and present complaints, I believe you have significant excess skin and fat to warrant a vertical incision. I hope this information helps you. Again, congratulations on your massive weight loss and good luck on your weight-loss journey.

Sincerely,J. Timothy Katzen, MD, FACS, FICS
Chief of Reconstructive Plastic Surgery

J. Timothy Katzen, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 183 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.