Lipo 360 vs Tummy tuck? Does it look like I have diastasis recti? (Photo)

Dear CarmelBri,
based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. Flanks liposuction would give you a better shape. I would suggest you to consult a board-certified plastic surgeon because only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Hello CarmelBri, and thank you for your question regarding whether you have diastasis recti and if a tummy tuck is necessary.

Thank you for providing your history and pictures. To fully answer your questions, more details would be helpful, such as your age, number of pregnancies, maximum and minimum weights, and any other relevant medical conditions.

From examining your pictures, it appears that you do have rectus muscle weakness, which is evident from the way your abdomen protrudes from the belly button down to the pubic region. Additionally, it seems that you may have some visceral fat, which is fat stored behind the rectus muscle and around your internal organs.

These factors, along with visible stretch marks, would lead most plastic surgeons to recommend a tummy tuck rather than liposuction alone. A tummy tuck would address the rectus muscle weakness, remove excess skin and fat, and help flatten your abdominal profile. During the same procedure, you could also have liposuction of the flanks and love handles, as well as fat transfer to your breasts.

Before moving forward with surgery, I would recommend trying to lose 5 to 10 pounds through methods such as intermittent fasting, a ketogenic diet, or calorie restriction, possibly with the help of medication under the guidance of a medical professional. Given your current situation, most plastic surgeons would not recommend 360 liposuction alone. Instead, a combination of weight loss, a tummy tuck, and possibly liposuction and fat transfer would likely give you the best results.

Good luck, and I hope this helps to answer your question regarding your options.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS

Thank you for submitting your question! That is correct, liposuction would create abdominal laxity (excess skin) whereas an abdominoplasty (tummy tuck) includes liposuction of the abdomen and muscle repair of the diastasis recti. This combination will create your abdomen to be as flat as you sucking in. I would recommend consulting with a board certified plastic surgeon like myself so we can create a surgical plan that is best for you and your goals!

It is hard to evaluate your lower belly because the photos cut off just there. You do have a good amount of fat around your midsection so a high volume lipo 360 would be helpful....but the question is do you need a tummy tuck and muscle repair as well? You did not mention if you had history of pregnancies but I'm guessing you may have and if you had multiple children, then more likely would need a tummy tuck. What I do see though is the lower part of your belly seems to have some sagging to it and I worry that liposuction alone would cause it to sag more. That is the bigger reason to do the tummy tuck. You probably do have some muscle stretching that would benefit from repair during the tummy tuck. But mostly from what I see your lower abdomen skin doing right now, it looks like you would probably need a tummy tuck to make it better. Best of luck on your journey!

Dear CarmelBri,
Thank you for your question. It is difficult to tell for sure if you have diastasis recti based on photos alone. This can be more easily diagnosed with a physical examination. If you have diastasis recti, that will not be improved with lipo and will only be fixed with a TT. I recommend you see a board-certified plastic surgeon who specializes in tummy tucks/abdominoplasty for further recommendations.

This is a common question many people have. Unfortunately, it is very difficult to tell if you have a diastasis recti or not based on photographs alone. This is determined by physical exam. If you are interested in fat transfer to your breasts for a modest augmentation, then Lipo can be done to obtain the fat to transfer to your breasts. If you want to address your diastasis recti also, you can combine both procedures as long as your plastic surgeon feels comfortable with doing it in on stage and based on your risk factors for complications.
In terms of if your skin will loosen post op, that depends on your skin characteristics (ie skin quality and elasticity). As we age, the quality and the elasticity (the ability of skin to contract after surgery) decline over time. Skin quality is best determined on exam, so again it is difficult to say with certainty how your skin will retract after surgery. Hope this helps!

Thanks for your question! It does seem as though you have a diastasis. I think that your best option would be a tummy tuck if you want your belly as flat as possible. I would suggest an in person consultation for the best evaluation. Good luck!

You would do well with liposuction of your flanks, back bra roll areas and the abdomen. Minimally invasive radiofrequency skin tightening like Renuvion could be added to the back bra roll area for more tightening. To help your abdominal muscle, consider noninvasive, no downtime EMSculpt treatments after liposuction.

From your photos you will have the best results from a tummy tuck with liposuction for contouring. It appears there may be some abdominal wall laxity. In addition, depending on your skin elasticity and the amount of fat removed you could end up with contour irregularities and loose skin from liposuction alone. An in person evaluation is best. I encourage you to schedule a consultation with a board certified plastic surgeon near you.

It's exceedingly difficult to diagnose a diastasis recti (unless it is severe) form photos alone. A physical exam is required.
That being said, it is always better to have a lipo 360 if possible provided the results would be acceptable. If there are risks of loose skin or convex (outward) curved abdomen, then lipo of your sides and lower back along with an abdominoplasty (TT) are indicated.
Best wishes,
Dr. Taranow