I weighed 280 lbs, but I now weigh 185 lbs. Do I need a body lift and what type of tummy tuck would be best? (Photos)

Question

I’m a 39-year-old, 6.2” male. In my early 20s, ￼I weighed 280 lbs, but I now weigh 185 lbs after several years of caloric-deficient weight training, resulting in a significant weight loss, I have some loose skin. Trying to figure out what type of tummy tuck I need (extended/circumferential). ￼ I would appreciate some professional opinions. I have had a few virtual consultations through pictures, and they’re putting me for a mini tummy tuck. ￼￼

Harry T. Haramis, MD, FACS · Answer

Extended tummy tuck will remove all excess skin, based on your photos.

You do not appear to require muscle tightening which would make recovery easier.

An exam and consultation in person with a plastic surgeon is recommended to confirm this as well as discuss your options and expectations. does

J. Timothy Katzen, MD, FACS · Answer

Hello, and thank you for your question regarding whether you need a body lift or what type of tummy tuck would be best after losing almost 100 pounds.    Thank you for your history and your pictures.    Congratulations on your massive weight loss.  There are several different types of tummy tucks, including a mini tummy tuck, low horizontal tummy tuck, high lateral tension tummy tuck, reverse tummy tuck, vertical tummy tuck, bilateral lateral tummy tuck, Fleur-de-lis (FDL), and extended tummy tuck.    All these procedures ONLY treat the abdomen.    Some of these procedures also include repositioning the belly button and plication of the rectus abdominis muscle.    By definition, these tummy tucks are abdominal procedures and do not address the hips or buttocks.  Again, tummy tucks do not treat the hips, buttocks, or back.    Most plastic surgeons agree that your case is fairly straightforward.    If your buttocks and your hips bother you, you need a 360 circumferential lower body lift.    If your hips and your buttocks do not bother you, then most plastic surgeons would agree you need an extended tummy tuck.    Most plastic surgeons would not suggest a mini tummy tuck.  Also, you do not need a vertical incision or an FDL component to your tummy tuck.    Therefore, your two best options are a 360 circumferential lower body lift or an extended tummy tuck.    During an extended tummy tuck, the excess abdominal skin and fat are removed.    The pubic region is corrected.    Rectus abdominis diastasis is plicated, and the belly button is re-oriented.    If the hips in the buttocks bother you, the extended tummy tuck can be converted into a 360 circumferential lower body lift.    Completing the 360 circumferential lower body lift eliminates excess skin and fat in the hips and upper buttocks.    The 360 circumferential lower body lift also lifts the hips and buttocks.  I hope I have answered your question about whether you need a lower body lift or a tummy tuck.  The choice is yours and depends on whether you want the hips and buttocks treated when you are having the tummy tuck.  Good luck!    Sincerely, Dr. Katzen.    (Plastic Cosmetic and Reconstructive Surgeon, President of the American Society of Bariatric Plastic Surgeons, Certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery,  and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Ned Snyder, IV, MD · Answer

Thanks for submitting your questions and photos.  Congrats on the weight loss, that is very inspiring!   Based on your photos, you are a great candidate for an extended tummy tuck.  This would not only remove the excess skin from the front, but can also smooth out the appearance of the love handles from the back.  Your scar would need to extend partially around the waist.  A small amount of liposuction to the abdomen for contouring would be an appropriate add-on as well.  You could also do a traditional tummy tuck with liposuction to the lower back, but would get less skin tightening.  I highly recommend seeing a board certified plastic surgeon in person to come up with a game plan.  Congrats again, good luck, and thanks for reaching out.

Daniel Barrett, MD · Answer

Dear x090111x,

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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Wayne I. Yamahata, MD · Answer

The degree of skin excess in your photos suggest that you would best served with an extended tummy tuck and possibly circumferential.  A more definitive recommendation would require a physical examination. Seek a consultation with a board-certified plastic surgeon. It has been my experience that men such as yourself generally have a very good outcome.

Warren Schutte, MD · Answer

Congratulations on your weight loss. You are a great candidate for a laterally extended abdominoplasty. You are also a candidate for a FDL laterally extended abdominoplasty as you have horizontal and vertical laxity; this option would remove the most skin but it does leave a hip to hip incision plus a midline vertical incision. I would advise to work on the front first, then consider stage II with back/posterior work as you may still want a variation of a back lift. I would not advise doing these at the same time.

Leila Kasrai, MD, FRCSC · Answer

Congratulations on your hard earned weight loss! If you have issues with loose skin on your back, a circumferential tummy tuck would probably be the most suitable option for you. If not, a more extensive tummy tuck that focuses on your front and sides may be suitable.

Gary M. Horndeski, MD · Answer

You will need a circumferential lift and can be done in one session. The incision would be 360 degrees since you have too much skin to get by with a mini tummy tuck. A mini tummy tuck would leave dog ears on the sides. If you want to do it in 2 sessions then you can do the front first and then the back.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Camille Cash, MD · Answer

Congratulations on your impressive weight loss!  An in person evaluation is best, but based on the photos it appears a standard tummy tuck would give you the best result.  This would address the loose skin both above and below the belly button.  It doesn't appear you have significant skin laxity on the backside.

John J. Obi, MD · Answer

Thank you for your inquiry and pics.  If you are going forward w surgery you will certainly benefit from a FDL extended tummy tuck.  This will of course result in both a vertical and a horizontal scar but will tighten the significantly redundant skin envelope demonstrated on your pics.
In my opinion a 'mini' tummy tuck would be a waste of your time.
Good Luck!

I weighed 280 lbs, but I now weigh 185 lbs. Do I need a body lift and what type of tummy tuck would be best? (Photos)

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