Male tummy tuck and muscle tightening. Is it recommended for men to do the abdomen wall with muscle tightening?

Question

I have lost around 90lbs in the past few years just from diet and exercise and want to get a tummy tuck to get rid of the lose skin and lipo around my love handles. All doctors have told me I need to do an extended tummy tuck and some even said that i should continue the scar behind lower back above my buttox to best get rid of the skin from my love handles? I have mixed feelings about that. I wanted to also know if it is recommended for men to do the abdomen wall muscle tightening? Thank you

Shim Ching, MD · Answer

With large amounts of weight loss, the excess skin can continue into the flank and lower back.  When the skin removal is done in these areas as well, the procedure is considered a belt lipectomy or circumferential body lift.  You may need this due to how much extra skin you have.  Most men who lose a lot of weight may have had some intrabdominal fat, which caused stretching of the abdominal wall.  A surgeon will be able to tell if you need abdominal wall tightening.  This is commonly done in men as well.

Jed H. Horowitz, MD, FACS · Answer

It is not uncommon to combine a tummy tuck with male breast reduction. There are three types of surgical treatment options available to treat gynecomastia. The excision technique is used on cases of #gynecomastia where excess skin and glandular breast tissue must be removed and the areola or nipple needs reduction and repositioning to create a natural looking appearance. Men who suffer from large #areolas may notice that after breast surgery, the skin of the chest muscles will tighten, causing the areolas to tighten and diminish in size. This is a result of the removal of glandular and/or adipose tissue.

The incision patterns are determined by the specific condition of the patient. The doctor will recommend this procedure which combines the liposuction technique and excision technique to create a natural look. Patients are given specific instructions for the recovery period.

Lastly, it is crucial you select a plastic surgeon who is #board-certified and has a great deal of experience with male breast #reduction. Plastic surgeons who have specialized in breast surgery and cosmetic surgery are suitable to perform your procedure. Aside from checking board-certification, it is suggested that you look at before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision.

William Andrade, MD · Answer

Without photos and/or physical exam it is not possible to comment whether a tummy tuck or circumferential body lift would be the better option.  Many but certainly not all of my male patients will benefit from a rectus plication but if there is no spreading of the muscles (diastasis) this is not absolutely necessary.

Kenneth Hughes, MD · Answer

You are probably a very good candidate for a tummy tuck. If a patient needs the muscle tightening, I perform this during the surgery.  Look at
reviews and before and after pictures as well as credentials to select
your surgeon.Kenneth Hughes, MDLos Angeles, CA

Ronald J. Edelson, MD · Answer

I generally do not perform muscle tightening for make tummy tucks.  Muscle looseness is usually due to pregnancy, so in your case it is probably not needed.  The difference between a full tummy tuck and a belt lipectomy, which goes all the way around the back, is that the latter is quite more extensive surgery.  Without photos, it is hard to tell if you need the full belt lipectomy or would be okay with just the tummy tuck.

Larry S. Nichter, MD, MS, FACS · Answer

Without an exam or even photos to review, it is hard to tell where the incisions would end, however if there is redundant skin hanging then it will need to be removed for best results and will leave a scar. If there is a significant separation of your rectus abdominis muscles or laxity of others then tightening often will give you  a better result.

Vishnu Rumalla, MD · Answer

Thanks for your inquiry, without a picture it hard to advise about the length of the incision. In general if you have a large amount of skin on your flanks onto the back, you should consider a body lift.  In terms of a muscle repair-most men do not develop muscle separation because the weight loss occurs over time compared to the rapid gain that occurs in a woman with pregnancy.  Only an exam can answer that question.  Also, tightening of the muscle may create a narrow waist that a man may not desire.  Good Luck.

Robert J. Spies, MD · Answer

Hello and good job on the weight loss.  When one loses this much weight, loose skin occurs both on the abdominal wall and the love handle areas.  The abdominal wall loosens both longitudinally (up and down) as well as transversely (side to side).  You do have choices between a tummy tuck, extended tummy tuck and body lift.  It all depends on how much improvement you seek.  The more skin removed, the more scars after the surgery.  You can hide the tummy tuck scar and flank scars in the bathing suit area.  The long vertical scar from the extended tuck is visible with a bathing suit.  It sounds like you need other opinions but need to decide yourself what is best for you.

Sutton Graham II, MD · Answer

Congratulations on your major weight loss. It is not uncommon after major weight loss to have loose skin and some fat remaining, which may be treated by plastic surgeons with a variety of body contouring procedures.  It sounds like you've met with several surgeons to help make your decision.  The plan they recommend would be based on their estimation of how to best tighten loose skin and remove adjacent fat.  Extended abdominoplasty vs. circumferential lift have significant differences in procedure, results, risks and recovery which may influence your decision.  If you are uncertain, discuss whether your surgeon recommends a staged procedure, with the front and sides first, then later the back if you see the need.The muscle tightening (fascial plication) decision is based on how lax your abdominal wall tissues are, duning examination.  Male patients certainly can benefit from plication.

Anne Taylor, MD · Answer

Hello. After loosing that much weight, it is common to have extra skin. The abdominoplasty alone will take care of the front. The addition of the back side is your call, and it can be done at the same time or at a second operation. The benefit from doing it in two stages is that the front can be pulled tighter if the back side is not done.Regarding  the muscle tightening, it is hard to say without an exam, but most men do not require this, and it does add to the risks of surgery.Good Luck.

Male tummy tuck and muscle tightening. Is it recommended for men to do the abdomen wall with muscle tightening?

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