Mom of twins, Lipo or full Tummy tuck? (photos)

Question

I am a mom of three children two are twins. I am not happy w my stomach after dieting, exercising, and going to a physical therapist to correct abdominal diastasis. I don't really want a tummy tuck and was wondering if lipo was an option for me, or if my skin would become loose and saggy. Maybe I should just give it more time w diet and exercise? Any input will help. I have a consult on Aug 30th.

Tom S. Liu, MD, MBA · Answer

When deciding between liposuction and a tummy tuck, it is important to consider how each procedure will help you achieve your goal. While liposuction does address excess fat, it does not take care of loose skin or repair rectus diastasis. Patients who may benefit from rectus diastasis repair (most commonly found in women who have had children) would benefit more from a full tummy tuck. A full tummy tuck addresses excess fat, loose skin, and it also tightens the abdominal muscles. Unfortunately, diet and exercise cannot fix rectus diastasis. Consult a board-certified plastic surgeon regarding a plan for you that would help you achieve your goal. Good luck in your research!

Robert J. Spies, MD · Answer

Hello and thank you for using RealSelf and sharing your questions and pictures.It seems that you have loose abdominal muscles from your pregnancies.  It is difficult to improve this with exercise in that there is not an exercise that can pull inward between two muscles.  Liposuction only removes unwanted fat.  It will not improve loose muscles.Thus, it seems like you need a tummy tuck to fulfill the goals you have.  It will not only tighten your rectus muscles but remove excess skin and fat from the lower tummy.  Liposuction with a tummy tuck contours hips, thighs and flanks if needed.You may want several opinions from board-certified plastic surgeons in your area.Good luck to you.

Austin Hayes, MD · Answer

Thank you for the question. It really depends on your goals. You mentioned using PT to fix a diastasis. If your goal is to make your tummy more flat, then your only option is a tummy tuck procedure. Sutures are used in the abdominal wall to fix the diastasis. This will flatten your tummy and can give a dramatic result.Unfortunately, liposuction can remove fat from under the skin, but it can't improve the diastasis. I would consider a tummy tuck procedure. The incision should be kept very low so that it is hidden by a bathing suit, underwear, and day-to-day clothing.

Steven J. Rottman, MD, FACS · Answer

Thank you for your question. Based upon photos provided, you appear to be an excellent candidate for a full tummy tuck. The abdominal skin excision and muscle tightening could give you an excellent contour as well as improve the tone of the anterior abdominal wall. Liposuction could be used to better define your flanks and hips at the time of tummy tuck surgery. Please see a board certified plastic surgeon who specializes in body contouring for an in-person examination to discuss the specific details of the procedures. Ask to see before and after photos to get an idea of what can be achieved. I offer complimentary consultations to discuss your treatment options. Hope this helps!

Jed H. Horowitz, MD, FACS · Answer

Tummy Tuck (abdominoplasty) is a plastic surgery procedure designed to flatten the abdomen by removing excess skin and fat, and to tighten the abdominal wall.

Women and men who have excess skin and/or fat around the abdomen which does not respond to diet and exercise are candidates for abdominoplasty. Many patients complain that they cannot flatten their abdominal muscles through exercise, which also means a tummy tuck may be right for them.

Abdominoplasty candidates have excess abdominal skin which may sag, a disproportionate or protruding abdomen, weakened or separated abdominal muscles, excess fat concentrated in the abdomen. It is definitely understood from your story and many other mother's like you, that pregnancy can increase that stretched and sagging skin of the abdominal area, and diet and exercise do not necessarily complete the correction. If you have already reached your goal weight, it would be a good idea to follow through with your consultation and determine how you feel about the surgery. Best of luck!

Johnny Chung, MD, FACS · Answer

Thank you for your question. Based on photos alone. You are a better candidate for either a mini tummy tuck or full tummy tuck. Liposuction and/or PT will not repair the diastases of the abdominal muscles. The amount of skin removed needs to be determined with an in person consultation. I recommend finding a board certified plastic surgeon who is also a member of the American Society of Aesthetic Plastic Surgeons. Best of luck with your procedure.

Jamie Moenster, DO · Answer

Thank you for your questions and photos.  I would recommend a tummy tuck to tighten the muscles that get stretched out during pregnancy, especially with twins!  Tummy tuck is the best way to get a smooth, flat and tight abdomen.  Liposuction will still leave the fullness in the abdomen because the muscles would still be loose.  Best Wishes!

Camille Cash, MD · Answer

If you are through having children and want a flat, contoured abdomen, then I would suggest the tummy tuck.  From your photos it appears that you have some muscle separation, probably from pregnancy, that can be addressed with the tummy tuck.  If you are looking for conservative improvement, or if you still plan to have more children, then liposuction would be acceptable.  The choice of which is best is influenced by what your goals are from surgery.

Michael F. Bohley, MD · Answer

Thank you for your question and photos. The skin and muscle changes following multiple pregnancies do not often lend themselves to treatment by liposuction alone. Particularly after a twin pregnancy, many patients will require a full abdominoplasty with or without adjunct liposuction. Once the skin has been over-stretched, it is not likely to retract sufficiently for an acceptable result following liposuction alone. The muscle diastasis  is not generally corrected without surgical tightening/re-approximation in a tummy tuck. During your consultation, your plastic surgeon can review the indications for, as well as the limitations of, liposuction and abdominoplasty. Good luck to you.

Shaun Parson, MD · Answer

Thanks so much for your question.  It's more a matter of what your final goals are in terms of how to answer your question.  In the photo that you sent that shows your front view you can clearly see how much of a diastasis you currently have in your abdomen.  If you want to just reduce size and have a quicker recovery then you would benefit from liposuction.  However, liposuction will clearly not address the diastasis.  So Liposuction will be able to correct a portion of the issues where tummy will be able to address the entire situation and really re-tighten the stomach.  Both would give you positive gain but tummy tuck would give you significantly more improvement.  Hope this helps.

Mom of twins, Lipo or full Tummy tuck? (photos)

Answers (11)

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