Loose skin & dog ears - good candidate for tummy tuck revision & liposuction? (Photos)

Question

I had a tummy tuck three years ago and I feel like there is still loose skin on the sides, dog ears and the vertical incision did not heal well. I am also not a huge fan of the belly button. Do I have enough skin especially near the vertical line? I also would like to liposuction my back but I am worried it will make my skin loose. Any other advice is welcome

Raffy Karamanoukian, MD, FACS · Answer

Abdominoplasty scars can be quite complex, ranging from the simple hypertrophic scar to a multiplane inflamed keloid. Pigmentation, discoloration, chronic inflammation, scar visibility can all occur in the short term. We begin each treatment with combination therapy using Yellow broadband BBL, Vbeam, fractional erbium, intralesional IIT, and scar modulation. Start with a combination of Plato's Scar Serum massaged twice daily after one week of epithelialization followed by Luminase/Exfolase. Scar consultation and revision may be recommended.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

John L. Burns Jr., MD · Answer

Yes, I'd suggest liposuction 360, re-plicate the rectus muscles, and excise more skin.  You would be able to remove the vertical scar

Ronald J. Edelson, MD · Answer

Your surgeon shouid be able to remove some more skin from your lower abdomen and correct the dog ears easily. This is a common situation because the skin dies stretch out after a tummy tuck

Zoran Potparic, MD · Answer

It appears that revision of TT and liposuction of abdomen, flanks and lower back would be a good combination for you. Details should be discussed with your surgeon. Good luck.

John LoMonaco, MD, FACS · Answer

If your weight is stable and you're not planning a future pregnancy, then a TT revision would probably get you better definition and tighter skin. Often, liposuction is also done to improve your contour or shape.

The back folds of skin visible in the side photos require an upper body lift.

The back folds of skin visible in the side photos require an upper body lift.

Camille Cash, MD · Answer

From your photos it appears you are a good candidate for a revision.  You should also have nice improvement by adding liposuction for further sculpting.  An exam is needed to know for sure but you may be a candidate to add J Plasma to the liposuction procedure to address skin laxity.

Mats Hagstrom, MD (license on probation) · Answer

To make an accurate assessment regarding the outcome of a plastic surgery procedure we generally need to see a complete set of proper before and after pictures. If you don’t have a before and after pictures, then ask your surgeon to forward the pictures they took. And some individuals who don’t have significant skin laxity it may be necessary that had a vertical scar representing the incision made around the belly button. That vertical scar is necessary if the scar is to be set low. Placing this car higher is aesthetically undesirable and it looks like your surgeon designed the procedure correctly. For individuals who have more extensive skin laxity, they may require a more extensive tummy tuck. In other words, the skin tightening comes to an end at the end of the skin excision.
Extending the skin excision onto your backside, may trade some of the skin laxity on your side and lower back. 
Well done Liposuction of your back should ideally not create more skin laxity, but at the same time, it will not treat issues related to skin laxity like the skin folds.
Extending the skin excision and removing the dog ears makes sense. I don’t think there is an easy way to improve the appearance of your belly button. It may be possible to remove parts of the vertical scar by pulling the skin tighter.
Revision surgery is not going to be transformative, but could improve the results slightly.
Delivering consistent quality, liposuction, results is more difficult than most people realize. This includes not only the technical aspect of doing the procedure well, but also making accurate assessment with the ability to deliver predictable outcomes.
An experienced plastic surgeon should have no difficulty showing you what results are likely to look like by showing you ample numbers of before, and after pictures of previous patient with similar body characteristics to your own.
Here are some thoughts on provider selection.
To find the best provider, I suggest patient schedule multiple in person consultations with experienced plastic surgeons in their community. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before and after pictures of previous patients who have similar body or facial characteristics to your own. An experienced plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. An experienced provider should in fact have hundreds or preferably thousands of before and after pictures to choose from for commonly performed procedures. 
Being shown a handful of preselected images, representing the best results of a provider’s career is insufficient to get a clear understanding of what average results will look like in the hands of each provider.
There is no correct number of consultations needed to find the best provider. The more consultations you scheduled the more likely you are to find the best provider for your needs. 
Take careful notes during each consultation, especially regarding the quantity and quality of before and after pictures. It’s not a bad idea to bring pictures of your own body/face to use as reference when reviewing before and after pictures. 
The biggest mistake patients make is scheduling only one consultation without properly vetting or comparing providers before scheduling surgery.
Best,
Mats Hagstrom, MD

Loose skin & dog ears - good candidate for tummy tuck revision & liposuction? (Photos)

Answers (7)

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