Uneven Fat Distribution and Saggy Belly Button - Options?

The degree of abdominal wall laxity depends on many factors including skin laxity, muscular laxity and degree of extra abdominal wall fax (lipodystrophy). Most patients who have lost signigicant amounts of weight loss or have undergone a full term pregnancy will have some degree of muscular laxity which needs to be addressed with open surgical tightening. However, some patients (particularly nulliparous women) will respond very well to liposuction alone. Should the skin remain loose afer your liposuction procedure, then you can consider some open surgical tightening in a second stage operation (i.e.tummy tuck.).

You are not a great candidate for a reverse abdominoplasty.  If you want your breasts lifted, lose the 30 and do the lift.  You'll probably also want a TT then but consult your PS for a real consultation and he'll be able to feel and see exactly what you mean.  For those things you are an excellent candidate so don't potentially change your outcome just by trying to get it in one scar.  Your outcome with the standard TT and lift techniques is potentially excellent.

To start with, if you are planning on losing more weight, do this and stabilize your weight prior to any surgery. Depending upon the quality and tone of your skin, liposuction alone may give you the results you are looking for. Otherwise, a full abdominoplasty will tighten the skin, correct underlying muscle separation, and improve the look of your belly button. In some cases this can be performed at the same time as a breast lift.

I recommend you wait until you have stabilized in your weight loss before you opt for any abdominal contouring procedures.  Although it is impossible to give recommendations without a formal physical assessment/exam of your belly, I would like recommend a full tummy tuck.

A tummy tuck (also called abdominoplasty) is a very popular cosmetic surgery procedure. A tummy tuck can be an effective tool for shaping and sculpting the body for better body appearance and improved self esteem.

Sometimes no amount of diet and exercise can create a flat tummy. Tummy tuck plastic surgery actually tightens abdominal muscles and removes excess fat and skin from the stomach area to create a tighter, slimmer, smoother belly. A tummy tuck can be combined with other procedures such as liposuction of your waists or flanks (i.e. love handles) to fine tune your result

Patients choose abdominoplasty cosmetic surgery for a number of reasons, including:

Excess abdominal skin following weight loss; Weight gain (beer belly or spare tire) from a sedentary lifestyle; Abdominal fat that is resistant to diet and exercise; Stretched stomach muscles from pregnancy; Desire for a thinner profile; Desire to look younger and fitter; Desire to fit into clothes better

I recommend you visit with an ASPS member plastic surgeon to further explore your options and to find out if you are a candidate for this procedure.

As you lose weight, you will experience a variable effect on your breast and abdomen. It is essential for you to plateau your weight prior to considering any surgical intervention to achieve the ideal result. Remember any body contour change involving surgery depends on your ability to maintain a healthy lifestyle, so best to do that first! You will be happier in the long run.

Based on photos, you could be a candidate for a lower abdominoplasty, combined with liposuction (a full tummy tuck if your skin is very lax), or just liposuction.

Tummy Tuck surgery is more like a game of Golf - you must play the ball where it lands. If you think you CAN lose the extra weight, that will improve any operation you subsequently have. Your skin elasticity, the extent of excess skin, the location of the excess skin and your wishes to have babies would determine the best operation for you ONCE you are ready to proceed.

If you are still planning on having babies, it would be best to postpone all tummy tuck procedures to when you have completed your family. If you have some fat deposits, liposution would be your best option. If on the other hand, you are done having children a combination tummy tuck and liposuction of the back and hips would be your best option.

Dr. Peter Aldea

If you plan on losing another 20-30 pounds, then you more than likely should have a tummy tuck if your skin is sagging.

Thank you for your question and photographs. You do not have a lot of loose skin thus a Tummy Tuck may not be your best option. Laser liposuction can remove the excess fat which bothers you and does produce some skin tightening. This is a less extensive procedure and may give you the result that you want.

Judging from your photos, I think you would be a good candidate for Smart Lipo.  It is best to be at a realistic weight prior to any procedure.  Your skin tone appears to be adequate.  I don't really see sagging of your belly button, but if there is some, that may also be improved with Smart Lipo.