Tummy tuck: skin removal only? (Photo)

from your photographs, it seems you would do very well with just the removal of skin. Your abdominal wall seems to be very tight. I don't think I would try to skimp on the length of the scar, but the more concerned about tightening the skin across the abdomen as much as possible. Plastic surgeons have different views on exactly what a tummy tuck is, but I prefer to refer to this as a lower abdominal skin excision when I discusse it with my patients.

Congratulations to you on your weight loss.  You would need to be examined by your plastic surgeon, but from the photos, it doesn't look like you have separation of the abdominal wall muscle, so you may very well be able to get away with having only the skin removed and tightened.  The advantage of this is much quicker recovery.  As long as the muscle is not separated, there is no disadvantage. It is still considered a mini tummy tuck.  With advanced techniques in tummy tuck, such as the Avelar technique I use for mini tummy tucks, there is much quicker recover and no need for surgical drains.  Please see a board certified plastic surgeon with extensive experience in performing tummy tucks for optimal results.  Best of luck to you.   

You have excellent muscle tone and have done a great job losing excess weight. You do seem to have enough skin to remove with a tummy tuck, and fat removal is not necessary with the procedure. However, you may need a full tummy tuck since you have prominent laxity above your belly button. A mini tummy tuck would only tighten the skin below your belly button. 
The option to have a drain or drainless tummy tuck depends on the expertise of your surgeon. Sometimes, a drain is necessary if the risk of fluid accumulation is high.

Tummy tucks are tailored to each individual patient's anatomy and desires.  Massive weight loss patients may only have the skin and underlying fat addressed.  Muscle tightening is not always performed during abdominoplasty.Drains help minimize seromas/ fluid collections postoperatively.  At times quilting sutures may be used instead of drains.  This is usually discussed at consultation.

It's possible you need an extended tummy tuck or body lift after losing weight. To be honest,it is quite a challenge to tell exactly what you would need without being able to do a full examination of your tummy area and rest of the torso. The photos you submitted show skin excess, but it is difficult to tell just how much. I am a fan of the skin only tummy tuck in women with your anatomy (tight looking abdominal muscles). Perhaps if you added a photo your backside it would help. Best wishes, Dr. ALDO

Danasny      All excellent questions!  Massive weight loss patients who have never been pregnant usually do not require plication, also called muscle tightening. Since your core is strong, skin excision is all you probably need, and yes it is still considered a Tummytuck. The downside of drainless surgery is increased surgical time and sometimes skin puckering. Drains are usually not much of an issue. I  ask my patients to bring in their typical bikini bottom bathing suits and design my incision to be certain that the scar will be hidden by the bikini (or panties). Be sure to consult with a board certified plastic surgeon. Good luck!

Thank you for your question and congratulations on your weight loss!  
From the photos that you provided, it does appear as though you would benefit greatly from a tummy tuck to remove the excess skin of your abdomen.  
The decision as to whether or not it is appropriate to tighten your abdominal muscles is dependent upon a physical exam, and for patients with uncompromised abdominal wall muscles with no separation or diastasis it is often appropriate to address the excess skin only.  
The incisions required to address the lax skin both below and above the belly button (yes, there is more laxity below than above) would be the same incisions utilized in a traditional tummy tuck (low incision hip to hip in the bikini line and another around the belly button).  I believe it would be a mistake to elect for a 'mini-tummy tuck' as you would continue to have the skin laxity above the belly button and this would ultimately leave you with irregular abdominal contour.  It is possible that your tummy tuck could be performed utilizing a drainless technique, but every surgeon has their own protocol including the use or non-use of drains.
I would recommend scheduling a consultation with a board certified plastic surgeon for a thorough evaluation.  Many plastic surgeons, myself included, offer patient complementary consultations that afford patients the ability to consult, have a physical exam, all questions answered and procedure reviewed in great detail.  I hope you find this helpful and I wish you the best of luck!

From the photos it looks like you would be a good candidate for a skin only tuck. In fact, you should be able to have a mini tuck with an excellent result. This would need to be discussed during an in person consultation with a plastic surgeon you trust. The downside of drainless surgery is a fluid collection. Quilting sutures tend to help with that. Again, this warrants further discussion during an in person consultation.

A "tummy tuck" typically refers to a removal of excess abdominal skin, a tightenening of any stretched fascia (the layer of tissue that the six-pack muscles reside in), and sometimes the use of liposuction to address any additional areas of fat.  However, a good plastic surgeon will tailor the approach to treat the specific anatomy and desires of the patient.  If only skin needs to be removed then the operation should performed that way, so that only the skin is removed -- it's still a tummy tuck.   No procedure is "one size fits all".  This is why plastic surgery is a beautiful marriage of art and science.  In order to get a qualified, ethical, and expert opinion on your surgical options and expectations, schedule an in-person office consultation with a plastic surgeon certified by the American Board of Plastic Surgery.
Best of luck,Keith M. Blechman, MDNew York, NY

Hello and thank you for your question.  Congratulations on your weight loss.   Based on your
photograph, you are a great candidate for a tummy tuck with liposuction.  This can be done through a low and short
incision, all completely below the bikini line. 
The belly button can be designed to look natural and have no scars on
the exterior.   Your muscles can also be
plicated resulting in a flat abdomen. 
Make sure you specifically look at before and after pictures of
real patients who have had this surgery performed by your surgeon and evaluate
their results.  The most important aspect is to find a surgeon you are
comfortable with. I recommend that you seek consultation with a qualified
board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon