Remove Excess Skin and Fat Inplace of Tummy Tuck?

I have to respectfully disagree with my colleagues. In my experience, you can get significant improvement with an operation that removes the fat and skin, without tightening the muscles. And more importantly, the recovery IS significantly shorter and easier when no muscle plication is done. Yes, the resulting belly will not be as flat or tight compared to a traditional tummy tuck, but the shorter recovery may be worth a small sacrifice in results.  I perform a non-muscle plciation procedure called Smooth Tuck that has shown great results in patients who are "too obese" for a tummy tuck, or are perfect tummy tuck candidates (like you) but desire a less invasive procedure with a more rapid return to work.  I understand why some surgeons "poo-poo" this approach, but my patients have been extremely happy and travel from all over the world to get this done.  Yes, your results will be better with a muscle plication, but that does not mean there are not acceptable alternative. smoothtuck.com

Thank you for your question.  Your set of problems will likely be very effectively addressed with a full tummy tuck.  Simple removal of skin and fat excess, without abdominal plication, will leave you with an abdomen that remains somewhat protuberant, and a waistline that lacks ideal shape.  Plication (tightening) of the abdominal wall muscles and fascia will truly flatten your stomach and will tighten the waistline, giving an attractive "hourglass" shape if done correctly.  Forgoing an important step of the tummy tuck will not significantly reduce cost, and will likely produce a result with which neither you nor your surgeon is completely satisfied.

Pregnancy can result in dramatic changes in a women’s
body.These changes are especially
noticeable in the abdomen, where redundant saggy skin, weakened muscles, and
stretch marks may occur.Your pictures
suggest that you might benefit from a full abdominoplasty.Abdominoplasty
is performed by making a lower abdominal skin incision and lifting the skin and
subcutaneous tissue to the level of the ribcage.This typically requires detaching the belly
button which allows more skin to be removed.The muscles are then tightened, excess skin removed, and the belly
button re-attached in proper position.In rare
cases, abdominoplasty can be performed without tightening the underlying
abdominal muscles.When patients have
tight underlying muscles, it’s not necessary to plicate them.It’s hard to understand why you’re opposed to
this maneuver in this specific case.In
most cases, plication adds significantly to the post-operative result.However, it’s important to realize that the
procedure will still significantly improve abdominal aesthetics even without
muscle plication.The
best results are obtained when correct analysis is performed and the best
surgical option is applied.In most
cases patients will require a full abdominoplasty.

Judging by your photo, you would probably benefit from a full tummy tuck. It would remove the excess skin and fat, as well as tighten any weakened muscles you may have from pregnancy. Some of your stretch marks would also be removed. You would have to have an in-person consultation with a board certified plastic surgeon for a better evaluation of your concerns and the cost.

You can have just the excess skin removed but tightening the muscle is helpful in allowing more lax skin to be removed in addition to flattening the tummy.  Also without muscle repair the tummy will remain pouchy.

Dr. ES

The tummy tuck helps with three problems on the abdomen after pregnancy. 

1) Loose Skin - Excess and loose skin are removed with a tummy tuck, there is no other way to get any significant tightening of the abdominal skin.

2) Excess Fat - The majority of excess fat on the abdomen is found below the belly button. When the lower abdominal skin is removed, this fat is taken away with it. Lateral fat (around the sides) can also be safely removed with liposuction at the same time as a tummy tuck.

3) Loose Muscles - Bulging of the entire abdominal wall is caused by muscle laxity. This allows the guts to fall forwards and make the belly look round.

In most cases all three need to be done for optimal results. Before ruling out muscle tightening, it would be best to see a Board Certified Plastic Surgeon in your area, and see what the risks and benefits will be for you.

I've included a link below that reviews many of the common questions about tummy tucks, and a video (part 1 of 3) about tummy tuck surgery.