Do I Need a Revision for Upper Abdominal Loose Skin? (photo)

Hi, I had a full tummy tuck with muscle repair nearly 7 weeks ago and am really happy with how well I have healed. My surgeon did have a massive job to do as I had lost nearly 100lbs in total over 5 years and my excess skin was bad, he said he took a massive amount of very thin skin and I had a fleur de lis. Although delighted with my lower abdomen my upper abdomen is still very loose, it still drapes between breasts and tummy button, Its not swelling as I've had very little. What can be done??

Doctor Answers 9

Do I Need a Revision for Upper Abdominal Loose Skin?

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What a great result!!!! Allow at least 6 months healing before thinking about further surgery! Best to continue you healthily life style. Good luck. 

Tummy tuck result

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I think your surgeon did a great job! You have loose skin I the horizontal direction because the skin in a standard tummy tuck pulls the skin in only one direction. The fleur de lis pattern corrected this situation I your lower abdomen. To correct the skin in the upper abdomen, the vertical scar would need to,be extended higher, and I do not think it would be worth it in your case.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 29 reviews

Fleur de lis

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You are clearly healing very well. By the photos it appears the vertical incision stopped at the belly button. If that is the case and the skin is loose in the upper abdomen, from the belly button to the rib cage then an extension of that incision to the base of the sternum will be necessary. Final contours will be achieved by 3 months so you may see some improvement in this area.

Bring your concerns to your surgeon on your next post operative visit.

Good luck and I hope this was helpful.

Robert W. Kessler, MD, FACS
Corona Del Mar Plastic Surgeon
5.0 out of 5 stars 130 reviews

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Revision for upper abdominal loose skin after tummy tuck?

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Thanks for the photos.  It is hard to definitively say without a proper exam.  Congratulations on your weight loss.  You are very early in the post operative course.  It usually takes a year to see the final result.  So far, you look good.    Best to see your previous Board Certified Plastic Surgeon.  If there needs to be a revision, you will talk about cost.   Cost often depends on the amount of revision to be done, and how much time is spent in the O.R.  For revisional surgery, the surgeon often does not have control over some costs, (O.R. fees, Anesthesia fees, Supplies, etc:). This is usually passed on to the patient.  Most surgeons will charge some fee for their own revision surgery, if needed.  This can be variable.  Communicate with them your thoughts, and together you should be able to come up with a plan. 

Jeffrey J. Roth, MD, FACS
Las Vegas Plastic Surgeon
4.6 out of 5 stars 17 reviews

Tummy tuck revision after a fleur-de-lys

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Wow.  You have an amazing improvement. 

It's clear that you still have some laxity mostly in the vertical direction.  My advice would be to wait maybe 6 months or so and then see if your surgeon would be comfortable doing some more vertical excision.  This would require vertical incision above your belly button.  Also, sometimes the upper abdominal skin can be tightened by removing some of the skin just below the breast fold.  This is a so-called reverse abdominoplasty.  It is rarely indicated but sometimes is the way to go.  Your surgeon is the best one to decide what the next step, if any, will be.  He knows your anatomy, your skin characteristics and he sure did a nice job for you.

Good luck.

Lisa Lynn Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 77 reviews

Tummy Tuck Revision

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Your plastic surgeon did an excellent job of limiting the scar to the lower abdomen. In order to remove the excess skin from the upper abdomen, a new scar would have to be placed there and the vertical scar below the abdomen would have to be revised. I would generally advise against this procedure as your result is aesthetically appealing and your scars are well hidden

Excellent Result!

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Thank you for your photographs and congratulations on your weight loss.  Your result is very good. Unfortunately, because your skin was so stretched by excess weight the elasticity is probably not as good as it should be.  Your skin will always be a bit "stretchy".  

Dr. ES

Revision of Tummy Tuck

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You will notice that the swelling will decrease in the next few months.  Options for tummy tuck revision would be to extend the vertical incision (not recommended in most cases), skin tightening, and liposuction. Raffy Karamanoukian, Los Angeles

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Result after a partial fleur de leis abdominoplasty following massive weight loss

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The real problem is there is excess skin in both the vertical and transverse directions.  Your operation took care of the excess skin below the umbilicus in both directions by using a transverse and vertical incision.  The problem is that you still have excess skin in the transverse direction above the umbilicus.  This could be corrected by extending the vertical incision above the umbilicus to the level of the bottom of your sternum.  It appears you had a nice result with the current surgical plan but if you want the superior skin to be tighter then you will have to extend the vertical scar.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.