34 year old male, 6' tall, 300 lbs to 220 now. Abdominoplasty w/ Liposuction vs Belt Lipectomy? (photo)

Question

Plan for procedure in Nov. & take off another 10-20 lbs by then, tho not preoccupied w/ the BR scale just the final results. I feel maintainable without being deprived w/ diet or over committed to workouts.Want to: ELIMINATE flanks, flat stomach, remove most stretch marks. Ideally, get somewhat of the "V" type torso. Are my expectations realistic? What Tx plan would the Drs recommend for me? How many lbs, roughly, could come off from redundant skin & lipo.

J. Timothy Katzen, MD, FACS · Answer

Hello, Doddmj in Roseburg, OR. Thank you for your questions regarding liposuction vs. belt lipectomy. Congratulations on your weight loss! Great accomplishment. Thank you for your history and your pictures. First, we should analyze your pictures to determine the best procedures. You have cutis pleonasmus (excess skin), striae (stretch marks), and dermatocholosis (loose skin) of your lower abdomen. Your best results would be achieved with a 360° circumferential lower-body lift or a belt lipectomy. This would include an abdominoplasty (tummy tuck), monsplasty (pubic lift and reduction), rectus abdominis plication, umbilical (or belly button) relocation, hip lift/reduction, “love handle” elimination, and a butt lift. If you have an extended tummy tuck and flank liposuction, you may be left with some excess skin. Also, liposuction does not remove as much fat as a 360 ° circumferential lower-body lift. Therefore, most experienced plastic surgeons would recommend a lower body lift rather than an extended tummy tuck with liposuction in your case. Of course, if any isolated pockets of fat remain after your lower body lift, liposuction could be performed; however, this is highly unlikely. It is impossible to anticipate how much skin and fat would weigh with your anticipated further weight loss of 10 to 20 pounds. Most plastic surgeons would estimate that you could have approximately 10 to 12 pounds removed during a lower body lift at your current weight. If you lose more weight, your 360 body lift specimen will weigh less. If you lose another 20 pounds, most plastic surgeons would estimate your body lift specimen to weigh approximately 10 pounds. Good luck. Go with the 360 circumferential lower body lift; you’ll be much happier than with an extended tummy tuck and “love handle” liposuction, which often yields irregular, unpredictable results. The 360° circumferential body lift will give you a more V-shaped back and torso than liposuction can achieve. I hope this information helps. Good luck. To get an accurate assessment of what exactly you need, schedule a free virtual consultation. Most plastic surgeons offer free virtual consultations. I hope I have answered your question regarding liposuction vs. belt lipectomy. If you have any more questions regarding the lower body lift, 360 circumferential lower body lift, belt lipectomy, belt abdominoplasty, or belt dermolipectomy, please get in touch with an experienced plastic surgeon. Since the body lift is a big procedure, please seek an experienced, board-certified plastic surgeon with significant experience performing the lower body lift. Do your research. Make sure they have performed at least 150 circumferential lower-body lift surgeries and have the before-and-after pictures to prove it. Carefully examine their before-and-after photos and review their RealSelf profile. If you cannot find an experienced, lower-body lift surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen, MD, MBA, FACS, FICS, FASMBS (President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

Kenneth Hughes, MD · Answer

The belt lipectomy will likely produce the best result, but an exam is always necessary to make that determination.Kenneth Hughes, MDLos Angeles, CA

George Marosan, MD · Answer

Thank you for the question and photos. At 6' tall, 220lbs your BMI is 30. If you drop another 20lbs, your BMI will be 27 and with surgery it will go down to 26. You would benefit from an abdominoplasty combined with a belt lipectomy and liposuction. You can expect 10-12lbs of skin and fat removed with surgery. In my practice, I do these operations on an outpatient basis in my accredited office surgical suite, under intravenous sedation and epidural anesthesia. See a board certified plastic surgeon experienced in these operations for an in person consultation/evaluation. Good luck, and congratulations on your weight loss.

Samir Shureih, MD · Answer

Your results and risks would be much better if you can loose more weight. Your BMI is 29.8 now you need to decrease weight to near ideal body weight. At that time, re-evaluate and add liposuction to contour the body, will get you a better results and decrease your surgical risks.

Mary Lee Peters, MD (retired) · Answer

Congratulations on your healthy change! Surgery of this nature will have best results when you are at a healthy, maintainable weight. With that being said, your BMI is still near 30. So whatever you've been doing, keep at it. You will have best results if you can safely continue to drop down to a lower weight. Especially if your goals are to "eliminate" your targeted areas. After that, an extended abdominoplasty to remove the excess skin and stretch marks and some liposuction to help with the areas of fat unchanged by diet and exercise might be of benefit. Best of luck.

Lisa Lynn Sowder, MD (retired) - Account Suspended · Answer

Great job with the weight loss.  It would be best for you to drop that 10 - 20 pounds and stay at that weight for at least 6 months before surgery.  You need to make sure you can really stay in the groove of diet and exercise to maintain that lighter weight.  It is just so disappointing for patients (and their surgeons) to rush into body contouring surgery and then the weight creeps back and leads to fat deposits in weird places.  Once you are stable, based on your photos, a belt lipectomy would help you a lot.  The scar could be kept low where the sun don't usually shine and your love handles and abdomen would be taken care of and you would have some improvement in you buttocks and thighs.  This operation is a BIG hit and you would need to be in great shape both physically, mentally and socially.Find a good plastic surgeon who can guide you through this life changing process.  Good luck!

Ronald V. DeMars, MD (Retired) · Answer

For maximum contouring you would want to consider a full abdominoplasty and extend the resection around your flanks and onto the back to encompass the belt lipectomy procedure. With that done I doubt liposuction will be necessary and you will get rid of all the fat and all the excess skin.

34 year old male, 6' tall, 300 lbs to 220 now. Abdominoplasty w/ Liposuction vs Belt Lipectomy? (photo)

Answers (7)

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