Can I Have a Safe, Long Lasting Tummy Tuck Done if I Have Visceral Fat? (photo)

I'm 49 yrs old, 5'0" 128-130 lbs. & non-insulin diabetic. I've been told I have visceral fat by 2 different PS's. My mid-section is rather hard and i have no lose skin. 1 PS said he could make me flat, hard as a wooden table. 2nd PS told me he did NOT recommend the surgery-Not a good candidate. Said my stomach would look the same as before.His alternative was breast enlargement-may help me with my appearance. Is it feasible & possible to have a successful TT or should I quit trying?

Doctor Answers 11

Source of abdominal bulge - fascial laxity vs. intra-abdominal fat

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You overall body shape appears thin.  Your abdominal protrusion may be due to fascial laxity.  An examination by a plastic surgeon will help determine if your condition is repairable by an abdominoplasty.   You may consider losing 10 pounds and see if this reduces your abdominal bulge.   

Tummy tuck will not help visceral fat.

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I know you don't need me to tell you this, and I know how hard it is to do, but it is the only useful advice I can think of.  Lose ten pounds and you will look so much better (and so good for your diabetes).

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Lose weight to lessen visceral fat before tummy tuck

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Thank you for your question and photograph. The surgeon who spoke of visceral fat sounds like an honest and knowledgeable plastic surgeon.

If you have a tummy tuck with fat on the inside wrapping around the intestines your tummy will still protrude and without a lot of loose skin you will not see her result.

Although your not overweight, visceral fat which is wrapped around the intestines can be decreased with weight loss. If by dieting you can reduce the protrusion of your abdomen, then a tummy tuck might be of help. However my suspicion is that you will not need or want a tummy tuck if the visceral fat is reduced.

A surgeons suggesting breast augmentation when you came in for a tummy tuck raises a red flag in my opinion.

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Visceral fat and tummy tuck

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Something that is important to know:  studies have shown that people with fat that is distributed internally around the intestines (visceral fat) are more prone to heart disease, heart attacks, dementia, and insulin resistance than people without that type of fatty distribution.  So, someone who is 49, has diabetes, and has intra-abdominal fat is going to be at more risk for heart problems in the coming years than someone who is 49 without diabetes and with fat in areas other than internally around the intestines.  In my experience, people with intra-abdominal fat who have firm, protruding abdomens are not likely to achieve a nice result from an abdominoplasty, and they will be at a fairly high risk for major cardiac complications.  From what you have described and from your pictures, I would have a hard time recommending that you undergo a tummy tuck.  However, your best option really is to visit with one or two more plastic surgeons who do a lot of this type of surgery.  Listen to, and more importantly hear, what they have to say.  Do your homework, and don't rush into this.  The stakes, the cost, and the frustration level (ie, not getting the result you were hoping for) may be pretty high.

Kelly R. Kunkel, MD
Fort Worth Plastic Surgeon

No tummy tuck for your anatomy

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There's absolutely no way any surgery can give you a flat tummy because of your visceral fat and the outward pressure it puts on any attempted muscle repair. Just today another patient posted about why she wasn't flat after a TT and subsequent lipo. She has visceral fat. Don't repeat her mistake, forget surgery for your case.

Tummy tuck question.

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If you lay on your back and have a flat lower abdominal area then you may be a candidate for surgery. I would say to interview a few more board certified plastic surgeons to get more information. Good Luck!

Diabetes and Tummy Tuck

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Thank you for your post. Diabetes is a disease that should demand a healthy respect from both surgeon and patient in plastic surgery. It is a disease that affects the immune system and can increase the risk of infection, a disease that affects the healing potential of a wound and can cause opening of a wound, and is a disease of the circulation that can lower the blood flow to the operated tissue and cause necrosis or tissue death. This needs to be managed as follows:

1. Tight blood glucose control with diet, exercise, and medication. You need to see your internal medicine doctor regularly and make sure your diabetes is well controlled.
2. If you are overweight, then losing weight decreases your risk in tummy tuck surgery or any other surgery for that matter.
3. If you have high blood pressure, this needs to be managed and well controlled by your internal medicine doctor as well.
5. Consider with your surgeon HyperBaric Oxygen therapy pre- and post-op.
6. Make sure you understand from your surgeon and anesthisiologist what medications you should take or not take prior to surgery.

It is very possible to have a great outcome as a diabetic following tummy tuck surgery, but minimizing the risk is the most rational way of accomplishing this.

Best Wishes,
Pablo Prichard, MD

Can I Have a Safe, Long Lasting Tummy Tuck Done if I Have Visceral Fat?

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You need to lost the visceral fat first, and after that  to think in surgery.


Spanish translation provided by doctor:

Usted necesita perder la grasa intraabdominal primero, y despues pensar en cirugia.

Maria Cristina Picon, MD
Argentina Plastic Surgeon

Cosmetic Surgery is an Art and a Science

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Without an exam it is hard to answer your question. In my experience, tightening the abs helps patients get their profile back with a TT. Your inside fat (visceral) cannot be addresed with surgery. Diet and weight loss will help that.Consult a board certified plastic surgeon in your area.

Great Question

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You have a very interesting question and dilemna.  It does appear that you have a significant amount of intra-abominal fat.  What is not clear is how much fascial laxity.  You do not have any skin laxity evident.  What is clear is that your case will be challenging. It is unlikely that you will get a washboard abdomen, but some improvement is possible. I would recommend another consultation and physical exam.  All the best.

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.