What to do about my stomach? Can I get away with lipo, or do I need a tummy tuck? (Photo)

From February until today I've went from 244lbs down to 130lbs (I'm 5'6"). I was recently looking into vaser lipo. My question is can I get away with just the lipo, or does my skin look like I will need a tummy tuck. I really don't want to get a tummy tuck because of the scaring. I also have a little loose skin on my arms and inner thighs. I was hoping thermage would tighten this up. I feel like I have good elasticity in my skin and just need to give it a little help to tighten back up.

Doctor Answers 14

Loose skin after weight loss

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Thanks for your question. It doesn't look like you have enough fat to have liposuction.  As you know, your options are surgical (tummy tuck) or non-surgical (skin tightening with radiofrequency).  With the surgical approach, the loose skin is definitively removed, although you have permanent scars. With the non-surgical approach your response to treatment is not completely predictable - most likely you will have improvement, although not a surgical result ( you may have some looseness of your skin left).  If you want to avoid scarring, you could try a radiofrequency treatment first and see how much improvement you can get.  You may be satisfied with the result.  If you want further improvement you can proceed with a tummy tuck.  The radiofrequency treatment will also most likely be effective for loose skin on the upper arms and thighs.

Cleveland Dermatologic Surgeon

Lipo or Tummy Tuck

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Thank you for the question and the pictures.   Looking at your pictures you need a tummy tuck to address the loose skin.    It does not appear you have any fat to suction.    See a board certified plastic surgeon to discuss your goals and options.     Good Luck

Tummy Tuck?

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Well done on the weight loss! I'm sure it's been a long road and I congratulate you on your motivation.

Are there non-invasive methods of producing skin-tightening? Yes. New technologies such as Profound offer microneedling and radiofrequency delivery that can result in skin tightening. However, there are limits. It is difficult to assess your entire body from the photographs but certain areas may be appropriate for such treatments if there is mild laxity. However, in areas with moderate to severe skin laxity (such as your stomach) you are much more likely to get the improvement you are seeking through abdominoplasty (tummy tuck). Male tummy tuck has special considerations and be sure to consult a plastic surgeon that can offer you both non-invasive and surgical methods that are appropriate and also has experience with male patients. Finally, make sure you have been weight stable for at least 3 months prior to surgery as continued significant weight loss may increase your risk of healing complications.

Nima (Nash) Naghshineh, MD
Beverly Hills Physician

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Loose skin after Weight Loss

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Congratulations on your weight loss! And thanks for the question and photos. You need skin removal on your abdomen which requires a tummy tuck. The placement of the incision can be low hiding it when you are wearing swim trunks. I also don't recommend thermage for your arms and thighs as the results can be inconsistent. Best of Luck - Dr Hardy...

Lipo or tummy tuck

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Great Job on the weight loss!! 

Unfortunately lipo won't  help with the excess skin. Consult with several Board Certified Plastic surgeons, talk to them about your concerns with the scar, asked them to show you how low your scar can be.  With a low enough scar you should achieve a flat abdomen and get rid of the excess skin giving you that tight abdomen you are looking for. And remember to follow your Surgeons pre and post op instructions along with any scar treatments that they may suggest for after the surgery.  

Lost over 100 lbs., will VASER help my abdomen?

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    Congratulations on your weight loss.  Unfortunately, VASER liposuction will not adequately tighten the loose skin on your abdomen.  Although the VASER procedure produces some tightening, it will not flatten you abdomen and remove the loose skin from your weight loss.  A tummy tuck, with the scar low so you can wear a bathing suit would be the best option.  This tummy tuck might be limited to skin only and your recovery would be rapid.  Regarding Thermage, the tightening is even less than VASER.  I owned one and the results were not impressive.  In fact, I could not sell the machine as there was no market for it due to poor results.

What to do about my stomach?

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Thank you for sharing your question and photographs and congratulations on the impressive weight loss.  With over a 100 pound weight loss the skin will have had a tendency to stretch and thin with time, leaving you with loose, excess tissue.  For this reason I think you would most benefit from a formal tummy tuck procedure.  Hope this helps.

Weight loss?

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Congratulations on your weight loss!  It does look like you have a lot of loose skin, and would benefit from a tummy tuck.

Skin laxity

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Hello. Congratulations on your weight loss. You will need a tummy tuck or skin removal without muscle tightening to enhance your abdominal contour. A laser will not be able to reduce your degree of skin laxity. 


Tummy tuck

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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.  This can be done through a low and short incision, all completely below the underwear line.  The belly button can be designed to look natural and have no scars on the exterior.  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

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.