Removal of More Skin? (photo)

I have met with many BC PS.  The doctor Im considering going with drew a visual of how much skin would be removed. I was hoping he would be able to remove a little more skin above the belly button. Do I have unrealistic goals and will I still see good results with the amount skin removal that is depicted?

Doctor Answers 18

Removal of skin with tummy tuck

In most instances diagrams like this drawn preoperatively on the skin are estimates.  It is virtually impossible to tell with accuracy exactly how much skin can actually be removed until the skin is lifted up and pulled downward.  Things like attachments to the underlying muscle and skin elasticity will influence this differently from person to person, and it isn't until we have  the skin elevated and we can measure the true excess on the operating table that we can make our final markings and remove the right amount of skin.  Most surgeons are as aggressive as they feel the tissues can tolerate, meaning that they make every effort to not leave excess skin behind.  In your case it appears from these images that your surgeon should probably be able to ultimately remove skin up to at least the level of the top of the belly button, but only he or she will be able to know for sure once you are in surgery.  Best of luck

Tummy Tuck Outcome

Procedures such as tummy tucks are usually tailor tacked.  That means that the amount of skin removed  is adjusted on the table. Factors such as performing liposuction at the same time, the size of the muscle weakness(diastasis) and the amount of skin  laxity effect the total skin removal and can only be judged at the time of surgery.  Your doctor has drawn an estimate only of how much skin he will need to remove.  Based on your photos I would expect that you will be very happy with the result.  Good Luck.

Beverly Friedlander, MD
Short Hills Plastic Surgeon
4.7 out of 5 stars 13 reviews

Removal of More Skin?

The markings done before surgery are a guess. Most surgeons begin by incising around the navel, then making the main incision, and continuing to elevated the abdominal skin and fat off of the abdominal muscles up to the breast bone. The skin is retracted downward, and the excess is trimmed. It could be more or less than the estimated markings. The surgeon will attempt to remove as much as is possible, and as much as is safe. 

All the best. 

How much skin can be removed with a tummy tuck.

The outline drawn by your plastic surgeon is a standard outline for an abdominoplasty. It is my guess that a little more skin will actually be removed during the abdominoplasty procedure, but that can only be determined during the surgery. The ideal is to keep the tummy tuck scar low, so that it can be easily hidden with bikini or underwear. Most of your improvement will be achieved by tightening your abdominal muscles, which appear very lax. I would consider a tripple abdominal plication to tighten your abdominal wall. This plication not only tightens your rectus muscles (six pack) but also your obliques.

Skin removal

Hello, 

Thank you for the question and photographs.  Based on your photos, it seems you are a very good candidate for an abdominoplasty. The preoperative markings are only an estimate of the amount of skin to be removed in surgery.  The actual amount depends on the conditions in surgery - how much does your skin stretch, the degree of muscle tightening, etc.  It is difficult to estimate these type of things through an online forum.

As many others have said, make sure you choose your surgeon carefully and make sure he/she is board certified in plastic surgery.  Best of luck!

Andrew Smith, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 20 reviews

Removal of Skin with Tummy Tuck #tummytuck

This one is pretty straight forward. While we can give you an idea of how much skin will be removed we don't really know until we get our patients into surgery. Once the skin is elevated we take as much skin as possible but still keeping it safe so that you do not have so much tension on your scar that we risk wound healing or the incision splitting open. This is mostly an in-operative decision as to how much skin can really be removed.

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 45 reviews

How much skin to remove during a tummy tuck

Your surgeon's markings appear to be very standard markings.  When I do these markings I consider these as "starting marks."  Adjustments on the OR table are then made according to the elasticity of your tissues, how much extra tissue you actually have, etc.  If you make known your wishes for your abdomen to be as tight as possible, and for as many of your stretch marks to be removed as possible, then your surgeon can adjust your marks during surgery to give you the best outcome, achieve as many of your goals, and still keep a reasonable margin of safety.  The most important part of the surgery is choosing a qualified surgeon who can achieve your goals with a good safety margin.  Good luck.

Gilbert Lee, MD
San Diego Plastic Surgeon
4.8 out of 5 stars 22 reviews

Removal of More Skin with Tummy Tuck Surgery?

 Thank you for the question and pictures.  Based on your pictures, I think you are starting at an excellent place;  you should achieve a very nice outcome with tummy tuck surgery!

Online consultants, will not be able to advise you as precisely as you may wish. My best advice would be to choose your plastic surgeon carefully;  one of the selection criteria should be viewing lots of examples of his/her previous work and  preferably see patients who have had similar work performed. Once you have seen enough examples of his/her work your comfort level will increase. During your preoperative discussions with your plastic surgeon do communicate your goals to have as much skin as possible removed, as safely possible.  Achieving realistic  expectations prior to proceeding with surgery will be  important. Remember that some redundant appearing skin may be present when you sit or bend postoperatively.

I have also attached some advice I provide to my patients prior to undergoing mommy makeover surgery:
1. Make sure you are doing the procedure for the right reasons (for yourself)  and that you have realistic expectations.  Be aware that an improvement in the “problem area” may not translate to an overall improvement in your life   situation.  You are bound to be disappointed with results of the procedure if your motivation for doing the surgery is not internally driven.

2. Time your surgery carefully; generally, it is not a good idea to have surgery done during or immediately after a stressful period in life (for example divorce or death of a loved one). The additional stress of surgery will undoubtedly be  more challenging to deal with if a patient's emotional reserves our already exhausted. Remember, that an improvement in your physical appearance will not translate to an improvement in your life situation.

3. If possible speak to patients who have undergone similar procedures and query them about the toughest times of their recovery period. Any practical hints previous patients can provide may be very helpful.

4. Make sure you are aware of potential complications that may arise how to reach your surgeon if necessary.
5. Make sure you have a strong and patient support system (several people if possible) in place who have time/patience to take care of you. Arrange for professional nursing if any doubt exists regarding the availability and/or stamina  of your caretakers.

6. Be patient with the healing process, understanding that it will take several weeks to months to feel “normal” again. It may also take many months/year to see the end results of your surgery.

7. Be prepared to distract your mind with things of interest such as books, magazines, and movies.

8. Expect less of yourself; do not go back to work, school or chores too early and let others take care of you (for a change).

9. Pick your surgeon carefully (a well experienced board-certified plastic surgeon) and trust in his/her advice. Keep in close communication with your surgeon and do not hesitate to communicate questions/concerns and the   emotional swings that you may experience.

10. Resume all medications that you were using preoperatively when cleared by your plastic surgeon and stop the use of narcotics and sedatives as soon as feasible after surgery.

11. Keep in mind the end results as you go through the tougher emotional times after your surgery.


I hope this helps.

 I hope this, and the attached link, helps.

How much skin to be removed with an abdominoplasty

Skin removal at the time of an abdominoplasty is usually tailored on the table.  I usually place the head of the bed up 12 degrees and pull the superior skin flap down.  In this manner the appropriate amount of skin will be removed.  The real story is how much is enough.  This is a question that only your surgeon can answer for he is responsible for your safety and management of your risks and complications. 

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 16 reviews

Removal of More Skin?

He is probably just being conservative with the drawing. With dissection up over the lower ribs and closure with progressive advancement sutures he will certainly take away skin at least an inch or two higher than the drawing and still keep the scar very low as drawn.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 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.