1 year post tummy tuck - do I need a revision or is this something liposuction could solve? (photos)

Hello @iDreamOfCurves, thank you for your question. It is important to look at what type of technique the surgeon used and whether he did muscle plication or not. When you are sitting the amount of skin that is left over is different than when you are standing. Is it necessary to check while standing. Is best if consult one or several board certified plastic surgeon for more information and recommendations. Best wishes! Alan Gonzalez MD, FACS.

Dear iDreamOfCurves,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

From your photos it appears you will need a revision to address the loose skin on the upper and lower abdomen in order to improve your results. If you are intending to lose weight I encourage you to complete that goal prior to the revision. This will allow your surgeon the opportunity to maximize your results. I would not recommend a reverse tummy tuck approach for you.

Although you do not show the full view with your standing, I think liposuction would be helpful to remove excess fat. Liposuction cannot be done in the area of the tummy tuck at the same time as the tummy tuck for safety to the skin.

I appreciate you attempting to post photo but the photos are not very helpful. Therefore best t do virtual consult with... I think full revision of TT with lipo is recommended. Expect fees in $10,000..

To make an assessment on the outcome of an operation we need to see proper before and after pictures. If you don’t have a problem before and after pictures then ask your surgeon to forward the ones they took. One it’s going to have a skin fold in a sitting position. It’s not possible to have a flat abdomen in the sitting position and still be able to stand up straight.
The procedure is a substantial improvement on where you were before surgery but I can also see that results could’ve been slightly better. The skin fold on your lower chest or upperabdomen a.k.a. under boobs are skin thoughts that form in individuals who have skin laxity. There is a band of connective tissue that anchors the skin to the muscle fascia creating a fold on individuals who have skin laxity in this area. It’s generally the same connective tissue skin attachments that cause the fold on the mid back and many adults.
To incorporate that skill laxity in the tightening during surgery requires that the separation of skin and fat from muscle fascia go up onto the rib cage a bit higher that was done on your procedure. The process of separating tissue planes during surgery is sometimes called undermining. case reminding was insufficient to incorporate the skin thoughts on your upper abdomen.
Undermining is sometimes appropriate but can increase complication rates and different surgeons have different levels of comfort, skill and experience doing this. The area of concern on your upper abdomen is a skin Ford and it should not be treated with Liposuction effectively. The only option is to redo the full tummy tock this time undermining higher all the way to the inframammary fold if necessary. The alternative is a reverse tummy tuck which tends to not be all that common but may be appropriate for some individuals especially women who had a breast lift for breast reduction previously.
The revision would not need to incorporate muscle tightening but otherwise it’s basically redoing the full tummy tuck. revising this would also most likely add a new small vertical scar between the main decision and the valley button. yes the opening of your skin that currently is holding your belly button. Further undermining it would create skin laxity and most likely more skin would be removed with a revision requiring re-positioning of the belly button.
I also am not a big fan of the fleur-de-lis pattern and believe most patients can avoid it by simply extending the skin excision around to the backside.
Your pictures are a bit incomplete and whenever making the assessment on the outcome of a procedure plastic surgeons need to see before and after pictures.
Their needs to be a reference point of what you look like before the operation.
Follow up with your provider or consider having a few in person consultations with other local board-certified plastic surgeons for a proper second opinion consultation.
For second opinion consultations patients should come prepared bringing with them before and after pictures and ideally a copy of your operative report which are all part of your medical record that you can request from your surgeons office.
Best,
Mats Hagstrom MD