What Would You Suggest I Do if I Am Unhappy (At 15 Days PO) with my Full Tummy Tuck Result?

I consulted with 4 accredited Plastic Surgeons and each assured me that I was a "dream" tummy tuck candidate. After losing 82 pounds, I had a great deal of loose skin on my abdomen. I was always an apple shape and discussed that I wanted to have a nice waist, midriff + flat tummy. I don't have any tightness or soreness in my midriff area,and not much even in my abdomen. I have never had to walk bent over and just don't seem that tight. I was supposed to have a full TT with lipo. Suggestions?

Doctor Answers 10

Tummy Tucks After Massive Weight Loss

An 82 pound weight loss qulifies you as massive weight loss (MWL). Congratulations on your outstanding accomplishment!  I have a special interest in MWL patients and wrote the chapter on it in"Plastic Surgery For Dummies".

To answer your concern directly: it is way too soon to see the final result of your TT.  The swelling will take 6-9 months to go down completely.  I have done lots of TT and had one myself so I know this to be true.

Not walking bent over after surgery does not mean that your tissues were not pulled tight.  You may just have a high pain tolerance which is a good thing.

Most MWL patients benefit most from a belt lipectomy (an incision all the way around).  Here's why.  Image you have a circle and you cut a wedge out of it.  If you bring the edges of the wedge together the circle becomes a cone.  The bigger the wedge, the taller the cone.  Now imagine that the wedge is the angle between the upper and lower incision made to remove the excess skin from your abdomen (or anywhere for that matter).  The same thing will happen when you close it.  So the more skin you remove in the up and down direction the longer the incision needs to be to make the angle small enough to close smoothly.  The cone that forms if the angle is too big we call a dog ear.  I suspect that you had enough tissue that an incision all the way around your trunk would have removed more of it.  If the incision is shorter less skin would have to have been excised to allow the ends of the incision to be smooth.

As you gained weight your skin stretched in both directions; vertically and horizontally.  You have had the excess removed vertically.  On MWL patients it is often not enough and more skin needs to be excised with a vertical incision if you want a really tight result.  This is usually done either along your abdominal midline or on either side.  This is best done at least 6 months later if you choose this option.

Unfortunately, your skin is not the same as a normal weight patient getting a TT.  No matter how tight the skin was pulled the first time; in a few months it will be loose enough to remove more. Body procedures on MWL patients are very different in many ways.  The correct expectations must be set, understood and accepted by both the patient and the surgeon.  You need to sit down with your surgeon and re-visit your expectations along with your results.   There appears to have been some miscommunication that needs to be addressed.

San Diego Plastic Surgeon
4.3 out of 5 stars 28 reviews

Tummy tuck

It is too early to tell.  You must another 2-4 months for the final result.  Since swelling (normal) stays around for a while, it takes time for the result to take it's final shape.  Another factor, is that you lost 82#.  This means that your skin has probably lost a good amount of elasticity, which means that it may never be "tight".  Another factor, also, is that simultaneous liposuction of the abdomen is frowned upon by most when done with an abdominoplasty.  Frequently, liposuction of the abdomen is done at a second setting (if necessary).  Liposuction is usually done of the flanks and hips, and a bit of the abdomen.

Shahin Javaheri, MD
San Francisco Plastic Surgeon
4.4 out of 5 stars 6 reviews

Unhappy after Tummy Tuck?

Thank you for your question.

I am sorry to hear about  your dissatisfaction  with the surgical results  but it is much too early to evaluate your end results.

Generally, swelling after tummy tuck surgery can take months to subside and it can take up to 1 year for skin redraping to occur. 

I would suggest that  you allow this time  for complete healing and then evaluate the results. If you still have concerns addressed some calmly with your plastic surgeon.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,485 reviews

Tummy tuck result

It would be hard to grade your result this early. We could all give a better opinion if we were able to see your before photographs. Your health history could also play a factor in your results.

Timothy Fee, MD
Jacksonville Plastic Surgeon
4.3 out of 5 stars 56 reviews

Early post-op tummy tuck

You are very early post-op froma tummy tuck,  You are going to have a lot of swelling. Give it at least 3-4 months to get a feel for the final result.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

5 weeks too early to judge tummy tuck results.

5 weeks is really too early to judge the results of any operation.  The healing process is just underway and you will see significant changes over the next months.  This is not to say that you will get the result you want.  However, don't be too critical at this stage.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

Tummy tuck after massive weight loss

I would agree with the previous physicians in that your results may not be apparent for at least 6 months.  That being said, massive weight loss does have a tremendous effect on the quality of the skin left behind.  The skin that is left is very inelastic and does not tend to shrink back like "normal" skin.  And so it is not uncommon to require a secondary skin tightening in patients who have lost a significant amount of weight.

Gregory A. Buford, MD, FACS
Denver Plastic Surgeon
4.9 out of 5 stars 42 reviews

Tummy tuck / abdominoplasty results

The final result after a tummy tuck is not obtained until 6 months after the procedure due to swelling and wound healing. Be patient and wait. Keep your appointments with your certified plastic surgeon. Most plastic surgeons have a policy regarding revisions when necessary, but you must wait until everything is healed.

Frank Agullo, MD
El Paso Plastic Surgeon
4.9 out of 5 stars 140 reviews

Wait first before making a final judgement.

As the others have said it is far too early to talk about any procedures at this point. Having said that, the patient is bent over because when we take off the excess skin it is so tight that they are simply not able to stand straight. If after waiting several months for the swelling to go down, discuss any problems with your surgeon.

Victor Au, MD (retired)
Chapel Hill Plastic Surgeon
4.5 out of 5 stars 7 reviews

Swelling is normal after a tummy tuck.

Swelling effecting your entire trunk and lower extremity is extremely common after an extensive procedure such as yours and is typically worse if liposuction was performed on the hips as an adjunct to the tummy tuck.  It is too premature to predict your final results.  You have to be patient and wait sometimes several months to see the finished result. 

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 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.