Have I got internal fat? Would I get a flat tummy from a tummy tuck?

Healthy people at their ideal weight should have the best overall recovery from a TT, but some of this will depend upon the surgical technique and adherence to postoperative protocols. A TT addresses both the loose skin and the lax abdominal wall as to give a nice, flat youthful contour to the abdomen. The TT also creates a more youthful belly button. If the waist was smaller at one time, the waist can likely be reduced to those same measurements or smaller provided the muscular and fascial integrity has remained the same.
About two-thirds of women experience diastasis recti after childbirth. TT without muscle repair may make the recovery easier, but, after three pregnancies, the result will be better with plication. In general, the muscles should be brought to anatomic norms. The smaller the separation, the less tightening required and probably the less discomfort. Swelling will occur irrespective of muscle repair, and almost every patient requiring a TT will benefit from the muscle repair.

You have a pregnant look from a damaged abdominal wall from three pregnancies. The pregnancies stretched out the support layer (fascia), which has been irreversibly damaged. The technique I recommend is abdominoplasty with mesh reinforcement, if you are not planning future pregnancies. The mesh creates a more hourglass figure by compressing the abdominal wall resulting in early satiety and helps maintain a reduced weight.

Best Wishes,

Gary Horndeski, M.D.

Thank you for your question. Every patient undergoing a cosmetic procedure must have realistic expectations. In your case, you would have a significant improvement in the contour and flattening of your abdomen. This would require a full abdominoplasty, abdominal wall tightening and flank liposuction. Because of your anatomy, the abdomen may not be perfectly flat.

Your BMI is pretty good 21.5 and that only reassures me that you have no intrabdominal fat, your muscle is extremely loose and weak and for that reason you look very protruding like pregnant.
Your Tummy Tuck must include a nice and tight muscle repair, in my hands my average is 4-5 inches, but I have done 8 inches (20 cm), so in your case the muscle repair must be tight to prevent you continue looking protruding.
My only concern is (besed on your photo where you are bending over), your skin is hanging a lot, and that skin hopefully retracts after the Tummy Tuck, because if you have a lot of excess of width, then you will need a Fleur de Lis.
Be encouraged
Dr. Cardenas

Thank you for sharing your quest and photographs. Although you have some mild visceral fat it appears that the majority of your tissue excess comes from skin and more superficial fat ,as well as muscle laxity. Both of these issues can be addressed with a tummy tuck. Hope this helps.

Dear lucyhlou100,
based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. I would suggest you to consult a board-certified plastic surgeon because only after a thorough examination you will get more information and recommendations.
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 you should have a nice result from a tummy tuck. It will remove much of your loose tummy skin and fat as well as address the abdominal wall laxity. Liposuction would add to the contouring of the hips and flanks.

Dear Lucy,
After looking at your pictures, I would like to address your question providing as much details as possible for you to make an informed decision on the surgery.
In your case, it will certainly become flat repairing the muscle wall with a full tummy tuck. In my opinion, this procedure needs to be paired with a liposculpture.
I encourage to ask further questions if the explanation above was not sufficient.
Kind regards,
Dr. Torres

During an examination when I assess someone for excess visceral fat I push the abdomen until it’s flat straight up and down between the pubic bone and the sternum. If I can do this quite easily or patients going to suck in their abdomen and hold it flat in this position it without difficulty they do not have excess visceral fat.

If on the other hand it takes a lot of pressure and force to push the abdomen a flat and it makes the patient feel like they have a difficult time taking a deep breath then they have access visceral fat filling up their abdomen.

Most likely you have some excess visceral fat and this would go hand-in-hand with getting worse with weight gain.

You can probably do this maneuver yourself by simply pressing your abdomen flat with your hands and feeling if it feels like the pressure goes up against your diaphragm when you breathe or if it takes a lot of force to hold your abdomen flat.

Regardless, there is no treatment option other than weight loss so you may as well start shedding a few pounds.

A tummy tuck can help to some degree but those with excessive visceral fat will still bulge even after muscle tightening.

In your case I think a full tummy tuck with muscle tightening regardless if you have excess visceral fat or not will make a big difference.

Obviously the best outcome would come from weight loss and a full tummy tuck.

Best,

Mats Hagstrom MD