Belly button sagging after tummy tuck - will liposuction and a mini tummy tuck fix the issue? (photos)

Thank you for your question regarding your belly button sagging after a tummy tuck. Will liposuction and a mini tuck fix this issue? Thank you for your history and your photos. Yes, I think the surgical plan is accurate. However, you must realize that liposuction does not tighten the skin and only eliminates fat. In the after pictures, you can see an area of fat around the umbilicus. This needs more liposuction. However, liposuction will cause loose skin, which will inquire either a mini tummy tuck at that same time or a tummy tuck later. Liposuction can damage the blood supply and lead to nonpredictable healing of the abdominal wall flap. Therefore, experience and a conservative nature may be the best way. However, I agree with liposuction, no relocation of your current belly button, and perhaps a mini tummy with liposuction or later.
Sincerely,
Dr. Katzen

Dear Graceful4321717,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Based on these photos and short of in person evaluation (skin tone, laxity) it appears that mayor cause for your concern are irregularities of fat tissue/deep scars; it takes at least 1 year for result of TT and liposuction to mature. Once fat tissue is soft it can be treated with further liposuction, in particular areas around BB. You should have in mind that liposuction done with TT significantly underminds blood supply to the abdominal skin; for that reason surgeon may decide to do a more conservative liposuction to avoid skin loss and healing problems. This should be discussed with your surgeon and when time is right, proceed with additional liposuction. Good luck.

You would benefit most from a full tummy tuck with rectus plication. You still have excess skin below your belly button as well as small dog ears on the sides of your incisions and contour deformities from irregular liposuction. A full tummy tuck with liposuction for sculpting will be your best option. It will extend your current scar by a few centimeters on each side and you will have an incision around your belly button. Good luck!

An in person evaluation is always best but from your photos it appears you had a mini tummy tuck when you needed a full. For the best result you should consider a full tummy tuck which will address the muscle separation above the belly button as well as remove excess fat and skin.

I agree that even though the skin of the upper abdomen is fairly tight and will only allow for several centimeters of inferior displacement, I would recommend an incision around the umbilicus to maximize skin tightness. The round umbilical defect is usually able to be pulled far enough inferiorly to be excised with the excess skin. In your situation, it will result in a small vertical scar in the midline or an inverted T shaped scar in the pubic area. These scars are usually acceptable after several weeks to months and fall in to the natural definition lines of a very tone abdomen.

Since your upper abdomen does not appear to have excess skin or much fat, the mini tuck with liposuction will probably work well for you.

Performing a procedure different than what was agreed-upon or in the end what was signed on the consent form it’s called operating without consent and this is a pretty serious medical offense in regards to both legal and moral issues.
Without having full context of what was discussed, what was actually done it’s not appropriate to make assumptions.
In regards to the front of the abdomen, there are four variables to determine what the abdomen looks like. When choosing providers the choice of procedure should be based on having a clear understanding of what those four variables are.
In other words, if somebody doesn’t like the way, their belly looks whether they’ve had surgery or not. It generally comes down to one or more of four different tissue layers.
Each of these tissue layers has its own way of being treated so understanding which of these is the primary, secondary, tertiary, etc. helps dictate the correct procedure.
The four variables that determine what the abdomen looks like our abdominal skin laxity typically due to previous pregnancies, and or significant weight loss. The second is excessive amounts of subcutaneous fat. The third is muscle separation from previous pregnancies, called Diastasis recti and the last variable is excessive amounts of visceral or intra-abdominal fat.
Muscle tightening should generally be done, and both the upper and lower abdomen and doing this generally requires making an incision around the belly button and repositioning the belly button to a new skin opening.
From your pictures, I would say your primary diagnosis is muscle separation followed by moderate skin laxity. Muscle separation and visceral fat can have a similar appearance. My best guess is visceral fat is not contributed significantly to your appearance. You can easily differentiates muscle separation from visceral fat by seeing if your abdomen goes completely flat when you lay flat on your back like when you’re laying in bed. if your abdomen still has a slight bulge, when laying on your back, then excess visceral fat may be contributing to your abdominal bulging. If it does, then weight loss may be indicated.
To confirm exactly what procedure you had gotten I suggest you ask your provider to forward a full copy of your entire medical record, including your signed consent, form and operative report. But sometimes it may be difficult to decipher medical term analogy. You could always ask another plastic surgeon to interpret days. If you truly believe the operation performed was not the operation you had signed up for. What is especially important is what is on the consent form. That is the legal document that allows the surgeon to perform the procedure.Based on your pictures, it does not appear that you had a full tummy tuck. Muscle tightening should get you a completely flat muscle while unless visceral fat is contributing.
If the operation performed is significantly different than what you agreed upon or what is on your surgical consent form, then at this point, you may need legal counsel.
Your liposuction results are not ideal. They may be somewhere in the spectrum of what is average. The number of plastic surgeons with mastered Liposuction and Ken consistently deliver high-quality results, including making accurate assessment with predictabl outcomes is a relatively small. Simply being bored certified in plastic surgery with years of experience, or overall good reputation does not mean anyone single provider is good at Liposuction.
There are a lot of variables and red flags raised from your post. Without having full context is difficult to do anymore than simply pointing out what’s obvious on the pictures.
At this point, I recommend slowing down and not having any more surgical procedures until you get everything well straightened out, including having a clear understanding of what your first procedure actually was, included, and if this is consistent with what you had agreed-upon based on medical records, including consent forms. Some medical records may be obtained from the facility where the surgery was performed, but your plastic surgeon should have all documents relating to their practice. Do you have a right to copies of all your medical records including the operative report, and all pictures taken by simply requesting them.
I suggest you get all your information together and schedule a few second opinion consultations before going forward.
When it comes to choosing providers for any cosmetic surgical procedure, I recommend patients have multiple in person consultations without choosing the provider. If you don’t have multiple consultations, then you’re not even making an effort to choose the best provider. You cannot properly vet plastic surgeons by looking at their website or reading reviews.
During each in person consultation as providers to open up their portfolio and show you their entire collection of the before, and after pictures of the previous patient who has similar body characteristics to your own for whatever procedure you are interested in. Liposuction has more variation and outcome based on who you choose as your provider than any other plastic surgery operation I’ve ever seen. This is my personal opinion, but it seems to be pretty consistent. Poorly done Liposuction can leave people disfigured and poorly done. Liposuction is almost impossible to improve upon. Liposuction is very much a procedure that should be done once and it should be done correctly. Do not assume a plastic surgeon is good at Liposuction, because they have credentials reviews, have high presence on social media or any other information other than having what seems like an endless collection of quality before and after pictures of the previous patient who look like you do.
From Liposuction I recommend patient start by having at least five in person, consultations and consider scheduling more. Love you very carefully at all areas treated. There should be no skin contour, irregularity in any areas treated. The transition between treated and untreated areas should look completely natural like somebody has not had cosmetic surgery.
Obvious transition zones between treated and on treated areas represent poor quality work and show clear evidence that someone has had cosmetic surgery which is not attractive appropriate for desirable.
Best,
Mats Hagstrom, MD