I need real, genuine help. How can I improve my chest, shoulders, back, flanks and stomach? (Photo)

Question

Hello. I had a procedure a couple years ago, but I was left unhappy and deeply insecure. I think I looked better before the procedure. I exercise 5 times a week, but i think is all invisible due to the fat and loose skin. I have substracted myself from the work, as I feel my body looks and feel weird. I'd like to improve and leave this behind so I can finally have a life. I'd like to improve my chest, shoulders, back, flanks and stomach. I have a visible TT scar.

J. Timothy Katzen, MD, FACS · Answer

Hello ImChanging. Thank you for your question regarding how to improve your chest, shoulders, back, flanks, and stomach.

Based on your history and your pictures, I would suggest you focus on weight loss initially. This can be achieved through intermittent fasting, dedicated calorie counting, and consistent exercise. Additionally, weight loss medications like Ozempic and Zepbound may be helpful. Aim to lose at least 20 to 30 pounds.

After achieving weight loss, a re-evaluation of your body will help determine the most effective surgical options. Since you previously had a tummy tuck, it is unlikely that liposuction alone will address all your concerns. However, the specific needs will become clearer after weight loss.

Post-weight loss, options could include aggressive VASER high-definition liposuction or a revision tummy tuck. For your chest, the insertion of chest or pectoral implants may be considered.

Good luck with your journey. I hope I’ve answered your question regarding the next steps to improve your body.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS

Camille Cash, MD · Answer

As you have multiple areas of concern the best place to begin is a consultation with a board certified plastic surgeon for a consultation.  A revision to your tummy tuck may provide more definition to the abdomen.  Liposuction to remove excess fatty pockets can be helpful for the areas that you mentioned as well.  Scar revision or scar treatments may improve the appearance of the scar.

Mats Hagstrom, MD (license on probation) · Answer

I’m not quite sure what you’re looking for with your post.
I’m going to assume that you have a history of significant obesity with successful weight loss.
That would be the most possible explanation for why you have skin laxity.
To assess the outcome of a previous plastic surgery procedure we need to see proper before and after pictures.
If you don’t have before, and after pictures and ask your certain to forward the pictures they took.
At chest lift may or may not be an appropriate procedure for you.
The procedure is less than perfect and tends to leave fairly visible scars.
For some people that procedure is warranted and for others, it leaves some disappointed similar to your previous experience.
In reality there is only so much a plastic surgeon can do when someone has significant skin laxity that is diffuse and omnipresent.
Certain skin tightening operations have better patient satisfaction than others.
Plastic surgery outcomes are generally based on each individual patient’s candidacy for the procedure, combined with the skill and experience of the provider.
 to get a more accurate assessment and better understanding of treatment options I suggest scheduling multiple in person consultations with plastic surgeons in your community.
I recommend patience, avoid virtual consultations when possible.
Quality assessment requires quality information and in your case this means an in person consultation, including the ability to have an examination.
for second opinion, consultations come prepared with a complete set of proper before and after pictures and a copy of your previous operative report.
Those should be available from your previous provider upon request 
Understanding what plastic surgery procedures can, and cannot accomplish, is key to maintaining high patient satisfaction.
There may be inherent limitations to what can be achieved with surgery.
Taking ownership of your own behavior patterns, including previous obesity, is probably an important part of the equation of maintaining quality of life and high patient satisfaction with any procedure.
 Blaming surgeons for loss of quality outcomes. Probably is helpful though. Provider selection is very important and getting quality care.
Best,
Mats Hagstrom, MD

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