TT with MR 5 months ago - not pleased with my results. Surgeon says it's visceral fat. It's squishy and a lot of skin (Photo)

Question

I am unsure if this is actually visceral fat or subcutaneous fat that would benefit from more lipo/skin removal. I did have abdominal lipo done in the office 1 month ago. Is it worth getting a second opinion?

Daniel Barrett, MD · Answer

Dear waggies,
I understand your concern. However, without a proper assessment, it would be difficult to determine what is 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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Carmina Cardenas, MD · Answer

Based on your photos you have almost nothing of excess of subcutaneous fat, your problem is not that. 
Your problem is the protruding appearance and the lack of shape around the waist. What you are pinching is excess of width and another skin resection  won’t eliminate excess of width. 
Your real problem is your muscle. You need to get redone the Tummy Tuck to tighten the muscle, I predict 5-6 inches muscle repair (13-15 cm), redrape the skin, may remove an extra inch of skin, no more, and create a beautiful smaller belly button and a tapered  more curvaceous shape. . 
I honestly consider you will have an awesome result!!
Be encouraged. 
Dr. Cardenas

Connie Hiers, MD, FACS · Answer

Just based on your photos, It appears that most of the fullness is internal and some structural from your back. You are sway back and push your abdomen forward. Abdominoplasty will not correct this.  Nonsurgical EMSculpt treatments might be helpful to tighten your muscle. An examination is needed to see if anything surgical could be done.

Camille Cash, MD · Answer

There is no harm getting a second opinion.  Pre operative photos would be helpful to determine what may be causing the abdominal contour.  If it is visceral fat then weight loss is the way to improve your results.  An exam would be needed to determine if further liposuction or skin removal is indicated.

Darryl J. Blinski, MD · Answer

Based on the series of posted photos YES you need in person or virtual consult with.... I think yiu need revision of TT scar to pull more skin and repeat aggressive lipo with J-Plasma to tighten rest of abdominal skin. Fee $6,000. Best to virtual consult with....

Mats Hagstrom, MD (license on probation) · Answer

There are four tissue variables that determine what the abdomen looks like.
In other words if somebody doesn’t like the way their abdomen looks it is always because of one or more of four different tissue variables.
Tissue variables that determine what the Abdomen looks like are.
1) abdominal skin laxity typically due to previous pregnancies or weight loss2) excess subcutaneous fat3) muscle separation from previous pregnancy4) visceral, or intra-abdominal fat
Considering you’ve had a tummy tuck, and Liposuction, the only two variables that could potentially be causing a bulging abdomen, is inappropriate muscle tightening or excess visceral fat.
Failure of muscle tightening is unusual and visceral. Fat is the most common reason for patient to have a bulging abdomen after a tummy tuck.
Ideally providers should make an accurate assessment during the initial consultation Explaining each of these variables and how the result will look based on patients having excess visceral fat on examination.
Results are fairly predictable based on the clear understanding of which variables are causing the problem.
Individuals who have excess visceral fat, should be told that without weight loss, the results will be inherently limited.
While insufficient muscle tightening is potential, it is unlikely to be the reason your abdomen is bulging. Most likely this is due to access, visceral fat.
I suggest taking baseline pictures and attempting weight loss.
Take new pictures if you experience weight change and you will soon enough know what weight you need to be to get an abdomen Consistent with what you want.
 While Weight loss is easy easier said than done. It is most likely the only way to get a flat Abdomen in your case.
Best,
Mats Hagstrom, MD

TT with MR 5 months ago - not pleased with my results. Surgeon says it's visceral fat. It's squishy and a lot of skin (Photo)

Answers (6)

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