Doctor said TT or lipo. Which would be better? Mom of 4 (Photo)

When deciding between a mini tummy tuck, a full tummy tuck with a vertical scar, and other options like liposuction and J-Plasma, it's important to consider the extent of the correction needed, your aesthetic goals, and your tolerance for potential scarring. Here are some key points to help you make an informed decision:
Mini Tummy Tuck: This option typically results in a smaller scar that is well-concealed below the bikini line. It’s best for those with minor skin laxity and less excess skin or fat to remove. If you only have issues in the lower abdomen, this might be suitable.
Full Tummy Tuck with Vertical Scar: A full tummy tuck addresses both upper and lower abdominal areas and is better for those with significant skin laxity, muscle separation, or excess fat. The vertical scar, though more visible, allows for more extensive correction. This option can help prevent the wrinkled appearance you’re concerned about.
Liposuction: This procedure removes localized fat deposits and can improve contour but doesn’t address skin laxity or muscle separation. It can be combined with other procedures for optimal results.
J-Plasma: This is a skin tightening procedure that uses plasma energy to tighten the skin. It’s less invasive than a tummy tuck and can be a good option if your primary concern is skin laxity without significant excess skin or fat.
Given your active lifestyle and desire to minimize scarring while avoiding a wrinkled stomach, consulting further with your surgeon about the combination of these procedures might be beneficial. Discuss how a combination of liposuction and J-Plasma, or a mini tummy tuck with J-Plasma, could provide the desired results with minimal scarring.

Thank you for your question and for sharing your history and photos. Based on your photos, you appear to have excess skin that cannot be adequately addressed with liposuction alone. Liposuction would likely leave you with even more excess skin, as it primarily targets fat but does not tighten or remove skin. For the best results, I recommend a full tummy tuck combined with liposuction of the flanks to enhance your contour and achieve a more defined waistline.

The full tummy tuck would also include muscle plication, which involves tightening the rectus abdominis muscles that can become stretched or separated after pregnancies. This will address the slight bulge in your abdomen caused by muscle weakness and improve your overall core strength and appearance.

Regarding the vertical scar your surgeon mentioned, it does not mean a full fleur-de-lis tummy tuck (FLD), which involves a long vertical incision from the pubic area to the ribcage. Instead, it would likely be a small vertical incision where your original belly button was. This is sometimes necessary because there may not be enough excess skin below the belly button to completely remove all the stretched skin above it. While no one loves the idea of a scar, modern techniques and proper scar management can make it much less noticeable over time, and the improvement in your abdominal contour will likely outweigh this concern.

With a tummy tuck and liposuction of the flanks, you can expect excellent results, smoothing your abdomen and creating a more contoured, proportionate shape. If you're unsure, I recommend having another consultation with your surgeon to discuss your goals and the specifics of your desired outcomes.

Sincerely,
Dr. Katzen

I recommend a lipoabdominoplasty. In my experience, when individuals like yourself have an upper abdominal horizonal crease with redundant skin above it, there is actually a fair amount of skin to pull down once the crease is correctly released during the tummy tuck. You appear to have a fair amount of muscle separation which is not unusual after 4 children. That can only be fixed with a tummy tuck. I do a more complex muscle repair than the classic vertical diastasis repair. My repair tends to give a better correction of the muscle laxity and gives you a nice low scar.

Due to the loose skin you appear to have, a full tummy tuck would be most likely be more suitable for you. Liposuction alone would worsen the loose skin.

Thank you for submitting your question and photos! Just doing Liposuction of your abdomen will cause more laxity to occur therefore creating more excess skin. A tummy tuck (abdominoplasty) is going to remove that excess skin while also incorporating liposuction and muscle repair. I recommend scheduling a consult appointment with a board certified plastic surgeon like myself so we can create a surgical plan that is best for you and your goals.

Thank you for your question and photos. It appears that you have excess skin in lower abdomen, as well as fatty deposits. Your abdominal muscles have probably separated from having 4 children. In my opinion a short scar tummy-tuck, or mini-tummy tuck with liposuction will address all your issues. It can tighten your abdominal muscles, remove excess skin, and contour with liposuction. I do not see the need for a vertical scar.

This can be a tough question for patients who fall into the grey area of not obviously having too much (tummy tuck better) or too little skin laxity (liposuction better). I tend to lean towards tummy tucks for my patients with your amount of skin laxity in light of avoiding worsened laxity and contour irregularity postop. The amount of skin recoil following liposuction can be hard to predict. I agree you may likely need a small vertical T component to the scar but the majority of these can often still fall within the underwear area. If you feel strongly about wanting to avoid incisions you could always try liposuction first and if your skin doesn't recoil as much as hoped, mini vs. full tummy tucks can always be performed later. This can be a common question for patients and I hope this helps.

Based upon your photos, a tummy tuck would allow the most contouring of the abdomen. If on exam you have any muscle separation related to pregnancy, this can be repaired to tighten the abdomen. Liposuction with Jplasma/Renuvion can allow for good results pending correct patient selection.
Your goals and desires should be discussed as this will help you select the procedure that is best for you.

It looks like you’re muscles are tight, flat with no diastasis. That means you do not “need” a tummy tuck. However, I think you would do well with liposuction of the abdomen with a mini-tuck. The skin of the upper abdomen look smooth and with good elasticity so it should retract nicely and the mini-tuck will take care of lower tummy laxity. You could also consider liposuction only and have a nice result, perhaps with some looseness in the lower tummy where the stria are located and opt for a mini-tuck in a delayed fashion. BTW- there is no effective non-invasive treatment (laser, j-plasma, radio frequency, etc . . . all unproven) for loose skin or cellulite so don’t expect much from those. I hope this helps. Thank you.

Thank you for your photos and question! I will include a video here to help answer some of your questions. In my practice, I offer bodytite with liposuction for areas like the abdomen that may need help tightening up if skin excision is not performed. Definitely discuss with your surgeon your concerns!