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.