Tummy Tuck or Laser Skin Tightening Post Pregnancies?

I am 130lbs, 5'5". I work out hard core everyday and have been for about 2 months, I have noticed my stomach shrinking and my skin firming up a little but, I have considered a Tummy Tuck but want to avoid that if there is a better alterntive, I do not want the scar.

My stomach looks great when I stand up, but when I sit down, its pretty disgusting. (2 kids, 18 months apart) Will laser skin tightening work or should I just do the tummy tuck procedure or just continue to work out?

Doctor Answers 21

Laser Liposuction Not Laser Skin Tightening May Avoid Tummy Tuck

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Thank you for your question. Non-surgical laser skin tightening will disappoint you as the best technology available provides at best 20% tightening compared to the 100% tightening of a tummy tuck.

However from your photographs it appears that you do not have a lot of excess skin and there is a slightly increased amount of fat beneath your skin.

In my experience in patients who have a similar appearance to your photographs, laser liposuction using the SSlimLipo laser liposuction technique safely removed the fat and also produces enough skin tightening for a satisfactory appearance.

If you want the tightest tummy possible then you will need a tummy tuck and a small amount of liposuction. However you say you do not want scarring and thus I think laser liposuction is an acceptable alternative for you.

Be sure to consult a plastic surgeon who is certified by the American Board of Plastic Surgery, experienced in tummy tuck and laser liposuction seizures, and who has an excellent reputation in your community.

Best treatment for the abdomen after pregnancy

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Almost every week I hear from another company that has a new great machine to get rid of excess skin without surgery. Of course there machine is touted as being better than all of the others out there. I lost faith in these companies years ago.

According to present day plastic surgery lore, there are 5 types of abdomens:
1. requires no surgical treatment
2. is best treated with liposuction only
3. is best treated with a combination of liposuction & a mini abdominoplasty/tummy tuck
4. is best treated with a combination of liposuction & a modified abdominoplasty/tummy tuck
5. is best treated with a combination of liposuction & a standard abdominoplasty.

In relatively few cases there is little or no liposuction needed in a specific patient who lies in one of these categories.

Which category you are in depends on the relative amounts of excess skin/fat vs. abdominal muscle laxity you have above vs. below the navel. There are some good plastic surgeons who believe 4 should not exist. Also, there are probably naturalists, trainers, etc. out there who believe none of these should exist except 1. My experience & training lead me to believe that all 5 are valid & that diet & exercise can be combined with any of the 5. Only 2 or 3 may be amenable to non-surgical skin shrinkage if the machine works. I am not sure that machine currently exists.

There are a significant number of people out there with a condition know as diastasis recti (separation of the 2 central abdominal muscles) which is never amenable to diet or exercise. It is more common after the inherent stretching of pregnancy especially if the muscle is cut during C-section. These people need surgical tightening of the displaced abdominal muscles. Excess fat can be lost to some degree with diet & exercise depending on age, metabolism, etc.. Resistant fat may be amenable to liposuction.

The end result of liposuction or weight loss in turn is dependent on the ability of the skin left behind to shrink. Excess skin is more of a problem. Its ability to shrink after liposuction, pregnancy, large weight loss (decrease in the amount of fat under the skin) or decrease in underlying muscle mass is dependent on age, genetic makeup & how much shrinkage is required to get the desired result. If you need a lot of shrinkage, especially if you are older, it just doesn't happen. Not even exercise can shrink this skin. The result is flabby wrinkled skin that may have stretch marks.

These people require surgical removal of the excess skin because once the skin has been stretched beyond a certain limit it will not shrink much like an overstretched rubber band that has lost its elasticity. Not even ultrasonic liposuction can shrink this skin. If you are planning to or are in the process of losing weight, at any age, it is better to go ahead with the weight loss for health reasons. Once the weight is lost you can then continue an exercise program to tone the muscles. If the skin doesn't shrink it can be excised at a later date. There is no form of exercise that can shrink excess skin. Mild excesses, however, may appear less so after increasing the bulk of the underlying muscle. If the skin does not shrink sufficiently within 6 to 10 months it is unlikely it will ever do so. The presence of stretchmarks means the skin is even less likely to shrink.

The amount of excess skin can be assessed by standing in front of the mirror and pinching the skin above the his on the sides. If the belly button is then covered by skin or if it is covered on standing without the pinch you are a candidate for regular abdominoplasty. In this case you have so much excess skin that no non-surgical machine could get rid of it.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Laser Skin Tightening Has Limitations

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The abdomen can be significantly impacted by pregnancy.Pregnancy can cause weakened abdominal muscles, loose saggy abdominal skin, abdominal fat collections and stretch marks.These problems can affect self-esteem, self-image, and the quality of life for anyone who has been pregnant.Because of this, patients are eager to correct these problems so they can resume their normal lives.
For many women, tummy tuck surgery is not an option following pregnancy because of the time required for recovery and the associated expense.Under these circumstances, laser skin tightening can sometimes be attractive to patients.Unfortunately, this procedure has significant limitations.The procedure is unpredictable, generally not effective on the abdomen and only effective in cases of mild skin laxity.
In the vast majority of cases, excess abdominal skin is best treated with tummy tuck surgery.This procedure can address multiple concerns including skin laxity, weakened muscles, fat collections and stretch marks.It’s important that every patient undergo a critical analysis of their specific problems.Each patients anatomic deformity is slightly different and this should be reflected in the treatment plan.Although there are occasional patients who benefit from laser skin tightening, the majority of patients will require abdominoplasty to correct their problems.

Laser vs Tummy Tuck Options for Loose Skin

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I understand that you are uncomfortable with a slight amount of loose skin, but with your fitness and the great job your have done on your own I agree with the others that no surgical procedure would be worth the scar. Likely neither procedure would help enough immediately. There is the potential to look into natural fitness for that surface fat under the skin, as it is not always completely removed with either procedure.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Tummy Tuck or Laser Skin Tightening Post Pregnancies?

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Thank you for the question. The tummy tuck and abdominoplasty terms refer to the same operation. Generally, this operation involves removal of excess skin/adipose tissue of the lower abdominal wall and re approximation of the abdominal wall muscles that may have spread with pregnancies and/or weight gain/loss. Liposuctioning is often used as a tool during the procedure.
Generally speaking, the “ideal” patient for tummy tuck surgery is one who has completed pregnancies, is psycho socially/emotionally/financially stable, has an excellent social support system surrounding him/her, is capable of arranging enough recovery time, does not smoke and who has reached a long-term stable weight.
Liposuction surgery, on the other hand, refers to an operation that essentially suctions out adipose tissue. The operation does not involve any skin removal or re approximation of abdominal wall muscles. The best candidates for liposuction surgery of the abdominal wall are patients with good quality skin elasticity and a moderate degree of diet and exercise resistant adipose tissue superficial to the abdominal wall muscle layer. Patients who are significantly overweight, have significant abdominal wall laxity, and/or have lost a significant amount of skin elasticity are not generally good candidates.
My best suggestion: seek consultation with board-certified plastic surgeons who can demonstrate significant experience helping you achieve the type of outcome you will be pleased with. You may find the attached link, dedicated to tummy tuck surgery concerns, helpful to you as you learn more. Best wishes.

Nonsurgical Tightening of Loose Skin Instead of Tummy Tuck

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Your stomach contour looks great in your photo - nice job on faithfully doing your core exercises!

If you don't want to get surgery, there are nonsurgical options that can help tighten loose skin and minimize the appearance of stretch marks. Laser based treatments and micro needling can help, however the results can be unpredictable and take longer to achieve. If you have the patience, please talk to a medical aesthetician or plastic surgeon about them. 

Post pregnancy tummy tuck versus laser skin tightening

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Laser will not produce the results you are seeking. It has marginal efficacy and the amount of tightening produced will be minimal. Your pictures indicate that you are a candidate for an abdominoplasty. Liposuction may be an adjuvant procedure to enhance the result.

Tight Tummy = Tummy Tuck NOT "laser"

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If you want to have the tightest tummy you ever had - have a tummy tuck. Yes, you will have a scar that stays hidden in your underwear but in exchange you WILL have a flat tummy that lasers, exercise, acupuncture, lotions, pills, will never get you as well as a narrower waist.

While exercise is good, it cannot take in and narrow your abdominal wall muscles which were stretched by your pregnancies - only a tummy tuck can do it.

To fully understand everything you need to know about Tummy Tuck, follow the comprehensive link below -

Dr. P. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon

Abdominal skin tightening

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In general, plastic surgeons assess the abdomen in a neutral standing position, not so much when sitting or bending since these dynamic changes are less controllable and are dependent on muscle tone and skin elasticity. Laser liposuction does not tighten skin per se and will not significantly change the way you look when sitting. You might consider a mini-tuck or modified tummy tuck approach. The other thing you have to understand is that plastic surgery does not have a good answer for all situations. SInce you look great when standing and are not too concerned with stretch marks, you might want to consider trying to be happy with what you've got until it is bad enough or intolerable where you will accept the scar.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Tummy Tuck or Laser Skin Tightening Post Pregnancies?

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TT is your only option. anything else will not address your skin which appears to have striae (stretch marks) that are like scars which will never go away and never allow the skin to shrink.  keep working out you you still have room for improvement on your own.

Rafael C. Cabrera, MD
Boca Raton Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.