Have lost 60 lbs but abs, flanks, and inner thighs are not going down. Is a TT, lipo, and fat grafting my only option? (photo)

I have had a consult where I was told I would need a tummy tuck, lipo and fat grafting. Is this my only option or would cool sculpting, smart lipo, large volume lipo work? I really do not want to have a tummy tuck. I am only 20 lbs away from my pre pregnancy weight but my abdomen, flanks and inner thighs are not going down with the almost 60 lbs I have already lost.

Doctor Answers 14

Tummy Tuck Only Option?

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Congratulations on your significant weight loss; you should be proud of this accomplishment. In my practice, I would not offer you any procedure except for a tummy tuck procedure. Any lesser procedure will leave you with unsatisfactory aesthetic results.

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 and who has reached a long-term stable weight.

I have also attached some advice that I provide to my patients who are about to go  major body contouring surgery:

1. Make sure you are doing the procedure for the right reasons (for yourself)  and that you have realistic expectations.  Be aware that an improvement in the “problem area” may not translate to an overall improvement in your life   situation.  You are bound to be disappointed with results of the procedure if your motivation for doing the surgery is not internally driven.

2. Time your surgery carefully; generally, it is not a good idea to have surgery done during or immediately after a stressful period in life (for example divorce or death of a loved one). The additional stress of surgery will undoubtedly be  more challenging to deal with if a patient's emotional reserves our already exhausted. Remember, that an improvement in your physical appearance will not translate to an improvement in your life situation.

3. If possible speak to patients who have undergone similar procedures and query them about the toughest times of their recovery period. Any practical hints previous patients can provide may be very helpful.

4. Make sure you are aware of potential complications that may arise how to reach your surgeon if necessary.

5. Make sure you have a strong and patient support system (several people if possible) in place who have time/patience to take care of you. Arrange for professional nursing if any doubt exists regarding the availability and/or stamina  of your caretakers.

6. Be patient with the healing process, understanding that it will take several weeks to months to feel “normal” again. It may also take many months/year to see the end results of your surgery.

7. Be prepared to distract your mind with things of interest such as books, magazines, and movies.

8. Expect less of yourself; do not go back to work, school or chores too early and let others take care of you (for a change).

9. Pick your surgeon carefully (a well experienced board-certified plastic surgeon) and trust in his/her advice. Keep in close communication with your surgeon and do not hesitate to communicate questions/concerns and the   emotional swings that you may experience.

10. Resume all medications that you were using preoperatively when cleared by your plastic surgeon and stop the use of narcotics and sedatives as soon as feasible after surgery.

11. Keep in mind the end results as you go through the tougher emotional times after your surgery.
I hope this helps.

Tummy Tuck is an smart choice for you.

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Yes, you need a tummy tuck for sure, no other procedures can provide you a best aesthetic result.

Jose Hungria, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 26 reviews

Is A Tummy Tuck My Only Option?

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Dear Cap1127,  Thanks for the photos.  Unfortunately, given the large amount of extra skin and the stretch marks that are present, your skin will not retract with liposuction alone. While liposuction can remove a percentage of the fullness in your abdomen and love handles, it cannot make skin shrink.  Different forms of liposuction claim their technology can increase skin shrinkage but none can achieve the amount needed to obtain a nice aesthetic result.  A tummy tuck will give your surgeon the most control over contouring and shaping your abdomen and waistline.  Yes, it does require an incision but the incision will fade over time and can be hidden under most swimsuits and panties.  You have done such a great effort at losing the weight that it would be a shame not to get the best result possible.  Please consult with a board certified plastic surgeon who can plan the best treatment course for you.  Hope this helps.

Herluf G. Lund, Jr, MD
Saint Louis Plastic Surgeon
4.7 out of 5 stars 88 reviews

Tummy Tuck May Be The Best Option

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I think your question is a common one - what is the least amount that you have to do to get the results that you want.  So what are you choices?

Liposuction by itself can remove some of the remaining bulk.  Cool sculpting and smart lipo are usually used for contouring and improving smaller areas.  The larger volume liposuction does a better job of removing more fat (thus the name).

If we look at the photos you posted (and thank you for posting, it makes it easier to answer) you will see that you have an excess of skin also.  Look at the small roll that you have.  (Not a criticism, just an observation).  Liposuction will not significantly shrink the skin.  Some of the liposuction techniques that apply heat energy will shrink the skin some - but not to the degree you would need.

I think for the most dramatic improvement a tummy tuck with liposuction is the way to go.  I'm sure you would be pleased with the result.  But ... if you really want to avoid the larger surgery then go with the liposuction and see if you are happy with the result.  If not then you can always do the tummy tuck later.

Lastly, make sure you are at a stable weight before any surgery.  It will make the results more predictable.  Best of luck to you.

Al Rosenthal, MD
Lawrenceville Plastic Surgeon

IS a Tummy Tuck my Only Option?

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If you want your surgery to result in improvement of your appearance, don't think about liposuction for your abdomen. When there is overhanging skin, that is a sign of poor elasticity, and indicates that removal of fat by liposuction will result in more overhang. Liposuction will be helpful in other areas that may bother you, such as the flanks and thighs. I am not sure as to the role of fat grafting that you mention. 

Congratulations on the weight loss, and keep up the healthy life style. All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

IS a Tummy Tuck my Only Option?

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Re post after you lose the 20 pounds so we can see the effect on your skin. Than seek in person evaluations. 

Abdominal Liposuction vs. Tummy Tuck

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When considering your abdominal options, the key question is what result are you willing to accept for what tradeoffs. While a tummy tuck for you would clearly create the best result, you may find the magnitude of the procedure or the scar unacceptable. You can certainly do any form of liposuction and fat treatments you want, and they are easer to go through without creating scars, but just don't expect a tummy tuck-like result from them. When it comes to your two basic abdominal contouring choices, less is never more.

IS a Tummy Tuck my Only Option?

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      Tummy tuck is probably the best option to address the loose skin, as liposuction will not address the element of skin laxity that you have.  Liposuction can be performed on the flanks at the same time.  Find a plastic surgeon with ELITE credentials who performs hundreds of tummy tucks and body contouring procedures each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Difficult decision but tummy tuck is best option

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Congratulations on your weight loss!  It is always difficult to see in pictures but it looks like you have some abdominal tissue that is hanging after losing weight.  Liposuction, cool sculpting or any other types of fat reduction will only make the skin hang more since you are removing the underlying volume.  In this case it would be best to remove the skin and the fat while fixing the underlying abdominal muscles with a tummy tuck.  The result will be worth it but make sure to see a board certified plastic surgeon for a formal consult. Good luck!

Tummy tuck or what

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I believe you would have the best result with a standard tummy tuck to correct the skin excess and abdominal wall laxity.  Donald R. Nunn MD  Atlanta Plastic Surgeon.

Donald Nunn, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 51 reviews

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.