What would be the recommended procedure to fix my midsection? (Photos)

Hi, thank you for sharing your question. I would recommend a full tummy tuck and 360 liposuction to achieve the most dramatic results.

Based on the photos you provided and the history of two C-sections, including one with twins, a full (or extended) tummy tuck (abdominoplasty) is the most suitable procedure to address your concerns. This procedure will help tighten your abdominal muscles, repair any separation (diastasis recti), and remove excess skin that is difficult to tone through exercise. Additionally, liposuction could be performed for contouring the flanks and helping to further shape and define your waistline. For those with multiple pregnancies, including twin pregnancies, this combination often provides the most dramatic improvement.
To explore the best option tailored to your needs, it's crucial to consult with an experienced plastic surgeon who can evaluate your body and provide personalized recommendations.
Krishna Vyas, MD, PhD, MHSHarvard, Hopkins, & Mayo Clinic Trained Aesthetic Plastic SurgeonNew York, New York

Hello and thank you for your question. For starters, it's great that you are doing what you can to maintain a healthy and active lifestyle- this helps physically condition your body for surgery and makes the recovery process easier. From the pictures you have provided, you have a significant amount of striae (stretchmarks) present throughout your lower to mid abdomen and extending to your sides into your flanks. You also have a severe amount of excess skin and subcutaneous fat in these regions. There is a significant amount of both horizontal and vertical excess tissue present. Based on all this, you would benefit from a fleur-de-lis abdominoplasty (tummy tuck) and staged 360 liposuction to improve your abdominal/trunk contour.
The fleur-de-lis abdominoplasty differs from the traditional abdominoplasty in that you will end up with both the standard horizontal lower abdominal scar, as well as a vertical scar extending from the horizontal scar up the middle of your abdomen to the bottom of your ribcage. In your case, there is a significant horizontal excess of skin and fat, which would not be adequately addressed with just a traditional abdominoplasty- therefore in order to resect this additional tissue and greatly improve the resulting trunk contour would require the additional vertical scar in additional to the standard horizontal scar. The horizontal scar should be well hidden within your bikini or underwear, and if you adhere to proper scar care and sun avoidance after surgery, both the horizontal and the vertical scars should eventually heal to be minimally noticeable.
Liposuction is a great adjunct which would definitely provide some additional benefit, particularly to the contour and symmetry of your flanks and back. In your case though, since there would be such a large amount of tissue resected (cut out) with the fleur-de-lis procedure, I would recommend delaying the liposuction to be performed at a later time (at least 6 months later). Separating liposuction into a separate procedure is important- this would minimize the risk of wound healing issues during the fleur-de-lis abdominoplasty procedure because the extensive dissection involved compromises the blood supply to the tissues, and liposuction there further disrupts it resulting in increased risk of complications. Delaying the liposuction would also allow for a better overall aesthetic result- any asymmetries from the initial surgery could be better corrected during the later liposuction procedure, and the liposuction can be more aggressive, especially to the anterior trunk (abdomen) as everything should be healed by this point so liposuction would not cause issues.
With all that said, it is always difficult to provide tentative surgical recommendations, as there is only so much information to be gained from any photos and descriptions provided. I recommend for you to come see me or another plastic surgeon for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) for your specific case. I hope this helps!
Best wishes,
Dr. Donald Groves
Plastic Surgeon

Hi there! Thanks for your question. I would reccomend an abdominoplasty with flank liposuction, aka a tummy tuck! You are an excellent canidate for this due to your excess skin. I would reccomend a consultation with a board certified plastic surgeon. You may also have diastasis seperation that needs repaired due to your pregnancies.

Dear lighthouse_lady,
based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. Flanks liposuction would give you a better shape. I would suggest you to consult a board-certified plastic surgeon because only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Hello @lighthouse_lady, thank you for your question. If you're looking to "tone" your midsection, the best recommended procedure in my opinion is a tummy tuck with muscle plication. During this procedure, excess skin and tissue are removed from the abdominal area and then the muscles are tightened in order to achieve a more toned look. This can be especially beneficial for those who have had multiple C-sections as it will help reduce scarring and/or lower abdominal bulging caused by compromised skin elasticity due to pregnancy or weight fluctuations. The best course of action is to consult one or several board certified plastic surgeon for more information and options tailored specifically to your needs. Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science Member (IFATS), Colombian Society of Plastic Surgery member (SCCP).

Thank you for your inquiry regarding the recommended procedure for your midsection. Based on my evaluation of the photos you provided, I would suggest a traditional or extended tummy tuck. It appears that you have significant adhesions within your abdominal cavity, which may have resulted from your pregnancies. To address this issue, I recommend freeing up these adhesions by dissecting the abdomen and plicating the rectus abdominus muscle to bring in your waistline by 3-6 inches. Subsequently, I would proceed to remove as much skin and fat as possible by pulling down and resecting the excess tissues.
Additionally, I would recommend removing the fat from the pubic region by dissecting the area (which should be included in a tummy tuck). This approach is likely to yield optimal results. To further enhance your figure, we could also perform liposuction of the flanks to create an hourglass shape and a more defined waistline.
I hope this helps to answer your question regarding the best procedure for your midsection. Please seek out an experienced board-certified plastic surgeon/ Thank you and good luck.

Mothers who were pregnant with twins or multiple children commonly develop Rectus Diastasis, a separation of the abdominal muscles. Despite healthy diet and exercise, these patients are unable to tone the abdomen and require a surgical procedure to repair the abdominal muscles. A physical examination of the abdomen, by a Board Certified Plastic Surgeon, would confirm this diagnosis. I recommend booking a consultation with a trusted Board Certified Plastic Surgeon for an Abdominoplasty.

You would benefit from a tummy tuck. If you are not planning future pregnancies, I recommend abdominoplasty with mesh reinforcement. The mesh creates a more hourglass figure by compressing the abdominal wall resulting in early satiety and helps maintain a reduced weight.

Best Wishes,

Gary Horndeski, M.D.

In person exam is essential. Based on limited photos and history of pregnancies- you appear to be a candidate for extended abdominoplasty with muscle tightening . I suggest that you seek an experienced Board Certified PS