What Would You Recommend After Weight Loss? (photo)

Me: 26, used to weigh 300lbs 10yrs ago, now at 200lbs. My questions: 1. What do you recommend based on the pics? 2. I will not be getting Muscle Repair-- I'm 100% firm on this decision. Whats the diff. in recovery time, honestly. And is this cheaper? 3. How can I best prepare post and pre-op? 4. With such a sharp upper abdomen 'fat cliff' as mine, and the tissue being noticeably thicker there, can I expect that it will, po, not protrude? 5. Does liposuction 'come with' or is it more (flanks)? :)

Doctor Answers 7

What surgery is best for me?

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You have a lot of extra skin after your weight loss and I think a tummy tuck alone is not going to make you happy.  I think you probably need to discuss with your surgeon the pros and cons of a circumferential abdominoplasty and liposuction.  This will get rid of a lot of the loose skin in the front but also the loose skin that you have out in the love handles.  

Not having the muscle repair is unlikely to change the cost in your case.  The upper abdominal area that you are concerned about may not be eliminated with tummy tuck and you may need a second procedure such as liposuction in the future to address this.  The cost of the liposuction is surgeon dependent.  

To prepare for surgery, I would recommend that you get as close to your goal weight as possible, have a thorough health evaluation by your general practitioner and optimize your nutrition including using a daily multivitamin.   

No muscle repair with a tummy tuck may limit your result

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Thank you for your question and photographs. Congratulations on your weight loss. If you are planning to lose more, it would be best if you did that before your surgery. Not having the muscle repaired at the time of your tummy tuck will likely reduce your pain and speed your recovery but may reduce how flat your stomach will be after surgery.  The muscle repair only takes a few minutes so there isn't much difference in cost. Some liposuction of the abdomen may be done as part of the tummy tuck, but this generally does not include the flanks so that would be extra. It is hard to say if you will still have some protrusion of the upper abdomen after surgery without an evaluation. Good luck.

James McMahan, MD
Columbus Plastic Surgeon
4.8 out of 5 stars 40 reviews

What Would You Recommend After Weight Loss?

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Many thanks for the question. I think if you have been successful in losing 100 lbs then perhaps continue to lose some more. If you loose weight after any of the surgeires the results achieved will be lost.A good Breast lift then and Liposuction with circumferential tummy tuck may the answer for you. In my practice I do Breast and the tummy in two stages to reduce the risk of postoperative complications. Circumferential Tummy tuck with Liposuction is a big procedure by itself .Wish you all the best.

Options in body contouring surgery

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Congratulations on loosing 100 pounds.  The first question is this your ultimate goal weight or do you plan on loosing more weigh as this will effect your final result.  If you are planning a skin only abdominoplasty without repair of the underlying fascia you may not get a totally flat result but it may be all you are looking for.  It appears that you would be a candidate for an extended abdominoplasty with liposuction of the upper back and posterior hips. There will be some degree of protrusion of the upper abdomen if you forgo the fascia repair. The cost for this procedure, in my practice, is totally based upon time in the operating room and you will save some time as well as have less pain if the fascia is not repaired. When you have a consultation with a plastic surgeon be certain to understand the differences in the result from every option.  A happy plastic surgical patient is one who, in the final analysis, gets what they thought they were going to get.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Tummy tuck without muscle repair

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You could certainly have a tummy tuck without the muscle repair and add some liposuction.  The real question is which operation is right for you.  If you do have loose muscles, then the tummy tuck result will be compromised and potentially aesthetically unacceptable if you don't have the muscle tightened.  I would hate to see you go through the expense and the pain of surgery only to be dissatisfied because you opted out of what could be an essential element of the procedure. Your tissues aren't "thicker" in the midline; there is more fat deposited there.   Did you reach this decision about the muscle repair on your own or after consultation with a board certified plastic surgeon?  Generally, an abdominoplasty with flank liposuction is slightly more expensive than without because of the additional OR time. Without muscle repair, the first few days are less painful but the recovery time is comparable.   Preparation for surgery entails obtaining medical clearance, abstaining from blooding thinning substances/smoking/herbals and complying with your plastic surgeon's regimen.  Abdominoplasty without muscle repair is usually less expensive than with; however, the presentation of your abdomen is more challenging than most and will be a bit more expensive.

What Would You Recommend After Weight Loss?

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I see two good options.

  • Vertical abdominoplasty. Here there would be a horizontal incision in the lower abdomen, and a vertical incision from upper abdomen to lower abdomen. This will result in removing the excess tissue in both vertical and horzontal directions, and will do some tightening part way around the back. The amount of protrusion will depend more upon the intraabdominal contents and the non-tightened abdominal wall.
  • "Belt lipectomy, with a tummy tuck incision continued all the way around the back. This still may not remove enough excess skin in all directions.

The abdominal wall tightening typically takes 10 to 15 minutes in a procedure that may last 4 to 6 hours, so the fees would not change much. The amount of discomfort might be a bit less. Liposuction in an area not adequately treated by the TT alone would usually engender a fee. 

Congratulations on the weight loss. Staying fit is the most important preparation you can do. 

 When you are ready for an in person consultation, RealSelf has listings of surgeons in your area. You should consider cross referencing the listings from the The American Society of Plastic Surgeons (plasticsurgery dot org). A listing in the ASPS website assures you that your surgeon is not only board certified,  but also is a member in good standing of the major plastic surgery organization in the U. S. Thank you for your question, best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

What surgery after weight loss

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you could go a couple of ways. one would be a tummy tuck with liposuction of the hips and flank region. I personally do not like the vertical scar approach to the abdomen. I do not like the scars, or the result.

the other alternative is a lower body lift with circumferential tightening. you may need an upper body lift in the future to tighten under the bra line if it bothers you. a mastopexy or uplift would complete the torso improvement. that could be done at the same time as the above procedures.

Rick Rosen, MD
Norwalk Plastic Surgeon
4.8 out of 5 stars 28 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.