Can Any of You Dr Look at my Photos & Give an Opinion on What You Think Needs to Be Done? (photo)

I believe Id need a full tummy tuck,to remove all other scars(c-section,hysterectomy)as well as fat,rolls,extra skin,a breast lift w/slight reduction(my right is 1 size bigger than the left,I am a 38DDD & would like to b a D) as well as lipo on the abs,flanks,love handles,inner thighs & chin....would like to know if Im right or need less or need more. Oh Id also like to know where incisions are made on the body for these areas to be lipoed.

Doctor Answers 18

Can Any of You Dr Look at my Photos & Give an Opinion on What You Think Needs to Be Done?

I would like to thank you for the excellent pictures.  The first question is "are you at the weight you would like to be".  It is important that you are close to your desired weight when you undergo surgery so you get long term results.  You may be a candidate for abdominal liposuction instead of a tummy tuck but one could only determine that at time of exam.  You look to be a good candidate for liposuction of the other areas you state.  Cannot comment on the chin though.  A breast lift with small redution would give you the size and youthful appearance you desire.  A board certified Plastic Surgeon will be able to discuss your options with you.

About the Mommy Makeover Procedure

The Mommy Makeover is a combination of procedures to bring a woman’s body back to the way she looked prior to pregnancy. Most commonly some variation of a #TummyTuck and #BreastSurgery are performed. Additional procedures can include liposuction, umbilical hernia repair.  The most common #breastprocedures include #mastopexy or #breastlift, #breastaugmentation, or #breastreduction.  #MummyTummy is a term given to modified tummy tucks which can use liposuction and skin tightening with radiofrequency such Vanquish, Vela3, thermage, thermiRF and others. The actual fat contouring can be done non-surgically as well with #UltraShape or Cool-Sculpting.  

In addition to a one-on-one consultations with a board certified Plastic Surgeon, patients always need to be seen by their primary care doctor prior to such procedures.  We screen every patient and their medical records for risks of blood clots (DVT) and then take appropriate measures.  MWL (massive weight loss patients of  75 lbs or more) tend to have poor skin elasticity and will frequently need additional tightening even afte 6 -12 months regardless of who or how their surgery is performed. This is simply the nature of such body tissues and the ability to heal with the lack or limited elasticity. 

Your procedures should be performed by a #PlasticSurgeon who is board-certified and has a great deal of experience specializing in cosmetic #surgery. You will then greatly improve your chances of getting the result you desire, and, without the need for a revision surgery. It is suggested that you look at before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 96 reviews

Changes after pregnancy...

It’s not unusual for women to note significant changes in their bodies following pregnancy. Your pictures demonstrate redundant abdominal skin with weakness of the underlying abdominal muscles, localized fat collections of the hips and thighs and bilateral breast sag with breast asymmetry.

                Although, it’s impossible to make specific recommendations without a physical examination, your pictures suggest that you would benefit from an abdominoplasty with tightening of the underlying abdominal wall muscles. This could be performed in combination with liposuction of the hips and thighs. In addition bilateral breast lift surgery is appropriate with a slight reduction on the right side for symmetry. This could be combined with placement of a small sub muscular implant if upper breast fullness is desired.

                If you’re considering mommy makeover surgery it’s important to consult a board certified plastic surgeon. This surgeon should be able to formulate a treatment plan that addresses your anatomic findings and achieves your aesthetic goals.

Mommy Makeover

It appears that you may benefit from a tummy tuck, liposuction of the flanks/bra rolls/ upper and lower back/inner thighs, breast lift with reduction, and maybe even a Brazilian butt lift. You need to see a board certified plastic surgeon to see if these are really what is best for you, and what procedures can be safely combined together.

Breast Lift Reduction and Liposuction

   There seems to be little skin laxity in the photos, and liposuction may be more appropriate.  In addition, a right sided breast reduction with a breast lift on the other would be reasonable.

Ultimate Breast Lift and Abdominoplasty with Mesh Reinforcement

I will start with your breasts first.  You need a new technique called The Ultimate Breast Lift.  This technique lifts your breast tissue higher on the chest wall, increases upper pole fullness and increases your cleavage.  This is all done without a vertical scar such as the Wise pattern, which was developed in 1956.  Your right breast is slightly larger than the left, so you will need a small amount of reduction to produce symmetry.  Next, you should consider an abdominoplasty.  An abdominoplasty can be done using a transverse incision hidden by your underwear as shown in your photographs.  This will pull in your sides and give you a more hourglass figure.  Abdominoplasty with mesh reinforcement has been shown to decrease weight and maintain the reduced weight.  After this is done, I would consider liposuction to your flanks and back.  I would delay this for several months to see if you need it.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.7 out of 5 stars 210 reviews

Mommy Makeover Candidate

Thanks for your photographs and for voicing your concerns.  I would like to know if you are close to your goal weight and what your current lifestyle is in terms of how you eat and how often you excercise.  This is important because your final determinant of how good your surgery is is how you take care of it afterwards.  From your description, you are clear that you would like rejuvenation of the breasts with a small reduction and correction of the moderate asymmetry, improvement of the abdominal contour as well as the contour of your chin and thighs.  My plan for this would consist of a lipoabdominoplasty to address the abdomen, flanks, and midback roll, submental liposuction, thigh liposuction of the medial and lateral thighs, and then a small breast reduction/mastopexy to elevate your breasts and try to get your breasts more symmetric (remember, they are sisters and not twins!)  With all of this surgery, in my practice, I am adamant about an overnight stay for postoperative monitoring.  This is the plan provided that you are medically cleared and that you get a preop mammogram if you have a family history of breast cancer or if you fall into the normal age for receiving screening mammograms.  I hope this helps, keep us informed of your progress so other women in REALSELF can see your changes!

Mommy Makeover Evaluation

Hello - Thank you for your question regarding opinions as to what surgeries would be recommended following your pregnancies.  . If you've finished childbearing and are close to your ideal weight (or have maintained a stable weight) it may be a great time for you to consider a post-pregnancy makeover.  All breasts have some asymmetry, so it is difficult to tell from your pictures whether you might best achieve your goals through a breast reduction on both breasts or a lift on the smaller breast, and breast reduction on the larger side would be best. From your pictures, it looks as though you have nice skin tone, and that is typically very helpful in achieving nice results from liposuction or a tummy tuck and those options would need to be discussed  with you during your consultation based on your own goals and whether or not the abdominal muscle has separated which it sometimes does during pregnancy.  An easy test is to lie on your back and raise both feet off the floor. If the upper abdomen still sticks out the muscle has most likely separated.  To repair that, a full tummy tuck would be necessary.  If not, sometimes a mini-tuck with liposuction would be sufficient to achieve your goals. The Avelar technique may be another option to discuss with your doctor. The scar would be around your C-section incision but longer and well hidden beneath the bikini line.  Liposuction of your flanks and thighs could be done at the same time. There are more options than ever when it comes to body contouring.  Please seek out a board certified plastic surgeon who offers extensive options in body contouring and one who is able to show you good before and after pictures and that you feel comfortable talking about your concerns.  Good luck to you.

Steven L. Ringler, MD, FACS
Grand Rapids Plastic Surgeon
5.0 out of 5 stars 61 reviews

What Needs to Be Done?

Based upon the photos and the question, I would suggest

  • right breast reduction with lift
  • left breast lift
  • abdominoplasty
  • liposuction to the flanks and thighs. 

The TT incision would be about where the c-section incision is now, but longer. The liposuction could be done through that incision. There would also be an incision around the navel, which remains in its original position. 

I would note that when the TT incision is closed with appropriate tension, there can be some upward pull on the inner thighs, sometimes enough that the lipo (or thigh lift) is not really needed. You can screen yourself by pulling up on the abdominal skin and seeing if there is tightening of the inner thighs. 

When you 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 your for your question, best wishes.

 

 

Mommy makeover - tummy tuck and breast lift

From your posted photos I would say your analysis is right on target though the chin is not visible in the photos. I do not think you need less or more except maybe some liposuction of the outer thighs/saddle bags. You could also have some of the liposuctioned fat injected into the buttocks. A high lateral tension abdominoplasty will tighten your thighs as well by opening the outside angles of the abdominoplasty as opposed to ellipse shaped abdominoplasty excision.

The incisions for liposuction depend on the technique used. Some surgeons use smaller cannulae and make more holes others use larger cannulae and make fewer holes. I am in the second group and confine my holes for liposuction in the white/non-tanned areas between your tan lines.


I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles 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.