2 kids, 1 emergency c-section, 1 Vbac, extended tummy tuck required? (Photos)

Question

Hi There, I have had a few consults and seem to be getting mixed opinions. I am getting a mommy makeover but cannot get a clear answer if a regular or extended tummy tuck is best. I do not have any skin laxity on my flanks, it is mostly in the middle as I tried to depict. However, I do have a lot of fat on my flanks. I was hoping Lipo would take care of this. if relevant - I have had 2 kids, one emergency c section & one vbac. weight lost after 1st pregnancy 70lbs, and 50lbs after my secon

Carmina Cardenas, MD · Answer

You have developed a severe saggy skin not only abdomen and also in lovehandles as the result of the the huge about of fat gaining and losing after every pregnancy. 
Your lovehandles are very thick and after liposuction the area will become extremely saggy and wrinkly, so you will be a great candidate for a Circumferential Tummy Tuck to remove the saggy skin on your abdomen and also lovehandles and take advantage to lift the buttocks, muscle repair to achieve a flatter abdomen and smaller waistline, Mons lift and liposuction to waist and lovehandles. If you want add some volume to buttocks. 
Just have in mind you are not getting any younger and the saggy lovehandles will only be worst in a just couple of years. 
As expert in After Weight loss surgery I am very familiar with patients who have developed severe degree of saggy skin. My goal is total rejuvenation. 
Be encouraged!
Dr. Cárdenas

William Andrade, MD · Answer

Thank you for your question.  Based on the left lateral photo, it appears that the skin fold extends at least partway on to the flanks.  Unless this loose skin were removed, you might have residual skin laxity ("dog ears") in this area.  You would need a proper assessment to determine the exact length of the incision but based on the images it seems that a short incision might not address this area of skin laxity.  Certain liposuction modalities can tighten skin a little, but not typically to the same extend as actually excising the skin.  In my experience, most of my patients will accept a longer scar if it creates a better contour, but this is an important discussion to have with your surgeon as part of the informed consent process.

Mahira Tanovic, MD · Answer

Hello!
This is a great question.From the photos you have provided, it seems that your incision would be from hip to hip for the best possible aesthetic results. 
As always, an in-office consultation is required to really examine your abdomen and your own unique anatomy, as well as discuss the procedure and any questions you may have.
Best,Dr. Tanovic

Daniel Barrett, MD · Answer

Dear svscorad,
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

Gary M. Horndeski, MD · Answer

You are a candidate for a mommy makeover. I would begin with your breasts using The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. You will need an extended tummy tuck and may even need a posterior continuation, depending on how the wound heals anteriorly. I would do the breasts and tummy is one surgery and then consider liposuction or circumferential lift in the second surgery.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Luis A. Mejia, MD · Answer

Dear Svscorad, thanks for sharing your pictures and concerns, after analize your case you look like great candidate for Vaser Liposuction + Tummy Tuck with muscle repair to get rid the saggy skin on your tummy. With just lipo all your belly will look wrinkled due as the skin will not have retraction. Make sure you go on consultation with a board-certified plastic surgeon. Hope this helps and best of lucks. Dr. Luis Mejia.

Connie Hiers, MD, FACS · Answer

I would suggest liposuction to your flanks and an extended tummy tuck to tighten your lower abdominal wall and remove the excess skin.  Find a surgeon you like and whose photos you have seen and go with that surgeon.  Not all surgeons differentiate between a full or extended tummy tuck.

Camille Cash, MD · Answer

An in person evaluation is always best, but it appears you will have a nice result from a standard tummy tuck with liposuction for contouring.  The incision will extend from hip to hip.  From your photos it appears you're a good candidate and should have a notable improvement!

Mats Hagstrom, MD (license on probation) · Answer

The most common revision, after a tummy tuck, is excision of the skin, redundancy at the lateral aspect of the incision line often called dog ears. This happens because plastic surgeons fail to extend the procedure far enough along the sides, creating an undesirable contour. If, in doubt, the excision should be taken longer rather than shorter. To do an extended tummy tuck, requires repositioning the patient during surgery, and this is time consuming and labor-intensive. It adds to operating room cost, and for that reason some plastic surgeons may be tempted to cut corners And do a standard tummy tuck when in fact, patient would benefit from an extended procedure. When removing skin laxity from a surgical perspective, it cannot be done so with an non-acute angle. If you pinch and lift the skin on the back of your hand you will see the skin fold becomes longer the more you lift your skin up. This is a bit what happens on your abdomen. The incision needs to gradually come to close of patients will be left with “dog ears”
I always encourage people to have more consultations then they may think necessary. The more plastic surgeons, you talk to the more likely you are to find the best provider. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patient who have similar body characteristics to your own. Look carefully at the amount of skin laxity, and how this continues to the side and look at the Contouring in the after pictures and how far the incision went. Make sure you’re looking at the patients from different angles.
An experienced plastic surgeon should have no difficulty showing you the before, and after pictures of at least 50 previous patients. Being shown a handful of preselected images of representing the best results of the providers career for a patient who don’t have a body characteristics that are similar to your own is insufficient to get a clear understanding what average results look like in the hands of each provider. It’s exceedingly rare that somebody makes an incision That’s too long. Plastic surgeons often err on making the incision too short, 
Like I mentioned earlier it is one of the most common reasons patients end up with revision surgery. My best guess is at least 1/3 of patients who have full tummy tucks end up with dog ears that could have been prevented had the surgeon made a better plan of action and paid more attention to detail.
Have each surgeon point out (consider having them make a dot with a sharpie pen) exactly how far the scar will go and specifically if they plan on turning or repositioning you during surgery. Without turning the patient it’s not really possible to do a proper “extended TT”. I suppose there is some subjectivity here but in general your better off having a longer scar not a shorter one. 
Best,
Mats Hagstrom, MD

Joshua Jacobson, MD - Account Suspended · Answer

Hi. You can get a good result just with tummy tuck and liposuction of abdomen and flanks. During your surgery, we may need to make the incisions a bit longer past the hips to avoid having dogears. Those incisions are pretty hidden and no one complains about them.

2 kids, 1 emergency c-section, 1 Vbac, extended tummy tuck required? (Photos)

Answers (10)

More Tummy Tuck Questions

Lipo or tummy tuck? Advice on which procedure I need for belly? (Photo)

Could my previous tummy tuck be the cause of my back pain? 4 years post op

How likely are the chances of developing skin necrosis after tummy tuck?

Mons pubis too high after tummy tuck - advice? (photos)

Bulged and hard tummy, no much feeling after 11 months post surgery - permanent?

Are there any resources to teach about the risk of cross contamination after surgery?

WE SEND PRETTY
EMAILS