If I can tighten my tummy, and only able to "pinch a few inches" why do I still look this way? (Photo)

Question

I am having a full TT w/lipo. PS is doing a "bell" shape TT along with tightening of all the tummy muscles. He said its normal to look like this, hence the reason for TT. I'm concerned they may be more wrong. I do have good tone from sit ups, etc. Your thoughts?

Scott Tucker, MD · Answer

It looks like your muscle have split (diastasis recti) This causes the bowing of your lower abdomen. Tightening the skin and muscles can help to flatten you tummy. It sounds like your surgeon is on the right track. Good luck,DrT

Antoine A. Hallak, MD, FACS · Answer

I agree with your surgeon recommendation of tummy tuck and lipo to flanks will give you great result and flattening of the bulging abdomen area.

Jaime Campos Leon, MD · Answer

Thank you for the pictures.I agree with your PS, tummy tuck and liposuction will give you the results you're looking for.Dr. Campos

Jeremy Pyle, MD · Answer

I absolutely agree with your doctor. If you can tighten up and things go away, or if things go away when you lay flat, then the part of the operation that you will most benefit from is the muscle plication or repair.I've included pictures of a similar patient to help you better understand how important and influential that muscle tightening can be.Best,Dr. Pyle

Steve Byrd, MD (retired) · Answer

When you tighten your tummy does your abdomen flatten except, as you mention for the "few inches" of "pinchable" fat?  If so then a portion of your rectus musculature is separated.  The plastic surgeon you have seen is planning to tighten the muscles.  It sounds like the appropriate procedure is planned, Tummy Tuck.  Your question does bring up a good point in relation to Tummy Tuck procedures and what they can accomplish, however.  For example If a patient tightens the tummy muscles and pinches the available fatty tissue and the abdomen is still protruding somewhat, it is likely that there is fat  inside the abdominal cavity and around the intestines. This fat is absolutely untouched by what a Tummy Tuck procedure can do and when I encounter patients in this situation I recommend dietary changes, hormone evaluation and increased exercise prior to doing the Abdominoplasty (Tummy Tuck) and Liposuction procedures.  These preoperative endeavors optimize outcomes and patient satisfaction levels in regard to their surgery.Steve Byrd, MD

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question and photograph.  You need to understand that when your belly protrudes like that and you only have a small amount of loose skin there are other things causing your tummy to protrude forward.  The most likely cause is that there is normal fat wrapped around your intestine called mesenteric fat which can only be reduced by weight loss.If you have a tummy tuck now there is a very good chance that your tummy will still protrude therefore U will be well served to lose significant weight before having a tummy tuck.In addition if your tummy muscles are split due to pregnancy this can also contribute to the abdomen protruding.  The split muscles can be repaired during your tummy tuck which will significantly help this.  However the most important thing for you now is to lose weight with diet neck shows size until the protrusion is much less before considering tummy tuck.

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