8 weeks post op TT, Mr, lipo & lift with implants. Can grab extreme amount of fat & nipples are out of proportion? (Photos)

I have extreme amount of fat I'm grabbing and my nipples are way out of proportion. My doc sais it's poor skin tone, that there's nothing left to be done. Sais my nipples will even out. I don't think so. I feel like he should have grabbed more or done a fdl.Am I correct? Also stated that I look better thanbefore, as if I should just accept that.

Doctor Answers 10

Tummy tuck

Thank you for your question and pictures.  I seems as if you had a large amount of weight loss before surgery, affecting your skin quality.  As for the nipples, this modest asymmetry can be addressed with a minor outpatient procedure.  As for the abd, while the results are OK, perhaps adding a vertical scar/component to the surgery  (Fleur-de-Lis TT) would give you a better result with less skin excess.


Pembroke Pines Plastic Surgeon
4.6 out of 5 stars 22 reviews

8 weeks post op TT, Mr, lipo & lift with implants. Can grab extreme amount of fat & nipples are out of proportion?

Thank you for your question and photos. I think your disappointment comes from too much being promised and less delivered according to your expectations. Based on your single view preop photo, my approach would've been different. First, I would not promise you that your major body makeover can be done in a single stage and achieve the best results possible. Maybe it is a philosophical difference, but I would've divided your surgery into two stages. First, liposuction your whole abdomen (upper, lower, pubic area, fat over rib cage), lateral chest wall, back, waist hips and fat grafts to the buttocks for reshaping. This allows, even your poor inelastic skin to tighten up and begin to see your underlying muscle anatomy. At the second stage, a full abdominoplasty, with muscle repair, umbilical transposition and a breast lift/augmentation would've delivered your expected results. Unfortunately, when surgeons try to do too much surgery (many times patients pressure the surgeon for this and the surgeon "caves in"), this is the expected result. Yes, you do look better, but were you promised something different?

In my opinion, to achieve the best results possible, you need to start all over again. Even though you are 2 months out and still healing, I disagree with the other consultants that this will get better by 6 months. I suggest VASER liposuction (traditional would be limiting due to the internal scarring you have now), of your whole torso as outlined above. 4-6 months later a tummy tuck, possible further muscle tightening if needed and revision of your breasts. Your tummy tuck incision does not need to be as long, due to the skin shrinkage.

You did not achieve your preop body shape in one day, and all those changes cannot be reversed by one operation. See a board certified plastic surgeon experienced in advanced body sculpting techniques for an in person consultation/evaluation. Good luck with your healing.

8 weeks post op TT, Mr, lipo & lift with implants. Can grab extreme amount of fat & nipples are out of proportion?

These questions are always difficult to answer as this depends upon a lot of factors that cannot be assessed in an online forum.  There may be room for improvement.  

2 months post op, some advices:

Thank you very much for sharing your concerns with us.
At this point (2 months post-po) the swelling is present.
To reduce it, I recommend you perform daily lymphatic drainage massage therapy over the abdomen and wear a postoperative girdle from thigh to the breasts.
Kind regards,
Dr. Emmanuel Mallol Cotes.-

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 174 reviews

Weight loss

It looks like you had a lot of weight loss and have poor skin quality. I think that overall your result is nice.  A touch-up of the areola asymmetry is always possible in the future.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Revision tummy tuck

There is definite improvement, but that doesn't mean that there can't be more. asymmetry in your breasts may improve as the swelling completely subsides. This may take 6 months so, for now, be patient there. In terms of your abdominal area, you may want to consider a revision tummy tuck either with your surgeon or with another board certified plastic surgeon in your area. 

Kindly,

Kouros Azar

Kouros Azar, MD
Thousand Oaks Plastic Surgeon
4.8 out of 5 stars 21 reviews

Revision tummy

Sometimes an abdominal makeover takes more than one surgery.  It's such a huge change that we do the best we can, and stage 1 is a significant improvement, but it's possible to need more.  Same thing with the vertical scar - some patients and surgeons don't like to do it unless it's absolutely needed, and we'll try to do it without it at first.  Not saying that's right, but that's often a tough decision to have.

It's tough to say since I wasn't there, but was lipo done to the entire abdomen?  You probably do need a Fleur-de-Lis, as you mentioned, to help narrow your belly in the horizontal direction.  Adding lipo to the whole abdomen may allow even more skin to come off.  

Basically, these are BIG surgeries, and there's always a chance for needing revisions or re-do's.  Not what you want to hear, but I always have the difficult conversations ahead of time so no one is surprised and they're on-board with me as their PS - we are a team.  

8 weeks post op TT, Mr, lipo & lift with implants. Can grab extreme amount of fat & nipples are out of proportion? (Photos)

From looking at your photos, I agree there is a dramatic improvement. But I also think it could be better. More liposuction of the abdomen and possibly a fleur de lis excision and more horizontal excision will help. You do have poor skin tone that will affect your result, but you can definitely have a bettter result than you currently have. Remember after significant weight loss or if you undergo plastic surgery when you are not at your ideal body weight it is more common than not to have to undergo more than one surgery to achieve the results that you want. 

8 weeks Post Op

I do appreciate what you are saying but also feel like you have a nice change from what I can tell from your before photo. I would keep a good rapport with your surgeon and perhaps revisit any additional touch ups necessary after 3-6 months post op. Revisions are possible if you're satisfied with your results in the future. 

Robert Heck, MD, FACS
Columbus Plastic Surgeon
4.8 out of 5 stars 62 reviews

8 weeks post-op

I agree with your assessment. I would like to see your nipples equal distance from sternal notch, and therefore appear to be level with each other.Also, I believe much more could be removed from your abdominal wall leaving you with a much flatter abdomen. The vertical component may also seem to be of potential benefit.

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.