I Want my Figure Back!

Hi, I'm a 59-year-old female. I'm approximately 5'10" at 160 lbs. I work out 3-4 days a week with a healthy diet but with problem areas. I had a hysterectomy 15 years ago and my stomach hasn’t been the same since. Even with dieting and working out, I still have a poochy belly that hangs over the scar. I also have flabby thighs and buttocks. Three questions: Would liposuction be the best thing for all three - thighs, buttocks and stomach? Or would a tummy tuck be better for the stomach?

Doctor Answers 7

Getting your figure back...

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Even if you work out everyday, there will always be problem areas that you just cannot get rid of with exercise.  Liposuction can be done to help any area you are concerned with, while a tummy tuck focuses on your abdomen and the extra skin.  It's hard for any surgeon to give you an answer without examining you, but if your main concern is your abdomen and loose skin, then a tummy tuck would be your best solution.  The results of liposuction depends on the ability of the skin to contract, so if the skin is too loose, then surgery will be needed.  Please be sure to consult with a board certified plastic surgeon to determine which procedure would be the best option for you.

Abdominoplasty with Mesh Reinforcement

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Abdominoplasty with mesh reinforcement is my preferred technique to change abdominal contour and reduce weight.  Two articles published in Plastic Reconstructive Surgery Journal describes this technique as effective in reducing weight and maintaining the reduced weight.  The hysterectomy has damaged the mechanical strength of your abdominal wall, specifically the fascia layer.  Abdominoplasty strengthens the fascia and mesh augments the repair.  This changes the dynamics of eating resulting in early satiety with decreased caloric intake and increased energy expedite resulting in weight loss.  Liposuction would be ineffective.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Tummy tuck and liposuction?

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It sounds like you may be a candidate for a tummy tuck and as for the other areas liposuction may or may not be the best thing depending upon the quality of the tissues.  Best to be seen in person.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Tummy Tuck vs. Liposuction?

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Thank you for the question. Based on your description of “poochy belly  that hangs over the scar”, I think it is a safe bet that you will do much better with tummy tuck surgery than liposuction surgery alone.  This may be especially true given that you seem to lead a healthy lifestyle with  good diet, exercise,  and weight control.

This operation serves to remove the “excess” skin ( majority of stretch marks for some patients)  and reapproximate the abdominal wall muscles that have spread with pregnancy and/or weight gain/loss.

The “ideal” patient for tummy tuck surgery is one who has completed pregnancies, is psycho socially/emotionally/financially stable,  has an excellent social support system surrounding him/her,  is capable of arranging enough recovery time and who has reached a long-term stable weight.

When the time is right, seek consultation with board certified plastic surgeons who can demonstrate significant experience helping patients in your situation. Learn about the potential risks/complications associated with the procedure as well as the significant physical/emotional recovery time associated with the procedure as well.

I have also attached some advice that I provide to my patients who are about to go tummy tuck surgery:

1. Make sure you are doing the procedure for the right reasons (for yourself)  and that you have realistic expectations.  Be aware that an improvement in the “problem area” may not translate to an overall improvement in your life   situation.  You are bound to be disappointed with results of the procedure if your motivation for doing the surgery is not internally driven.

2. Time your surgery carefully; generally, it is not a good idea to have surgery done during or immediately after a stressful period in life (for example divorce or death of a loved one). The additional stress of surgery will undoubtedly be  more challenging to deal with if a patient's emotional reserves our already exhausted. Remember, that an improvement in your physical appearance will not translate to an improvement in your life situation.

3. If possible speak to patients who have undergone similar procedures and query them about the toughest times of their recovery period. Any practical hints previous patients can provide may be very helpful.

4. Make sure you are aware of potential complications that may arise how to reach your surgeon if necessary.
5. Make sure you have a strong and patient support system (several people if possible) in place who have time/patience to take care of you. Arrange for professional nursing if any doubt exists regarding the availability and/or stamina  of your caretakers.

6. Be patient with the healing process, understanding that it will take several weeks to months to feel “normal” again. It may also take many months/year to see the end results of your surgery.

7. Be prepared to distract your mind with things of interest such as books, magazines, and movies.

8. Expect less of yourself; do not go back to work, school or chores too early and let others take care of you (for a change).

9. Pick your surgeon carefully (a well experienced board-certified plastic surgeon) and trust in his/her advice. Keep in close communication with your surgeon and do not hesitate to communicate questions/concerns and the   emotional swings that you may experience.

10. Resume all medications that you were using preoperatively when cleared by your plastic surgeon and stop the use of narcotics and sedatives as soon as feasible after surgery.

11. Keep in mind the end results as you go through the tougher emotional times after your surgery. 

I hope this, and the attached link, helps.

I Want my Figure Back!

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      Liposuction in conjunction with a tummy tuck will probably give the best result based upon your description.  Find a plastic surgeon with ELITE credentials who performs hundreds of liposuction and tummy tuck procedures each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

You can get your figure back

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Liposuction can help with many areas but it sounds like you may need a tummy tuck to improve the abdomen. The buttocks can be lifted sometimes by injecting your own fat from other areas, the so-called Brazilian Butt Lift. Seek a consultation with a plastic surgeon who is board certified by The American Board of Plastic Surgery.

John Squires, MD
Denver Plastic Surgeon
4.9 out of 5 stars 82 reviews

I Want my Figure Back!

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You should be able to get some significant improvement in your problem areas. It will probably take more than just liposuction for the abdomen, but it really isn't possible to comment further than that without photos. Better yet, see a plastic surgeon for consultaton and an exam and yoou will get all your answers.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 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.