Q&A: I had liposuction twice, but my skin feels and looks like an old lady's skin. Should I have a tummy tuck?

Ask A Doctor Question: 

hi, i'm a 31 yr. old female and had liposuction twice on my abdomen, i'm 5'3 and 110 pd. 80%of my body fat seem to be in my stomach, my first lipo i wasn't satisfied because the moment i ate food i got fat bulges coming out on my sides and lower ab, so my doc. redid it, it seems to me that he took out pretty much all the fat out, but my waist is still fatty feeling, it seems like i have fat rolls, but i think that maybe it could be excess skin,when i tighten my abs it goes pretty flat but my skin feels and looks like an old lady's skin, kind of like "chicken skin" very loose but the rest of my body my skin is very tight, but the first time he did my lipo my skin was firm, do you think that maybe he took out too much fat?.. do you recommend a tummy tuck for this, i don't want to do lipo again, and if youdo recommend a tummy tuck how is the scar situation for this and also what if i decide to get pregnant will that put me back to square one or worse with stretch marks, please help..thanks 

- Rachel


Itzhak Nir, M.D., F.A.C.S. -

Dear Rachel,
It is very hard to visualize your exact problem from just a description. I understand your concern, your height and weight are appropriate but you feel that you have either excess skin or fat in the flank areas. The best way to begin is to have an evaluation by a Board Certified Plastic Surgeon. If anything, just to get another opinion on what needs to be done, if anything.
If you would like, you can schedule an appointment with me at my Wellington, Fl. Office. Just call 877-526-8863 and my staff will be more than happy to schedule your complimentary consultation.

--Itzhak Nir, M.D., F.A.C.S.
West Palm Beach, FL


William W. Ehrlich, MD FAACS -

Dear Rachel:
If you are thinking of getting pregnant, DO NOT spend the time or money or energy having any further abdominal cosmetic surgery.  Wait until after your last child is born. Do not do lipo again.
Your BMI is very low, at 19.53.  Basically, you have no (or very, very little) subcutaneous fat to push the skin out, to make it flat.  You have several choices:
1. Gain enough weight to "put on" just enough subcutaneous fat in the belly to push out the skin. 
      2. Have a skin only "tummy tuck" with a very low, short, C-section type, bikini line incision.   
      3.  Try one of the non-invasive tightening technologies.  Ultrasound, laser, radiofrequency.
I'm not at all convinced that these would work for you, but you might see a 25-35% improvement, with luck.  Don't spend alot of time or money on these.
You should also know that, with a BMI of 19.53, your facial skin will begin to wrinkle much earlier than it would if your BMI is over 21.5-22 (10-14 pounds more than you now weigh), like the "chicken skin" on our tummy.  I know that you don't want to hear that, but it is true.  You might also Google "body dysmorphic disorder"just to see if any of the criteria may apply to you.  I'm not judging, just checking. 
Good luck. 

--William W. Ehrlich, MD FAACS
Oklahoma City, OK


Atul Kesarwani , MD -

At 5’’3” and 110 lbs you have a Body Mass Index (BMI) of 19.5 which is certainly not overweight.  You have not indicated in your history, how active you are, whether you have had any significant fluctuations in weight, whether you have had any pregnancies or whether you plan to become pregnant soon as these situations may affect the decision we can help you make.
I would be reluctant to advise a young women of your height and weight to undergo  a “full” tummy tuck as the incisions may be too much.  A mini tummy tuck with a short C-section type scar may tighten your skin enough for you to feel better about your tummy without placing a scar around the belly button.
Alternately, there are some new non-invasive skin tightenign technologies that are getting better results that you may see a plastic surgeon to get more information about.

--Atul Kesarwani , MD
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