Extended TT or 360 TT after 115lb weight loss? (photo)

Hello and thank you for your question.
Congratulations on your weight loss! Based on your photographs (but without the advantage of a physical examination), I would recommend a 360° procedure ( lower body lift). Your first photograph demonstrates significant fatty deposits and skin excess along the lateral trunk/ thigh that would not be effectively addressed with an extended tummy tuck. The lower body lift also reduces posterior trunk adiposity and corrects gluteal ptosis. Ultimately the decision should be based on your aesthetic goals, keeping in mind that the lower body lift is a more involved procedure with a longer recovery. Good luck. I hope this helps.

It depends what your expectations are. If you can accept a little bit of looser skin at your hips, then I think you could get a very nice result with an extended tummy tuck. Good luck!

Thank you for your question. You are an excellent candidate for a 360° lower body lift rather than an extended tummy tuck. After significant weight loss, excess skin often collects around the midsection, not just the front. A 360° body lift removes this surplus tissue from the abdomen, flanks, lower back, upper buttocks, and lateral thighs. Additionally, due to the amount of weight you've lost and the presence of both horizontal and vertical skin laxity, a fleur-de-lis technique may be necessary. This technique will help better contour the upper abdomen, create a more defined waistline, and eliminate excess tissue in the central area.

Dear a022702,

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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

A 360 lower body lift with your tummy tuck is an option, but because we are not seeing a rear view, we cannot see how much drooping of the lower back and buttocks is present to justify a circumferential body lift. It does not appear from the pictures presented, that 360 is needed, but it doesn't matter because it can be done as a second stage if needed.
The abdominoplasty incision has to go the the mid-axillary line to allow elevation and redistribution of the abdominal flap and excess skin without a dog ear or bunching. This may require some extension of the incision past the mid-axillary line, an "extended" abdominoplasty, to begin with, and you should be prepared for some additional revision, usually in the office under local, to take care of any residual dog ear or bunching.
You may get some recommendations for a midline incision or fleur-de-lis to take care of the horizontal excess skin. The upper abdominal skin, despite the significant vertical pleating and excess in the lower abdomen, appears of pretty good quality. It can probably be redistributed after removal of the excess skin and not do a flour-de-lis. That would be a decision between you and your plastic surgeon at an in-persion evaluation.

Thanks for your question! I would probably suggest an extended tummy tuck or possibly a Fleur De Lis (would have to see you in person to determine). I might also add some liposuction to the waist and love handles to help contour. I think a backside lift might be overkill. Best of luck!