At Atlantic Coast Aesthetics, we want our patients to look and feel as beautiful on the outside as they are on the inside. Sometimes, especially after an initial surgery to correct an area the patient finds problematic, a secondary, follow-up or revision procedure may be necessary to restore the area’s appearance and help it better align with the patient’s ideal outcome. An example of this is the focus of this week’s Ask Dr. Pane post. A patient in Jupiter, Florida found us on Facebook and asks, “About two years ago I had a muscle repair and umbilical float. Since then I’ve lost around 30 pounds, leading to some excess skin in that area. Do I need a reverse tummy tuck, a revision or just lipo?”
Dr. Pane says after reviewing the pictures, the belly was a little rounded to begin with. He says there is evidence of diastasis or loosening of the abdominal wall, likely secondary to pregnancy. After the tummy tuck, it’s better, but there’s still some roundness. This could be due to a pregnancy after the tuck or weight gain and loss in the intervening period.
It appears a plication [folding operation] was done because of the rounded belly, but it may not have been done well. If a plication is done too aggressively, it can lead to complications, but not enough plication can be bad in its own way, as this would leave the abdominal area looking more convex than the patient might prefer. He says around six weeks post-op, after the initial trauma and insult to the area had corrected itself, the surgeon would or should have known that the area was going to remain more or less in its current appearance.
There are a couple of different options here, Dr. Pane notes. Depending upon the results of an in-person examination, he says if there’s an excess volume of pinchable fat but the abdominal wall is flat, then the answer would most likely be liposuction. However, for what Dr. Pane believes to be going on based on the photos and available history, he says a better plication might need to be done. The problem with that is that the tummy tuck would need to be redone, or at a minimum the scar denoting the original incision would have to be reopened, which as we have mentioned before can lead to its own set of issues and complications. You wouldn’t necessarily need to have a lot more skin taken out, but to flatten the abdominal wall down properly, redoing the plication would be the most direct method. He says this would be the option he is leaning toward, and given the patient is relatively slender overall, it makes sense to consider the revision.
In most cases like this, Dr. Pane observes the available options can go either way. The patient’s anatomy will dictate what the optimal path forward would be.
Dr. Pane cautions that it is very difficult to give an accurate estimate of what the patient will need from photographs. An in-office consultation, coupled with an extensive medical history, is needed to get the full picture of where the patient is and the final outcome they’re looking for. In addition, patients should consult with a board-certified cosmetic surgeon to ensure they obtain the best possible care and results at every phase of the surgical and recovery process. Therefore, without an in-person consultation, the opinions stated here are purely informational and not to be construed as medical advice or an endorsement of any particular procedure, as the patient’s medical history and outcomes may reveal another alternative that would be better for them.
Your question could be ACA’s next Question of the Week! Just follow us on Facebook, call us at (561) 708-1070 or email us at https://acplasticsurg.com and ask away! Dr. Pane may choose your question to answer in an upcoming live Google Hangout, helping us help others while getting you the straight answers about cosmetic surgery you need. Remember, at ACA we believe the only bad question is the one you don’t ask!