Cosmetic surgery is rapidly becoming one of the most “democratic” fields of medicine, as more male-presenting patients start looking into procedures that were once thought to be exclusively the province of women and female-presenting patients. A prime example of this shift in thought regarding cosmetic surgery is the subject of this week’s Ask Dr. Pane segment. The patient wrote in through our Facebook page. He says, “I lost 100 pounds. Will an extended tummy tuck with lipo to flanks and lateral chest help correct my issues?” Here’s what Atlantic Coast Aesthetics founder and Chief Medical Officer Dr. Thomas Pane had to say.

This is an interesting case because there isn’t the skin laxity Dr. Pane would expect to see after such radical weight loss. The skin isn’t severely loose, which might be expected in cases of drastic weight reduction.  

For a male, tummy tuck may be a somewhat bigger deal than it is for female patients. Men are not generally prone to C-section and other scars related to corrective surgical measures for the female reproductive system, the obvious exceptions to this observation being transgender and nonbinary patients. Because of this, Dr. Pane says the question for the patient becomes how much loose skin there really is to deal with, and where the patient places the value of having the tighter skin versus showing an abdominal scar. While a tummy tuck will give a snugger appearance to the skin, it may prove to be a lot of scar relative to the benefit the patient gains.  

As a rule, Dr. Pane says lipo in cases where significant weight loss has occurred would not be ideal because of stretching of the skin. However, lipo alone can help with skin tightening, and when other technologies and advances in cosmetic medicine are added in, may be all a patient really needs. Obviously, the results in these cases would not rise to the level of skin removal surgeries, but where there’s not a lot of loose skin to start with, that’s not as much of a factor as it could be in other circumstances.

For this case, Dr. Pane says he would really need to see the client in person to properly evaluate the skin. Palpating, pinching, considering the laxness and relative suppleness of the skin are very much hands-on diagnostic process. Dr. Pane would also want to speak with the patient directly and find out exactly what the ideal endgame is based on the skin and overall condition. However, in this case and depending on the outcome of an in-person clinical consultation and evaluation, Dr. Pane is leaning toward advising the patient to consider lipo by itself with the option to return later and have a tummy tuck if the lipo fails to deliver the desired outcome, as this would make the least invasive procedure appropriate to the case the starting point rather than going for something larger which may not deliver anyway.

Everyone has different priorities, concerns and bodies. It is important to understand that what worked for Patient A may be completely inappropriate for Patient B depending on the totality of factors in play. Also, once skin has been stretched out, it can never be completely returned to its pre-stretched condition. A tummy tuck or other skin tightening strategies can achieve a compromise, but skin tightening on a forty-year-old won’t give you the skin of a twenty-year-old. It’s crucial that patients understand and be realistic about the benefits, risks, potential complications and limitations of the procedures they are interested in have to offer before they undergo a surgery which may not be right for them.

If you have a question related to cosmetic surgery, Dr. Pane and the staff of Atlantic Coast Aesthetics welcome the chance to discuss your concerns and options with you. Simply follow us on Twitter, Instagram, LinkedIn and Facebook, email us at https://acplasticsurg.com/contact-us or call us at (561) 422-4116. Your question could be ACA’s next Question of the Week, to be answered live by Dr. Pane in an upcoming live video and letting us educate others with the same concerns and issues you have. Remember, at ACA, we believe the only bad question is the one you DON’T ask!