Abdominoplasty (Tummy Tuck)
Archived Q&A and Reviews
Jan 2009 : Liposuction or tummy tuck?
I am a very fit 40ish mom. I work out, run regularly, eat well, and overall, look pretty good. My body fat is in the lean range. But I have been unable to really get rid of the flab around my middle. I don't need advice about working out or eating. I'm wondering about plastic surgery.
There is a lot of information on the BPN about about tummy tucks but nothing about liposuction. Has anyone had liposuction for their tummy and if so, are you happy with it? How long ago did you have it? Is it true that liposuction doesn't last? How much can I expect to pay?
I would rather not have surgery but know I would be happier if my stomach looked like the rest of my body. If you have had a tummy tuck, how long were you recovering? How long until you could work out again?
Finally, can I trust a plastic surgeon to guide me towards the right procedure? I am sure the surgery is more expensive than the lipo and wouldn't want to go under the knife just so someone can make their payroll.
Thanks! tired of my constant companion
Hi I was in the same position a few years ago you are in but several years older. On my wonderful internist's (Dr. Michi Kawachi) recommendation, I went to see Dr. Michael Cedars on Pill Hill in Oakland. Dr. Cedars has been spectacular. I had him perform liposuction on the areas that I couldn't get to go away after my three children. Since then I've had him perform a facelift, a forehead lift and a chemical peel. He's NEVER tried to talk me into anything. He'll tell you just what is the best thing for YOU and if he can't do any thing to help you, he'll tell you that too. He'll look out for your pocketbook, his staff is really friendly and all in all, Dr. Cedars and his office staff are great. I really urge you to check them out. Good luck what ever you decide to do! Happy in Piedmont
Whether you need liposuction or tummy tuck depends on your goals and on your anatomy. Basically, liposuction removes fat deposits from under the skin. Liposuction does not tighten or remove loose skin. If you have stretch marks, the deep layer of the skin has been torn by overstretching (as during pregnancy) and simply removing fat from under that skin will make you smaller, but is likely to leave you with loose skin. Some women want to fit better in clothes and so the loose skin is not of concern as long as the fat bulge is gone. Liposuction also does not address the midline muscle separation that can occur with pregnancy. In short, if your skin and muscles are in good shape, you may be a perfect candidate for for a good result with liposuction. If your skin and muscle layer need some tightening, a tummy tuck might be a better choice. However, the choice is yours. The purpose of a consultation with a plastic surgeon is to help you understand what your options are and what the surgeon's educated recommendations are and why he or she makes those recommendations. The decisions on how to proceed are ultimately yours. Local Plastic Surgeon
I am wondering how long do you need to wait before getting a tummy tuck/abdominoplasty? I am 5'2'' and was 120 lbs prior to giving birth. I have had two 10 pound babies as well as excessive fluid levels and have severe abdominal muscle separation that has just become worse after giving birth to my second large baby.
I have also had two c-sections so I am not sure how long to wait before I make an appointment to see the plastic surgeon. I am also wondering if anyone else that has had a C-section has had a tummy tuck and how they would compare the pain/recovery. Thanks!
Like you, I am petite, had two big babies by C-section, and although I returned to my normal weight, I was left with a diastasis and extra skin on my abdomen. I waited until my second (and last) child was three before I had surgery (done by Dr. Elizabeth Lee, whom I highly recommend). This was partly because I was still trying other approaches (e.g. pilates) in an attempt to close the diastasis, and partly because I wanted my children to be older and more independent before I voluntarily made myself unable to care for them for several weeks. I don't think you necessarily have to wait three years, but I'd wait at least 1.5. Your figure can take a long time to bounce back after giving birth, especially if (like so many of us around here) you're an older mom.
As for the recovery, it was MUCH worse than recovering from the C-sections. After the abdominoplasty, I couldn't stand up straight for several weeks! I was embarrassed to be seen all hunched over like that--luckily, I was able to work at home for the first two weeks. I'm not sorry I did it, though. I was tired of going around looking pregnant. Go for it--just be sure you have plenty of support while you're recovering, and you can take a few weeks off work (or work at home). No longer pregnant-looking
I also am petite and had large babies via c/s. I lost the weight fairly fast, but still had a flabby belly. I started with pilates and saw results almost immediately. One year after my second child was born, my abs were in great shape. There is no ''shelf'' and the rest of my body is getting much more toned as a result. I'd try pilates first, but if you experienced abdominal separation, that cannot be fixed with exercise. I'm sure others will chime in here, just wanted to let you know that pilates worked for me. Good luck. anon
Hi, I'm looking for words of wisdom from anyone who's had a tummy tuck (abdominoplasty). I've been thinking about it for several years, and just had my first consultation with a surgeon. I have two more consultations to go.
I had two 50-pound pregnancies, four years apart (the first was a c-section). I've worked hard to get fit. I've never been skinny, and never will be, but I'm pretty happy with my body and fitness level. Except for the sagging, stretch mark-covered skin on my belly.
I'm clear on the fact that I want the tummy tuck. The cost gives me pause, of course, but I'm pretty confident that I'll feel it's worth it. My biggest obstacle is explaining it to my daughters, 4 and 8, and my stepdaughters, 12 and 14. I feel like I'm a good role model, healthwise. I don't diet, but eat healthy, whole food. I exercise, but not obsessively. But how do I explain my desire to spend a LOT of money for a flat tummy, without undercutting our efforts to make sure that they all feel good about having healthy, athletic bodies that are beautiful just the way they are?
Anyone on the list who's had a tummy tuck, I'd love to hear your experience and if you feel it was worth it. And I'd also love advice on how to talk to my kids about it. Thanks. anon
Good luck with your decision. My family, genetically, has really poofy tummies and my mom's, after many years, has lost a battle with gravity. It is not easy to live with. Please keep in mind you may need to modify your behavior to keep your new shape, talk to your doctor about it. Good luck! tummy fighter
I had a tummy tuck about 2 years ago. My kids were only 2 and 3 years old at the time so I didn't have to explain much. Just that mommy has to go to the doctor to fix her tummy.
Getting the tummy tuck was the BEST thing I could have done. I have absolutely no regrets. The recovery was a bit long, however, totally worth it for me!! I would do it again in a heartbeat - several times over! :)))
Good luck! anon
After two big babies, my small frame went back to normal except for my tummy, which still looked 5-6 months pregnant (with extra pleats under the bulge). For years, I tried pilates and other exercises, to no avail. Finally I decided to get a tummy tuck (which included fixing my diastasis--a gap in the abdominal muscles). My kids were 3 and 6. They really didn't ask many questions, and they describe my recovery period as ''the time Mommy was sick''. I told my boss at work that I was having surgery to repair damage caused by having children (which was true). She didn't ask any questions, either. It was kind of embarrassing going back to work all hunched over like Quasimodo--I couldn't stand up straight for 3-4 weeks--but no one asked me anything.
I'm glad I had the surgery, but the recovery was much worse than I'd expected. I had been told it was similar to recovering from a C-section (which I had, twice), but it was much more painful and took longer for me to feel normal. In fact, nine months later, my tummy still feels unnaturally hard, and it's numb in a big oval around my navel. A friend who had the surgery years ago said her scar area still feels numb.
I don't see that there's any conflict between having your excess tummy skin removed and practicing a healthy lifestyle. I certainly didn't give up exercising just because I had my tummy fixed--if anything, I exercise more now, and since I've stopped obsessing about my tummy, I can now spend my time at the gym doing other things such as working on my upper body strength. I don't think your daughters will conclude that you had surgery because you didn't like the way you looked, unless you give them that message. Tell them that sometimes things go wrong with women's bodies when they have babies, and that doctors can fix these things. Maybe hearing that will help ensure that they avoid teen pregnancy. :-)
My surgeon was Dr. Elizabeth Lee, whom I highly recommend. She is not only technically skilled, but also compassionate and great to talk to, which are qualities that are not easy to find in surgeons. I don't look pregnant anymore!
I have not had a tummy tuck. However, I come from a family that has been pretty accepting of plastic surgeries. Here is what I would say to your daughters...something like this.... I am having sugery to remove this excess skin that some women get after multiple pregnancies. I value health and fitness and have done as much as I have been able to around this excess skin and I am going to let the doctor's do the rest.
end of story. don't go on and on about it. It should be simple. and don't beat yourself up if other people write and say you are not making the right decision or you are sending the wrong message. You do what works for you!!! good luck. anon
I believe that it is important to recognize that tummy tuck is often not just about loose skin and concerns about how you look. Many postpartum women with stretched out skin also have stretched out muscles and connective tissue. When this deeper layer is stretched out, the muscles are not in the correct position and they cannot function properly. You lose ''core'' strength and cannot support your back properly. This muscular and fascial loosening is corrected and tightened as an integral part of a tummy tuck. This should help move the procedure out of the realm, to your sensibilities, of ''frivolous'' and more into the realm of something done also for physical health benefits.
As to what to tell your girls in your position as a role model...How about that it is important to take good care of yourself and be able to recognize when you need to make changes for yourself and to be brave enough to do it. Local Plastic Surgeon
I had a tummy tuck after the birth of my second baby. My kids were 3yrs and 1yr at the time so I didn't have to do a lot of explaining to them beyond 'mommy doesn't feel good today'. I also struggled with questioning my motivation for the procedure, my vanity, my expectations of my body. The reality for me was that I had a pretty significant diastasis (separation of the abdominal muscles)after two big babies, I'm a small woman, and no amount of exercise could possibly rectify this physiological change in my body following pregnancy. So I consulted a plastic surgeon in Berkeley, Dr. Elizabeth Lee, and she helped me to understand that realigning my abdominal muscles was more than just getting a flat stomach so I could wear a bikini, it was about re-establishing the core of my body so I could get relief from my low back pain, improve my posture, literally re-center myself. I am so glad I did it, it was painful to be sure, but the recovery was manageable with some help for the first few weeks. Don't think about who you need to justify this decision to, it is your decision to make and the only person who really needs to be ok with it is you. Explain to the girls in your life the impact pregnancy had on your body in a very physiological way and that in your case there is a surgery that can correct the changes that need fixing. totally worth it
All pregnancies stretch out the abdominal wall; all four layers, not just the deepest, or Transverse Abdominis (TvA) as well as the mid line connective tissue. After pregnancy, women need to strengthen and shorten all four layers of the abdominal wall, as well as realign the spine.
Women who try to rehab the abs using exercises that flex the spine, like crunches, will strengthen only the external layers, the Rectus Abdominis and the External Oblique. This leads to a functional imbalance between the TvA and those muscles. The result is a lack of core strength and stability, which often manifests in back pain, and a protruding ''still pregnant'' looking belly.
Proper postpartum reconditioning strengthens the TvA first, then trains the muscle to function as a stabilizer. When contracted, the TvA compresses the abdominal wall and acts as an internal splint, which closes the mid line. There are many VERY effective exercises that work to close diastasis as well as create good functioning and core control.
Additionally, connective tissues respond to exercise and become stronger and denser as the muscles to which they are attached are strengthen. Diastasis can be remedied through the proper series of exercises.
Surgery is not the only, nor the ideal, option. Surgical realignment of the TvA does nothing in regards to it's ability to contract or to function properly. These are neuromuscular skills that can only be developed through proper conditioning. Helene
i have a completely stretched out, saggy tummy with a lot of stretch marks. it's a pretty big pooch which makes me look fat and/or pregnant. i am so self conscious about it.
i have gained and lost weight several times since adolescence, and have had 2 kids. my mother, aunts, grandmother are built the same way so i know genes are not on my side. i have lost all but 5 lbs since my last pregnancy. i am still trying to lose another 10 lbs. however, it's obvious that no matter what, the tummy is not going. i exercise several times a week, i eat well, i am happy with my body in all the other areas.
my hesitation is that i've got 2 young kids and what if something went wrong. on the other hand, although it is a major surgery it is usually successful.
money is not an issue, i have a family member who is a plastic surgeon-which makes it all the more tempting! he says i am a good candidate, however as a respectable doctor, he still says that there are risks, as with any surgery.
if you have had the surgery, did it go well? would you do it again? if you considered it but didn't do it, why? anything else you think is important to know would be great. anon
A friend of mine delivered twins a few years ago and she had the same feelings about her saggy post-partum tummy that you are having. She had a tummy tuck and she has never regretted it. Of course you would want to talk to your doctor about the risks and to weigh it all out, but in my opinion, if it is really bothering you,you should not keep yourself from seriously considering it. Life is too short not to be happy. Be happy
My friend had this done. She is tiny (maybe 5'1'' and shoe size 5 and a similarly tiny body). After three kids she had SO much ''saggage'' you couldn't even distinguish her belly button on her stomach. She waited and eventually just did it and was SO HAPPY she wished she had done it earlier. She is very modest (i.e. no bikinis for her) and really the only person she did it for was herself. Even her husband didn't really care. She did have a definite recovery period that was difficult (it's surgery!) but she is extremely pleased. -
My friend had this done, and while happy with the final result, she wishes she had been better informed about what a difficult recovery it is. Several weeks of pain and limited mobility, no lifting for six to eight weeks. She felt she really needed a lot of help to take care of the kids for many weeks. hope this helps
I have not had a tummy tuck but know some who have. First of all, I bet people will write to you saying not to do it! We are in berkeley.......however, those I know who have done it were very happy with the results. They said that the recovery was much more painful than they had expected. The scar can be quite large and uneven. Other than that people love their less juggly tummies. good luck! anon
I have had worsening low back pain since giving birth to my second and last child 21 months ago. I carried big and lost a lot of muscle tone in my lower and mid abs, I'm 41, but I'm quite fit and back to pre-pregnancy weight. (I think I'm a candidate for a mini tummy tuck BTW) I have ongoing instability in my sacroiliac joint that started with before kids, but has gotten much much worse since then. I don't think I have a disk injury. I've worked with Pilates trainers to strengthen the transverse. Believe me, I'm doing all I can there. But still, my low back is a mess. That's my story in a nutshell. I'd like to hear from other women in my situation who got tummy tucks. Did it really help your back? How much? Was it worth the money and recovery time? I need details. Is plastic surgery the answer?
When I saw your question, I forwarded it to the plastic surgeon I work for, Dr. Michael Cedars in Oakland, and this is what he wrote. (By the way, since you want to hear from women that have had the operation, I'd be happy to arrange for some of our patients to speak with you).
''Back pain is a complicated problem that can have contributions from many sources. Nevertheless, many women do obtain significant improvement in how their back feels after tummy tuck surgery. Perhaps as a result of the tightening of the muscle the whole height of the abdomen, there is a change in body posture that we see on pre- and post-operative photos.
Certainly, exercise, including the abs, is good and should be part of a woman's routine following recovery from childbirth. Tummy tuck itself doesn't place sutures in the muscle fibers but rather in the ''fascia,'' a thin tough layer that lies on the surface of the muscle. This holds the muscles in and gives a flatter tummy. It's a good idea to take advantageof this change in body mechanics and do a daily ab exercise, in order to make the muscles themselves stronger and tighter, for long-term health.
Also, this tummy tightening usually makes women feel full sooner when they eat. If one pays attention to these feelings, it is possible to train yourself to eat less. I have a number of patients who are thereby able to use the operation as a lever to lose weight by eating less. Plastic surgery is not a cure-all, but it can be a very good assistant.''
Hope this helps! Call me if you need more info. Patty
I had a tummy tuck 2 years ago after having 3 large babies and very stretched out abdominal muscles. I also had a very large diastasis (space between the abdominal muscles) that would not go back together despite working out. My back was in pain daily, and that has improved tremendously since the surgery. I had a regular tummy tuck, where they sew up the muscles, take off a bunch of skin, new belly button, etc. I couldn't stand straight for about 2 wks, and it was very painful, but I'd do it again in a heartbeat. The added bonus was my insurance covered it completely, because of my diastasis.I no longer have to tuck my skin into my pants, and last summer I even wore a bikini. I LOVE my new belly! anon
As you have already become aware, pregnancy stretches the whole belly wall including the muscle and connective tissue layers that give strength and stability to your 'core.' If you have a separation of the muscles in the midline called rectus diastasis, it is because the connective tissue or fascia has stretched permanently and cannot rebound back into shape. As the fascia remains stretched out, the abdominal muscles are no longer anchored in the midline of the belly, but bow out to the side, creating a physical imbalance of all the muscles of the belly wall. The transversus abdominus you are trying to strengthen ends in the outside border of the rectus muscle. If the rectus is out to the side, the transversus is also out to the side or held in a shortened position. Muscles work best at the length for which they were designed, so if the transversus and external and internal obliques are not held out to length, they cannot work properly no matter how hard you train. And all of these muscles stablilize your trunk and so support your back. If they don't work, your back is unsupported. By repairing the rectus diastasis, the fascia is tightened, the rectus is pulled back into appropriate position in the midline and all the other abdominal wall muscles are pulled out to length with the repositioning of the rectus muscles. Your core can be strengthened and your back better supported.
There are papers in the plastic surgery literature that demonstrate clear improvement in back pain after tummy tuck with diastasis repair. I never promise my patients that their backs will be better. However, I can state with certainty that if your back hurts now and you have a significant diastasis, your back will continue to hurt and possibly worsen without diastasis repair. Local Plastic Surgeon
Hi there, I wanted to give you some answers as someone who had this procedure done and who also works for a plastic surgeon, although I had the surgery years before I started working for the surgeon. I opted for the procedure due to the extent of my diastasis and the back pain I was experiencing, not to mention the fact that no matter what I did as far as exercise and diet I could not rid myself of the loose skin around my belly from my two large babies. It is major surgery, so have your back-up in place if you are considering it because you will need the help in the weeks to follow. I am very pleased with my results, the scarring is not as extensive as I had initially thought, my stomach is flat and the muscles are all re-aligned so I feel much stronger. As for the back pain though, I'm not sure it was a cure so much as it just eliminated one of the many contributing factors. When you abdominal muscles are stretched out and out of alignment they cannot properly support your spine. I don't think this surgery was a cure for me because I still experience low back pain but I think I am now in a better position to strengthen those muscles than I was before, but now my kids are so much heavier that anytime I lift them I'm in pain! My surgeon was Dr. Elizabeth Lee, she came highly recommended and it was important for me to find a female plastic surgeon, she was the first consultation I had scheduled and after meeting her I canceled all the others. We got along so well that two years after my surgery, during a post-op visit I told her I was looking to go back to work and she told me about an opening in her office. That just shows you how much she cares about the person she's sitting across from in her exam room, now that I've been a part of her staff I see firsthand how many women walk in the door patients and walk out friends, it really says something about how she practices medicine. Hope this helps...
Looking through the website, it seems that many people were happy with having a tummy tuck, for getting rid of the loose skin left on their bellies after pregnancy. However, no one seemed to have posted their doctor's contact info. Does anyone have a recommendation? I don't have time to visit all the thousands of plastic surgeons around for consultations. Too young to have a belly like this...
I had a tummy tuck last June with Dr. Elizabeth Lee. www.artfulsurgery.com 510.704.2170 As you can probabably tell through the archives, she is highly recommended. I am very pleased with my results and recommend Dr. Lee enthusiastically! She is a very approachable, objective, and caring surgeon. Belly hangover, no more!
The same thing happened to me after the birth of my children. Even though I lost a lot of weight, my stomach skinned sagged terribly. I've since found out that once you exceed the maximum elasticity of your skin (and often the membrane that holds your stomach muscles together) no amount of dieting or exercise will fix the problem. I saw a plastic surgeon - Dr. Elizabeth Lee - and learned that the membrane holding my stomach muscles together was stretched something like five inches. Also, my skin was never going to regain its previous elasticity. I decided I was too young to look matronly. So, I had an abdominoplasty (commonly called a 'tummy tuck') a little over a year ago. My waist looked much better almost immediately, and now it looks great. The scar has faded almost completely, and my clothes fit again. I couldn't recommend it more. Dr. Lee was great before, during, and after surgery. She has a website: www.artfulsurgery.com and her number is 510-704-2170. She's on Regent Street in Berkeley and I really couldn't recommend her more highly. Julie
I am a plastic surgeon in practice in Berkeley, and I see alot of this situation. Unfortunately, sometimes pregnancy stretches our bodies past where we can completely spring back. It is great that you have lost almost all of the weight you gained and that your tummy is flat, but if your skin has stayed loose and wrinkled and you have stretch marks, it is possible that this will never be smooth again. Skin with stretch marks has lost elasticity and tends to hang loosely forever.
Exercising is important for the underlying muscles and there are alot of great recommendations for exercise routines and trainers on this website. Exercise usually does not tighten overstretched loose skin. Sometimes, that skin just needs to be removed, which involves a surgery. You should not consider anything operative unless you are finished having children as another pregnancy will just stretch you some more. I also would recommend waiting until you are at least one year post partum before seeking any surgical treatment, as things can continue to improve during that time. Until then, exercise and enjoy your baby! Congratulations.
Local Plastic Surgeon
Hi, I have many stretch marks and very loose skin on my belly from having had 2 big babies. It's now many years later and I'm considering a tummy tuck/liposuction to transform the one part of my body I really don't like, no matter what my weight. I'm worried about the procedure though - pain and healing afterward, and results, especially if my weight fluctuates over time. Has anyone had any experience with this type of surgery, positive or negative, and would you do it again? also, any surgeons you'd recommend or not? thanks. anonymous
I am in a similar situation regarding stretch marks and loose skin after two big babies. Whenever I feel like my tummy is unattractive I remind myself of someone I met once in a bellydance class. I was about 20 pounds heavier then, and the fattest one there, so I wasn't exactly your sterotypical dancer. But a woman came to class who was very uncomfortable with her trim, tanned, slender tummy. She said she'd had liposuction and a tummy tuck and wished she could reverse it. I had noticed that she was stiff and self-conscious, but when I was invited to look closely I saw that her belly was slightly lumpy. She hated the feel of her new belly and couldn't get used to it because it wasn't symmetrical. I hope this helps. I'm not thrilled with what I have, but in time I'll come to accept it. anonymous
I had twins almost 4 years ago. My stomach (which was always my ''problem spot'')was much worse even after losing most of my 50 pounds of pregnancy weight. Even after 3 years of excercise, my stomach was flabby and disproportionate from the rest of my body and clothes did not fit properly. I decided to consult several doctors regarding liposuction and/or abdominoplasty (tummy tuck).
Because I did not have a great deal of excess skin, most of the doctors I saw thought that liposuction would do the trick. It would also be a much less invasive surgery with a faster recovery time. I selected a doctor named, George Commons, in Palo Alto (very reknowned and teaches Cosmetic Surgery at Stanford) and checked many of his references).
It has been one year since my procedure and I would do it again in a second (if I needed to!). It was a relatively quick recuperation and the results exceeded my expectations. Clothes look good on me again!
I would interview several doctors that have a good reputation and see what procedure they would recommend. You may find that liposuction is all you need. I struggled with the ''vanity'' of doing something like this but it has really saved my self esteem and made me a much happier person.
Good luck, Anon
I had a ''tummy tuck'' about 6 months ago. Dr. Elizabeth Lee was my surgeon and I couldn't recommend her more highly - she's great. (See Elizabeth Lee for the rest of this review)
If you'd like me to answer any more questions, feel free to email me. Julie
I just had a tummy tuck done (3 1/2 weeks ago). I had a permanent separation of my abdominal muscles and lots of loose skin due to my two pregnancies. I am thrilled that I had it done. Not only are my muscles now properly aligned and will hopefully work better (and prevent the back pain I've been having), but for the first time since my second child was born, I don't look 4 months pregnant. And yes, all the loose skin is gone! The healing process has been more rapid than I expected.
I highly recommend my surgeon, Dr. Elizabeth Slass Lee. (See Elizabeth Lee for the rest of this review) KandD