Do I Need An Extended Tummy Tuck Or A Body Lift?

Q: Dr. Eppley, I had gastric bypass six years ago and lost over 100 lbs. My weight went down from 324 lbs to 205 lbs and has remained stable for the last three  years. While I am not small by any means, I am comfortable with my body where it is now. I will never be less than a size 14 but that is okay. It is just that I need to get rid of this inner tube around my waistline as it is heavy and interferes with a lot of activities and the wearing of clothes. My question is what type of tummy tuck do I need? Would a body lift be better than a tummy tuck? I have attached some pictures that show my unholy inner tube.

A: Losing a lot of weight always create a frontal pannus and skin excess that extends around the waistline and into the back. The fundamental difference and question to consider between an extended tummy tuck and body lift is your concern about the buttock area and any sagging that it may have developed. A body lift involves a 360 degree excision of tissue around the waistline and its effect is essentially like ‘pulling up one’s pants’. Based on your pictures, I would say that I see little benefit to the addition of an excisional area completely around your back. When it comes to incisional length and location, the more relevant issue is whether your extended tummy tuck should include a vertical component in the front, known as the fleur-de-lis type tummy tuck. This adds the extra dimension of pulling in your sides more by a vertical tightening down the middle. This would produce for you more benefit in my opinion than anything done in your back/buttock area.

Dr. Barry Eppley

Indianapolis, Indiana