Inside vs Outside Fat
Visceral (or inside) fat refers to the normal fat that surrounds the intestines and abdominal content. This can not be reduced with an abdominoplasty – only with weight reduction.
Outside fat refers to fat within the skin layer- this can be be reduced with surgery. Looking at your pictures, you have components of both and I agree with the other experts who feel that you should see an improvement with a tummy tuck.
That being said, to get the best possible result, we would like to plicate (or tightenting) the abdominal muscles when possible. The issue of visceral fat has to do with the fact that if a patient has too much inside fat, the surgeon can not effectively plicate the muscles.
A good rule of thumb is that when you lay down on your back, if your abdomen flattens, you will do well with a plication. If however your abdomen remains protuberant when flat, there is probably too much visceral fat to do an effective plication.
I encourage you to see a board-certified plastic surgeon who can fully evalaute you and make the best recommendation. (Lawrence Iteld, MD, Chicago Plastic Surgeon)
Although you may not get quite the result you (or your surgeon) would like, you should attain an excellent improvement. The tummy tuck will remove excess skin and fat from the abdominal wall -the tissues outside the abdominal muscles.
There is also fat within the abdominal cavity -around your “viscera”- your internal organs. That fat is not accessible during a tummy tuck, or liposuction for that matter. It will go away with weight loss. The abdominal muscles will be tightened.
Some get a dramatic improvement, but those are usually predictable when the patient has a wide separation of the muscles noted on exam. I cannot tell from the photos alone (that is without an exam) how much flattening of the abdomen you would get with a TT. I can tell you that if you were to lose weight down to your goal, you will get a better result, perhaps the one you want. (Jourdan Gottlieb, MD, Seattle Plastic Surgeon)
The TT will address the amount of loose and lax skin above the muscle, however, the visceral fat will not really be affected by this procedure since it sits behind the muscle and really responds to diet and exercise. You will see a difference but a completely flat abdomen may not be realistic outcome.
I would revisit with your PS and get a realistic picture of what the outcome would be and if that meets your own expectations. (Edward J. Bednar, MD, Charlotte Plastic Surgeon)
Tummy tuck with viceral fat explained
It is very valuable that your surgeon discussed with you the internal fat that all patients have and how it contributes to your ultimate tummy tuck result. The internal or visceral organs have fat much like the rest of the soft tissues of the body. This fat is lost when we undergo weight loss. The muscle plication and waistline narrowing a tummy tuck achieves is limited by this internal fat. Although you will likely have a good result, the best result will be with some more weight loss first. (Neil Gottlieb, MD, Philadelphia Plastic Surgeon)
What to expect after tummy tuck
Visceral fat is fat inside your abdominal cavity that pushes out your belly. It is not fixed with a tummy tuck. A tummy tuck will remove the extra loose skin you have (such as the skin folding down your lower abdomen), tighten the skin, and tighten the muscles a little.
It will not result in much weight loss at all. You will be noticeably different, but will still not have a completely tight flat belly. If you are considering weight loss, it’s a good idea to lose as much weight as possible before a tummy tuck so this visceral fat will be lessened and you can get an even better, more noticeable, dramatic result with a tummy tuck. (Armin Moshyedi, MD, Bethesda Plastic Surgeon)
Visceral fat considerations with tummy tuck
In looking at your photos I agree, I think you will have a nice result. There is some loose skin (mild pannus) from the side view that will be corrected with a tummy tuck. There still may be some fullness left on top of the abdomen and this often requires a second minor procedure – liposuction only – to get fully flat.
Some plastic surgeons will do lipo in this area at the time of the tummy tuck; however, the blood supply is a bit more tenuous in the upper abdomen. For this reason, I prefer to do it in two “steps” because of enhanced safety. Visceral fat shrinks with weight loss so as you start to see the improvements, improved diet and fitness will lead to further weight loss and naturally “shrink” the residual visceral fat. (James F. Boynton, MD, FACS, Houston Plastic Surgeon)
Visceral fat and tt
This is an excellent question. The fat of the abdomen develops in two places, in front and behind the muscles. The fat in front of the muscles, the subcutaneous fat, is reated with liposuction and/or a tummy tuck. The fat behind the muscle is called the visceral fat and is not treated surgically. This fat is around your abdominal organs and is only lost through diet and exercise.
During the evaluation for a tt, the surgeon assesses the amount of each type of fat in order to estimate your degree of improvement and final outcome. If you have a high percentage of visceral fat, your result would be more limited. It is best if this fat is lost through diet and exercise prior to your surgery. (E. Scott Macomber, MD, Albany Plastic Surgeon)
Abdominoplasty with Mesh Reinforcement to lose visceral fat
Visceral fat is fat within the abdominal cavity as opposed to the fat that you can feel in your abdominal wall, which is subcutaneous fat. You would benefit from a new technique called Abdominoplasty with Mesh Reinforcement. This technique has recently been in Plastic and Reconstructive Journal literature.
The advantage of this technique is the mesh will provide additional support, which will help you lose weight and maintain the reduced weight. (Gary M. Horndeski, MD)