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Background: Large amounts of weight loss has created a need for some patients to pursue secondary body contouring procedures. While the initial weight loss, whether achieved by surgery or on their own, may have been initially satisfying the goals of even improved results drives some to go even further.

There is a unique subset of extreme weight loss patients that ‘graduates’ on to having plastic surgery. They almost always have done their weight loss on their own through a near addictive approach to diet and exercise. Once the weight is off they continue to work  diligently to hone and shape their bodies. But they reach a limit, even with extreme efforts, that is limited by whatever abdominal skin excess remains. They reach a point where the realization is that you simply can’t exercise off loose skin.

The most common body contouring procedure after weight loss is a tummy tuck. But a tummy tuck can have numerous variations in how it is performed and it must be tailored to each patient’s needs. In the male tummy tuck, for example, there is no need for muscle tightening and the incision will be ultimately obscured by hair in many men.

Case Study: This 48 year-old male had lost 60 lbs through diligent diet and exercise over a several year period. While he was in terrific shape, there remained a lower roll of excess abdominal skin that extended around into his flanks that he could not get rid of no matte what he did.

Mark Tummy Tuck result front viewUnder general anesthesia, he had a tummy tuck done through removal of a horizontal segment of abdominal skin that reached up just above his existing belly button. It extended back just to the hips. No rectus fascial plication was done. Aggressive liposuction was done around the waistline through the flanks back to the near the midline spine.

Mark Tummy Tuck result oblique viewThe male tummy tuck after weight loss is different from women in that no muscle tightening is usually needed. When done in men that achieved their weight loss by their own personal efforts and have continued to reshape their body, any loose lower abdominal skin is a frustrating problem. The low horizontal excision of abdominal skin can be the final change that they seek.


  1. Significant weight loss results in excessive abdominal skin and small fat collections that can not be exercised off.
  2. Loose lower abdominal skin in men after weight loss can be unraveled and removed through an ‘simple’ tummy tuck approach.

3) The acceptance of a low horizontal scar must be seen as a worthy trade-off instead of the loose abdominal skin.

Dr. Barry Eppley

Indianapolis, Indiana

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