My weight fluctuated quite a lot when I was younger, and though I’ve been stable for the past five years at this lower weight, I still feel like the skin on my stomach is very loose. What can I do about it?
The number of male patients who come into my practice regarding skin laxity of the abdominal region has definitely increased 
over the years thanks to bariatric (obesity) surgical procedures with resultant weight loss that leaves many men and women unhappy with excess skin throughout their bodies. Then there are the men who have come to terms with a weight problem without surgery, but still find themselves afflicted by lose skin and extra fat when the bulk of the weight has been lost. Women have been looking into “tummy tucks” or abdominoplasty surgery for many years, mostly following child bearing. But today, many patients who have lost weight after weight loss surgery find that their skin doesn’t tighten to their satisfaction. Traditionally, men haven’t considered this option, but more and more, as big guys lose their bellies, they have to look toward surgical means of correcting the skin laxity. As bodybuilders, we’re aware of exercises that will bring up a lagging body part, but this isn’t something that can be remedied by exercise.
So what does a “tummy tuck” entail exactly? There are various ways to approach this problem, and the solution is dictated by the anatomy. In some cases, where the problem is mostly fat and little skin, liposuction alone, done through small incisions around the abdominal region, can remove the extra fat, and if the skin is not excessively lax, the amount of tightening that follows the liposuction procedure will be enough to correct the patient’s concerns. Where more fat is present and there is also loose skin, it’s possible that either a mini-tummy tuck or a full tummy talk will be required, possibly with some liposuction as well. The difference between the two is significant on the inside, but not so much on the outside. With a mini-tummy tuck, the incision is a little shorter on the outside, and the belly button doesn’t get moved, so everything that’s happening is below the belly button. This can be useful in patients who mostly have a lower abdomen flap of skin that needs to be tightened. If the skin excess is found throughout the abdomen—above and below the belly button, then a full tummy tuck is required. In this case, there is a lower incision, which may be an inch or two longer than previously, and the belly button is brought out through a new hole in the skin, keeping it in the same position as before surgery in terms of location on the abdominal wall. The final result in either case will be a smoother looking stomach with tighter skin with a lengthy scar of the lower abdomen that can be hidden in underwear, a bathing suit or even posing trunks. The scar is a trade-off that is worthwhile for those who decide to have the surgery.
Dr. Rick Silverman is a Boston-based plastic surgeon, whose practice is rooted in bodybuilding. One of his first patients in 1992 was a bodybuilder with gynecomastia, and his involvement with these patients eventually led him to the competitive stage, where he competed from 1996 to 2005, achieving professional status in the WNBF and competing in the masters level in the NPC. His practice focuses on providing optimal care for gynecomastia, breast enhancement, liposuction and other body contouring procedures, with a minimal interruption in your work-out regimen. He can answer your questions about bodybuilding and plastic surgery in the forum at http://forums.rxmuscle.com/showthread.php?t=34335
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