Reverse Tummy Tuck (Abdominoplasty)

Andrew Kaczynski, MD

Article by
Sacramento Plastic Surgeon

What is a reverse abdominoplasty? Is it plastic surgery for someone who had second thoughts after their tummy tuck? No. It's a procedure designed to lift the upper abdominal skin from above instead of from below. Let's start with a basic abdominoplasty. This is designed to remove the pouch in the lower abdomen of hanging skin. Evaluation of the patient looks at the skin, the fat and the muscle separation. If all of these are present, the patient needs an abdominoplasty. This consists of making a hip to hip incision, listing all the skin up to the breasts, tightening the muscles vertically like a corset and removing the extra skin. This usually is necessary because of big babies, multiple babies, or several babies, one after the other.

But what if the problem is not loose hanging skin, separated muscle and a blob of fat in your lower abdomen? For some women especially over 40, the problem is loose skin above the belly button. The skin lacks elasticity and just starts to form several rolls. ln the past these patients either had to have a full abdominoplasty with a the lot of pull or couldn't have anything done.

Sometimes the non-invasive Thermage Skin Tighteing can help tighten up the skin in mild cases.

Now there is a procedure that takes care of that. With the reverse abdominoplasty an incision is made just under the breasts in the fold and across the entire abdomen in a horizontal manner. A small dart is placed in the midline to interrupt the scar for better healing. Then the skin is lifted possibly after some Vaser liposuction. This listing goes down to the belly button. The skin is pulled up just as I've seen patients show me on themselves many many times with their hands on their upper abdomen pulling up. "Why can't it look like this?" The excess is marked and trimmed usually from one to 3 inches.

The underside is sutured with quilting sutures to hold it and prevent excessive tension. Then it is sewn in with special zipper type sutures which achieve barely noticeable scar. The procedure is very comfortable postoperatively and has much less downtime than a full abdominoplasty. lt also does not limit the type of bathing suit afterwards. This is because there is no scar at the hip. With a conventional tummy tuck, even with a selection of the scar curving up or down or straight across this area places limits on future bathing suit styles.

lf you're a candidate it's a quick and straightforward procedure to improve upper abdominal rolls and loose skin with a less visable scar than a conventional tummy tuck.