You only had a mini tummy tuck and the upper abdomen wasn't addressed

Richard P. Rand, MD answers: Loose and saggy upper abdomen after Tummy Tuck

I had a full Tummy Tuck 6 months ago. After the procedure, my surgeon told me that since my belly button was 'high' to begin with, he was able to leave it intact after the Tummy Tuck. My fear is that this really translates into, "I didn't remove as much skin as I should have." I now have a taut lower abdomen, but the entire area above my navel is loose and saggy. Last week, my surgeon performed laser skin tightening on my upper abdomen (his solution). I am not at all convinced that this will remedy the problem. Is this a normal result, or am I right to have expected better? I am not overweight and I have done regular abdominal workouts both pre and post surgery. Thank you!


Richard P. Rand, MD
11 months ago

When a patient comes in for abdominal improvement, there are basically 3 options for them:

1. Liposuction - this only removes fat and doesn't tighten muscles or remove excess skin. It is limited to those patients who would benefit only from this and have good skin elasticity. This would not appear to be what you needed.

2. A mini tummy tuck - this procedure only addresses the lower abdomen and tightens the muscles below the belly button and removes a small amount of skin. The muscles and skin above the belly button are not addresses and there is no incision around the belly button. I personally almost never do this operation because I don't want patients to end up with your result. If you have issues and needs above the belly button, the will not be improved by anything other than a full tummy tuck.

The problem with a full tummy tuck in someone like you is that you don't have much extra skin and in order to avoid a vertical scar in the lower abdomen from where your belly button was, the horizontal scar would need to be higher than where yours is now. The only other way around this is to "float" the belly button but this can make it look too low on the abdominal wall. So your was maybe not a simple case.

3. A full tummy tuck - what most patients need to address their lower AND upper abdominal issues. The scar is a bit longer but not too much especially if you get the abdomen you want.

These issues would preferably have been discussed preop so you could have voiced some preferences in the choices. At this point, I don't know of any external treatments that will change your upper abdomen significantly. Either you need to accept the result or consider having a full tummy tuck.

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A: mini vs. full tummy tuck

Richard Baxter, MD
11 months ago

First, some clarification on terminology: It looks like what you had was a version of a mini-abdominoplasty, with the umbilicus (belly button) relocated to a lower position. This is actually a common procedure but isn't a "full" abdominoplasty. If you were to have the full version, there would be a scar around the umbi, and more tightening of the upper abdominal skin, but because you had a high umbi to begin with it would likely not have been possible to remove all of the skin between the pubic area and the umbi, which is how the standard full version is done. This means there would be a hole in the skin flap where the umbi was, which would have been closed leaving a scar somewhere in the lower abdomen. It may or may not have been a good trade-off but your surgeon's judgment was to avoid it so there is no scar on the umbi or the lower abdomen, which is a good thing. So yes he could have removed more skin but there is a trade-off to doing that.

The laser treatment will take some time to have full effect, so i would advise some patience and make sure you are being followed-up regularly with your plastic surgeon.

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