I'm 25, had 5 kids inc. twins. I have diastasis, hernia, excess skin/stretch marks. My PS said I dont have enough loose skin in upper ab so I can't have a full TT. So he's planned a mini-TT + endoscopic repair. Lookin into other options as I've read mini-tt aren't usually satisfactory to most patients. So far I've researched: 1. Full TT with a small T-incision or 2. Reverse TT + mini TT or 3. Floating BB + mini TT I'm learning more towards requesting a full TT with *short* T. Recommendations?
Tummy Tuck Options for Me? (photo)
Doctor Answers (11)
Full Tummy Tuck With High Incision Or Small T Best Option
Thank you for your question and photographs. Congratulations on staying so fit after having 5 children. You are in excellent shape and should have a good result following a tummy tuck.
I agree with you that you will be disappointed with a mini tummy tuck because your diastases will not be repaired and the excess skin above your belly button will look out of place with a tightened lower abdomen.
With the amount of loose skin that you have it is often possible to do a full tummy tuck by placing the horizontal incision slightly above where it is normally placed still in a position that can be covered by standard underwear or a two-piece bathing suit that he is not a string bikini. If that is not possible then a small T incision may be required on your lower abdomen just above the horizontal incision.
Be sure to consult a plastic surgeon who is certified by the American Board of Plastic Surgery, experienced in tummy tuck surgery, and who has an excellent reputation in your community.
Tummy Tuck Options for Me?
You will get the best long lasting results with a full TT. As long as the doctor dissects the skin high enough, which means up over the lower ribs (we do this with all our TTs) you will either get the standard horizontal scar or at worst a very short vertical scar, the "T" you mentioned which is worth the extra benefit of the tightening and redistribution of the entire abdominal skin surface. You have too much loose and damaged skin above the BB to leave it untouched, and your belly button is not high enoughto float it down far enough to improve the upper skin. And of course you want to have a surgeon who uses progressive advancement closure sutures, because that allows another inch or so of skin to be resected without putting undue tension on the scar.
A tummy tuck can be done as a solitary procedure. Many times the results are enhanced by adding liposuction to the hip and love handle area. A tummy tuck is also done in combination with a breast augmentation in a mommy makeover.
Please find an experienced Board Certified Plastic Surgeon and member of the Aesthetic Society using the Smart Beauty Guide. These Plastic Surgeons can guide you on all aspects of facial surgery, breast augmentation and body procedures including tummy tucks or mommy makeovers!
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Tummy Tuck Options for Me?
Congratulations on having completed pregnancies and remaining in good shape. Based on your history and photographs, I think that you will do best with a full tummy tuck operation. The “ideal” patient for tummy tuck surgery is one who has completed pregnancies, is psycho socially/emotionally/financially stable, has an excellent social support system surrounding him/her, is capable of arranging enough recovery time, does not smoke and who has reached a long-term stable weight. I hope this, and the attached link, helps.
Tummy tuck after twins?
A tummy tuck would do wonders if you are at a stable weight, and don't plan to have any more children. Lipo would not be helpful because the main issue is a laxity of your core. If the core is loose then the skin just takes the shape of whatever is underneath. A tummy tuck is the definitive solution and a mini will likely get mini results.
from your history it sounds like the twins really stretched you out. the diastasis repair by itself will significantly add to your shape. the amount of skin excision will become a intraoperative decision based on safety.
What type of TT?
You're smart to do the research you're doing. And you have the most difficult type of physique for TT: Very good physique, very damaged skin, poor abdominal skin elasticity and relatively high belly button.
Some comments: Short scar / mini TT will not give you a good result. Your diastasis is not major, but looks like it does need repair. And, have you finished having babies? You look young in your pix... if more babies are a possibility, wait till you're done before having a repair.
I think the best way to go is to have a full TT. The issue really is getting the central portion of the scar low enough. I really don't like the T and never do it. What I would do is to do a full TT, transpose the belly buttom, get the diastasis repair done, then move the upper skin flap as low as I could safely. If it got nice and low, then you're done, and you have a good result. IF the horizontal scar needed to be a little higher because the upper flap did not elongate enough ( by the way I think it will elongate fine), the nI'd leave it high and 6 months later when it's all settled down and relaxed I'd do a day surgery further lower wedge which will lower the scar to a nice position.
So, in summary, a full TT, getting the upper abdomen right, and hopefully in one stage. At worst, a later minor second stage to further lower the scar to the best position once skin relaxation has occurred.
A vertical scar component is forever, and if avoidable should be avoided.
Hope this is clear and not confusing!
A full tummy tuck with hernia repair is best
Your history and pictures suggest that you can, in fact, have a full tummy tuck and diastasis plication with a hernia repair. After child birth, especially in the case of 5 children, the skin has been stretched multiple times almost always allowing for a full tummy tuck. The best and tightest waistline appearance can only be achieved in this way. The full tummy tuck will also allow for you to have the most skin removed including your lower stretch marks. Good luck
Options for Tummy Tuck
The options you have researched are reasonable for some, but not all. Based on your photos, it appears that you have excellent rectus abdominis ("6 pack") muscle tone. If this is the case and your abdomen looks fairly flat on a side view, then plication repair of your rectus muscles above the level of your belly button may not be necessary and a mini-tummy tuck can be performed to address loose skin below the belly button. But, if your goal is to remove as much stretch marked skin as possible, then the full tummy tuck is the way to go. However, in your case, you would very likely end up with a small vertical scar (inverted T) at the lower abdomen. This vertical scar may be visible if you wear smaller swimsuits or underwear. Hope this helps!
Thank you for your question and photos. Best of Luck!
Tummy Tuck Options for Me?
Looks like you have listed all (at least most) of the options. It is hard to tell based on a photo alone.
But based on the photo and your surgeon's opinion that the upper abdominal skin is not loose enough for a classic TT, I would probably favor a full TT which would then require a vertical closure of the defect from the navel. But with an exam, that recommendation might change!
Thanks and best wishes.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
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