I had two consults with plastic surgeons. One said I have enough loose skin for a full tuck, but that the scar might be higher than I'd like and I probably won't want to wear a bikini due to that and the scar around my new belly button. The other said he can do a limited incision tuck, move my belly button down a bit, and still repair my muscles and fix my hernia, but that my stomach could be 10% less flat than it would be with a full tuck. I'm torn. Is one option better than the other?
Do You Recommend a Limited Incision or Full Tummy Tuck? (photo)
Doctor Answers 23
Mini vs. Full Tummy Tuck
Thank you for you question. It is difficult to give accurate recommendation without an in office exam. When I evaluate the abdomen, I assess:
1. The amount of loose skin
2. The volume of fatty tissue
3. The degree of muscle laxity.
I evaluate this in each of 3 areas:
1. Upper Abdomen
2. Area around the Belly Button
3. Lower Abdomen
MINI TUMMY TUCK: If a patient has loose skin, fatty tissue, and muscle laxity limited to the Lower Abdomen, then I recommend the mini tummy tuck. In order to qualify for this, the patient must have good skin and muscle tone in their upper abdomen and area around the belly button. I will frequently perform liposuction of these areas with my Mini Tummy Tuck to enhance the overall contour.
FULL TUMMY TUCK: this is for patients who have loose skin and muscle laxity of the upper abdomen, belly button area, and lower abdomen. This procedure tightens all 3 areas with a bikini line incision. I often encorporate liposuction with my full tummy tuck as I feel it offers a superb end result.
EXTENDED TUMMY TUCK: This works well for patients who have loose skin that extends over the hip bone into the flank area. I will perform extensive liposuction and skin excision to the hip and flank area combined with full tummy tuck.
BODY LIFT/BELT LIPECTOMY: this is essentially a 360 degree tummy tuck which involves removal of loose skin and fatty tissue of the lower back and buttocks, in addition to the extended tummy tuck.
I wish you a safe recovery and amazing result!!
Mini surgery = mini results
There is no question that you would be very dissatisfied with the limited results that you would achieve with a mini-lift. This type of abdominoplasty has a very limited application. You need a standard abdominoplasty with anterior abdominal wall fascial repair.
Tummy Tuck Options
Based on your photographs and description, you appear to be a candidate for full abdominoplasty to correct out your stretched out abdominal muscle and tissues. However, to verify, an in person exam and consultation to review your objectives, lifestyle, and lifestage are required. With a better understanding of these aspects, the optimal scar placement can be determined.
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Best tummy tuck option?
Your photos demonstrate significant muscle stretching with little skin laxity. You need a top to bottom rectus plication muscle tightening. When the muscle layer is pulled in, this will "un-mask" skin laxity, because the muscle will no longer be bulging out and stretching the skin. The degree of skin laxity will be such that moving the umbilicus down with the skin as it is pulled down (floating the umbilicus) will cause significant downward displacement, which I feel would be unacceptable. Rather, I recommend a low bikini incision and an incision around the umbilicus leaving it attached to the fascia where it is. If the skin opening is included with the skin removed , that's great. If not, the skin opening is simply sewn with a short vertical closure.
I feel this is the preferred approach for your particular situation.
Your problem is not excess skin, but stretched abdominal muscles and tissues causing you
belly to extend out. Another part of your problem is lordosis(excessive curve of your lower
back) pushing your abdomen out. There is no correction for lordosis.
You do not want a high incision that is also long. It will be much to high and very visible.
There will also be a scar around your navel. Or if this long scar is too low, there will be a scar where
the navel used to be attached. The shorter incision is much more difficult because there is less
working room, but the muscles can be tightened just about as much as with the long incision.
The length of the scar is determined by the amount of excess skin that you have, and it looks
like there is not very much excess skin. You should get a much better result with the low shorter
Full vs limited incision tummy tuck
Thanks for the excellent pictures it really helps. You have very significant muscle separation and I would offer nothing but a tuumy tuck with full muscle repair from the sternum to the pubis. I think what your question more surrounds is do you float the umbilicus or accept a higher scar. I propose another alternative. Do not float the belly button, keep the scar low and close the hole where the belly button was with a small 2 cm up and down incision. The long horizontal scar then remain low. A board certifed plastic surgeon should be able to further discuss with you this option.
Full Abdominoplasty Recommended
Based on the photos, in my opinion, I think a full tummy tuck (abdominoplasty) is the best procedure for you. The longer incision will allow easier access to the muscles and tighten them more completely.
What type of tummy tuck would provide the best results?
The pictures you provided are very useful and suggest a significant seperation of the muscles of your abdominal wall. In my opinion, you would get the best result from a full abdominoplasty rather than a limited, or mini-abdominoplasty. This would allow for a more complete tightening of the muscle layer. I believe it is still possible to keep the scar low so as to allow you to conceal it with a two piece bathing suit. Thanks for the question!
Best Result Possible
If you want the best result possible, have a "full abdominoplasty" with tightening of the muscles, repair of any hernias present, transposition of the umbilicus, and resection of the excess skin and fatty tissue. There are various options for scar placement and if carefully considered can give you a result that still allows for bikini wear.