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Redo Mini Tummy Tuck to Correct Upper Abdominal Area?

Hi there,

One week after Mini-Tummy Tuck to correct diastasis, PS removed 450 cc's and minimal skin, but I am left with the odd upper-abodminal area looking not as tight as the lower abs. The procedure was performed endoscopically with sutures all the way up the abdomen. At my fifth-day visit, the doctor's first words were "this is unacceptable"...The two options were that: 1) it was just swelling and it will decrease or 2) worst case scenario the issue was worse than he thought and would have to perform a full procedure. Can anyone offer advice or suggestions here?

Asked 36 months ago by confusedinca in california

Upper abdominal swelling after Tummy Tuck is usually excess skin or muscle bulge

Dear confused, It is early and hopefully swelling will resolve and you will get better. In my experience, when I have had a patient with persistant swelling above the umbilicus or belly button, it has been because the upper abdominal muscles were not adequately repaired and continued to bulge in marked contrast to the tightened lower abdomen. The other possibility is that by not doing a full abdominoplasty with skin excision and transposition of the umbilicus, excess upper abdominal skin is... more

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Brooke R. Seckel, MD

Boston Plastic Surgeon

ASAPS ASPS

Mini tummy tuck revision should wait

Dear Confusedinca, From the comments of your surgeon in California it sounds like the verdict is not out. It can be hard to tell at five days if your are experiencing swelling, or is the skin and tissue in the upper abdomen bunching or showing through the muscle plication performed underneath. Your doctor expressed concern and no doubt you are anxious as well. As surgeons we all have times when we have felt this way, and with experience we learn how to guide patients through uncertain... more

Peter E. Johnson, MD

Des Plaines Plastic Surgeon

ASAPS ASPS

Unfortunately, I think you will need a full abdominoplasty

Hi, confusedinca! Of course, you should not do anything for 6 months, and I don't exactly know what you look like. But I think I can picture your appearance in my mind, because I have seen at least a dozen patients in this situation. The mini tummy tuck has real limitations, and is not good for many patients. The main problem is that the skin above the belly button is not tightened. When you tighten the lower skin, it makes the upper skin look even bulgier and more loose by comparison. The... more

George J. Beraka, MD

Manhattan Plastic Surgeon

ASAPS ASPS

You will need to wait at least a month

You may have too much swelling, but if the result is not acceptable to your doctor, you may be better of to have redo surgery early than late. The most common cause for your situation is that rectus muscle was not repaired correctly.

Kamran Khoobehi, MD

New Orleans Plastic Surgeon

ASAPS ASPS

Reverse Upper Abdominoplasty

Not infrequently I see patients in whom there is as much skin laxity in the upper abdomen as there is in the lower abdomen. In fact, some patients after pregnancy will have fairly 'toned' lower abdominal skin, but very lax and redundant upper abdominal skin. In these situations, the removal of skin in a vertically downward direction ( a conventional tummy tuck) is not adequate to correct the upper abdominal skin laxity. Such patients are often very good candidates for what I refer to... more

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Michael Law, MD

Raleigh-Durham Plastic Surgeon

ASAPS ASPS

Re-Doing a MINI Tummy Tuck for Upper Tummy Bulging and Excess Skin

Regarding: "Redo Mini Tummy Tuck to Correct Upper Abdominal Area? Hi there, One week after Mini-Tummy Tuck to correct diastasis, PS removed 450 cc's and minimal skin, but I am left with the odd upper-abodminal area looking not as tight as the lower abs. The procedure was performed endoscopically with sutures all the way up the abdomen. At my fifth-day visit, the doctor's first words were "this is unacceptable"...The two options were that: 1) it was just swelling and i more

Peter A. Aldea, MD

Memphis Plastic Surgeon

ASPS

Improving Mini-Tummy Tuck Results

The upper abdominal area after a mini-tummy tuck occasionally has what looks like extra skin or fat due to incomplete redistribution of excess tissues. The belly button that is attached to the abdominal wall restricts the inferior movement of this upper abdominal skin for removal. I have found to help with skin tightening in this area your options would be: Try a variation of Vaser Liposuction called Vaser Hi Def Liposculpture that releases the skin to allow the skin... more

Daniel Shapiro, MD

Scottsdale Plastic Surgeon

ASAPS ASPS

Mini-tummy tuck (abdominoplasty) is seldom a good operation.

Most patients with mini abdominoplasties are dissatisfied because the skin above the navel is loose, there is a noticeable transition of tension centrally to laterally below the navel, and commonly they are left with dogears. I very seldom do a mini tuck because almost always a full abdominopasty is indicated. The convalescence is not that differenct and the scar is usually not much longer.

Vincent N. Zubowicz, MD

Atlanta Plastic Surgeon

ASAPS ASPS

Mini tummy tucks are not great for all body types !

This is a tough situation: a woman with minimal skin laxity and maximal myofascial laxity- the temptation is to do a 'minimally invasive' repair of the full-length abdominal wall laxity and excise a little skin. I have personally made this mistake, and regret it. The solution (at least in my hands) for these types of patients in the future is to offer a 'standard' tummy tuck with full-length plication of fascia. Since there is minimal skin laxity and patients want... more

Scott Sattler, MD

Bellevue Plastic Surgeon

ASPS

How to improve upper abdomen after mini-abdominoplasty

Since the mini only addresses skin laxity in the lower abdomen, even with endoscopic access and lipo to the upper abdomen there is the potential for residual problems. Part of the pre-op assessment is existing skin laxity and a prediction of how loose it will be after the fat removal with lipo. It is possible that your best choice might be to actually re-do it and convert to a standard abdominoplasty, but your own surgeon is in the best position to advise you on this. Sometimes a... more

Richard Baxter, MD

Seattle Plastic Surgeon

ASAPS ASPS

Results after a mini tummy tuck

Patients appreciate the significant results that can be obtained with a mini tummy tuck. During this procedure, it is possible to tighten the rectus muscles with plication, perform liposuction, and remove a limited amount of skin. However, at one week after surgery you are not seeing your final results. In our practice, we encourage our patients to wear a compression garment after their tummy tuck to help their body heal, help resolve the swelling, and provide support. After the surgery... more

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B. Pat Pazmino, MD

Miami Plastic Surgeon

ASAPS ASPS

Probably convert to a full tummy tuck

Endoscopic tummy tuck surgery never made much sense to me. A big part of the average tummy tuck patient's goal is tightening of the abdominal wall. A big part of that is skin removal. You can't remove much skin without an incision. Treating upper abdominal skin is part of the job of a full tummy tuck. I would probably have recommended one to you if I had seen you before your endoscopic adventure. Best Regards.

John P. Di Saia, MD

Orange Plastic Surgeon

Limitations of a mini-tummy tuck and correction for the upper abdomen

In my estimate, only about 10% of women who have had children are eligible for a mini-tummy tuck, and they are lucky enough to only have problems in the lower area of their abdomen. The hybrid kind of procedure you had, where the abdominal wall was plicated all the way up using an endoscopic technique, tries to be the best of both worlds, but frequently fails. If someone has any laxity in the upper abdominal wall, or upper abdominal skin, I believe they need a full tummy tuck. The... more

Douglas J. Mackenzie, MD

Santa Barbara Plastic Surgeon

ASAPS ASPS

Loose upper abdominal skin

Too many people get caught up thinking that they can get away having a mini-tummy tuck when they actually need a full tummy tuck. I think that you are the latter. It sounds like you need a full tummy tuck.

Steven Wallach, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Loose upper abdominal skin is best treated with a FULL tummy tuck

This is a somewhat confusing scenario but in general the best technique to treat loose upper abdominal skin is to perform a full tummy tuck. This eliminates loose skin above and below the umbilicus. see video

Otto Joseph Placik, MD

Chicago Plastic Surgeon

ASAPS ASPS

Mini Tummy Tuck Scar

Patients with mini tummy tucks may still have residual upper abdominal contour that will require additional correction using a more definitive abdominoplasty technique. The second procedure is less complicated because there is already some degree of lower abdominal plication. Discuss these with your plastic surgeon as it appears as though he is being thoughtful with you in terms of finding a comprehensive solution.

Raffy Karamanoukian, MD

Los Angeles Plastic Surgeon

A number of possibilities for Mini Tummy Tuck redo

Of course this is all conjecture without true facts regarding your pre-op condition, your actual surgery, and what you exactly mean be "odd" upper abdominal area. But a couple of general comments: 450cc's of fat is a relatively moderate amount of fat and if most of this was in the upper abdominal area as opposed to the lower where the mini-tuck was performed there could be epigastric induration or edema where the interstitial fluid or edema doesn't drain well against gravity and... more

Robin T.W. Yuan, MD

Beverly Hills Plastic Surgeon

ASPS

Endoscopic Tummy Tuck

It sounds like your surgeon was not pleased with the early results. I am not a fan of endoscopic tummy tucks - especially if combined with a mini-abdominoplasty. In operations where suturing and skin flap advancement are critical, the endoscopic approach, in my opinion, is not a good idea. The analogy that comes to mind is building a ship inside a bottle - I can do it, but why? I can understand trying to minimize the scar length, but at least in my hands, the difference between a mini... more

Daniel Reichner, MD

Newport Beach Plastic Surgeon

ASPS

Too soon to judge the outcome of your Tummy Tuck

It is too soon to make a judgement regarding your outcome. One possibility is that when the muscle separation was repaired that it caused the skin to bunch in the midline. Most of the time, liposuction will allow the skin to spread out and appear even after time. Continue to wear a garment and give it some time.

Michael Chiaramonte, MD

Washington DC Plastic Surgeon

ASAPS

Patience

First, you did not post photos, so no one can really give you meaningful advice about a procedure. What I can tell you is that one week after a procedure is way too early to pronounce it a success or failure. This goes for almost all operations. This is very difficult to live with when you are anxious, as everyone is. Presently you must wait and see what your results will be. In the mean time talk candidly with your PS. Ask him what is causing the deformity, is there a diagnostic test that... more