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Alternative To Tummy Tuck With Muscle Repair? (photo)

I'm 29 5'4 125 lbs. Have two pregnancies 16 months apart the second pregnancy was twins. I have 3 finger speration of my stomach muscles. I have no extra skin or stretch marks below my navel, I do have a little extra skin above my navel. What is the best option for me. when I pull my skin towards my chest from my navel everthing looks good. It looks better to pull up then down.what options do i have. I would like to stay away from a full tummy tuck due to the look of the navel and scar.

Doctor Answers (13)

Abdominoplasty with Umbilcial Float

+4

Tiffany,

You are an ideal candidate for an abdominoplasty with an umbilical float.  This is a fairly common tummy tuck technique that I use about 25% of the time. There is NO UMBILICAL SCAR and the length of the scar is limited, the rectus abdominis muscles are also repaired.  I can't be sure, but it appears you may also have an umbilical hernia from the photograph, a physical examination would be necessary to confirm this.  The hernia can also be repaired with this technique. Here are the highlights of an ABDOMINOPLASTY WITH AN UMBILICAL FLOAT:

  • Low, very low, position of horizontal scar
  • Limited length of horizontal scar
  • No umbilical scar
  • Umbilicus (belly button) moves about one inch down
  • Umbilical hernia repair
  • Separation of rectus muscles repaired
  • C-Section scar removed
  • Small amount of skin removed from lower abdomen
  • Fat removal from entire abdomen including hips
  • Extra skin above navel pulled tight

You have great shape now and this procedure will make you look even better, probably 6-pack abds!!!  The scar will be completely hidden in any type of clothing, bathing suit, panty, thong, etc.

Call and shop around until you find a Board Certified Plastic Surgeon in your area with experience using this technique.  Also, before you undergo this procedure I would recommend not becoming pregnant again, as this would ruin the result of the procedure.  Good luck!


Omaha Plastic Surgeon
5.0 out of 5 stars 45 reviews

Mini tummy tuck with abdomenal tightening

+3

I would recommend a mini-tummy tuck, diastasis repair throught the mini tummy tuck access with tapering lipocontouring of the abdomen and an unbilicoplasty to improve the appearance of your umbilicus.  The scar would not be much different from what you have now and it would leave you with a nice flat belly.  I would steer aweay from reberse tummy tuck as it will ruin the appearance of your breasts over time.  I hope this helps!

 

All the best,

 

Rian A. Maercks M.D.

Rian A. Maercks, MD
Miami Plastic Surgeon
5.0 out of 5 stars 31 reviews

That's a great question!

+2

There are many women like you who have muscle separation after pregnany and only a little extra skin.  Most patients I treat with this set of problems are also quite petite and a long tummy tuck scar seems too much for the issues that need to be addressed.  At most, a short scar "mini-tummy tuck" is needed.  However, I tend to favor repairing the muscle separation with the use of an endoscope (fiberoptic camera) and then repositioning the belly button which smooth out the skin above it.  Finally, if there is a little skin to remove at the lower part of the tummy, we remove it directly.  I am in your neck of the woods and would be glad to see you in consultation any time.  Good luck!!!

Daniel Sherick, MD
Ann Arbor Plastic Surgeon
5.0 out of 5 stars 3 reviews

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Choosing Between Types of Tummy Tucks

+2

Yours is a common situation in which you don't have enough of an abdominal problem (loose skin) to justify the scar from a full tummy tuck  and a partial or mini-tummy tuck would probably leave you a little wanting. (better but not perfect) In these cases, I think the patient's attitude towards the scar in the determining factor. It is a choice between which you would despise more...a long horizontal scar and a belly button scar but with the most flat and tight stomach that you can get or a small low horizontal scar and no bellybutton scar but with some residual loose skin around the bellybutton. In either case, a full muscle repair would be done.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
5.0 out of 5 stars 26 reviews

Answer to RealSelf.com question regarding abdominoplasty or not

+2

Despite the pregnancies you have maintained a reasonably good abdominal contour.  This makes the decision to proceed with an abdominoplasty more difficult.  As you are aware, an abdominoplasty will remove excess skin/fat and also tighten your abdominal muscles.  The muscle separation that you mention will not improve without surgery.  Your options, in my opinion, are as follows:

1. Do nothing and be thankful that you have maintained a fairly well-shaped abdomen.  If the C-section scar bothers you a revision could be completed.

2. Do a "mini-tummy tuck" with the primary goal being to tighten the diastasis.  The rectus muscles can be plicated/tightened all the way up to the xiphoid (sternum) through a small incision, although endoscopic assistance is sometimes required.  This approach would only remove a small amount of skin and should not be expected to significantly improve the skin laxity.  This approach is used primarily to address the "pouch" or looseness in the abdomen from the diastasis.  Lowering or "floating" of the umbilicus is not something that I would recommend.

3. Do a full tummy tuck.  This would address the loose skin and the loose muscles.  It does, however, leave scars around the umbilicus and in the lower abdomen.  Only you can decide if this is a reasonable trade-off.

Good luck.  Be sure that you wait a minimum of 6 months after your last pregnancy before making any decisions and undergoing surgery.

Eric T. Emerson, MD, FACS
Charlotte Plastic Surgeon
4.5 out of 5 stars 14 reviews

Best tummy tuck for me

+2

I would probably recommend a modified abdominoplasty with a short scar above the pubic hair region and a small skin resection just to clean up above the c section scar and then do a muscle repair thru that limited scar.

Rick Rosen, MD
Norwalk Plastic Surgeon
5.0 out of 5 stars 8 reviews

Options for better looking abdomen

+2

Hello,

Your options for a better looking abdomen depend largely on your desires and goals.  These options include:

1) Liposuction plus mini tummy tuck

2) Mini tummy tuck plus endoscopic muscle tightening

3) Mini tummy tuck plus reverse tummy tuck

4) Full tummy tuck

I suspect many patients including yourself might prefer just a small mini tummy tuck and liposuction.  Doing so would not improve the appearence of your belly button and would not address the abdominal muscle.  The second option would be a small mini tummy tuck with endoscopic muscle plication.  This would also improve the abdominal muscle issue but would still leave the belly button without rejuvenation.  The third option would be mini tummy tuck plus reverse abdominoplasty.  This would correct all of the issues but requires a plastic surgeon that is experienced in doing the reverse tummy tuck.  Finally, the last option is a full tummy tuck.  Since you do not have a lot of excess skin you would likely end up having the location of your current belly button close as a small vertical incision in the midline somewhere between the new belly button location and the horizontal incision at the bottom.

All the best,

Dr Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 81 reviews

Tummy Tuck - Alternative To Tummy Tuck With Muscle Repair? (photo)

+1

I think you have a few choices - even though none of them may be perfect.

First, you could consider a lipo of your abdomen and a modified or mini-tummy tuck, in which the skin of your lower abdomen is tightened (ie, only below the belly button) and the skin is flattened all over (from the lipo).  You may have a little more dimpling of your skin and you can't really get a good muscle repair but you'll have a significant improvement over what you have, even if you have a longer horizontal scar across your lower abdomen, with much less morbidity (ie, potential for problems) than a full TT.
 

The second choice, though, is a full TT.  You'll have the longer scar low down and a scar around your belly button.  And, if you don't have enough skin above the BB to stretch down to your lower scar (which you may not) then you'd have to have an additional vertical component added to the horizontal scar.  The benefit is that your upper abd can be tightened with a MR.  The downsides are that it is a more involved procedure, you may need that vertical limb and, after all that, you may still not wind up with a perfectly flat abdomen, since there is a limit to how tight the sutures can make the abdomen.  Some of your appearance is, therefore, due to abdominal wall attenuation (stretching out) rather than exclusively a diastasis (I'm assuming you don't have a hernia).

Putting all of this together, I would probably recommend a lipo of the abdomen (and perhaps hips while you're at it) along with a modified or mini TT, and just go with the benefit you get from that since it's a significantly less involved procedure than a full TT in your case.

I hope that this helps, and good luck,

Dr. E

Alan M. Engler, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 146 reviews

Abdominoplasty scar

+1

first you look great. There are a couple of issues. If the rectus muscle is plicated ( tightened) you will have more loose skin. Pulling up the skin is not an option. You have a csection scar so the options would be

1) do nothing

2) mini abdominoplasty which as the name implies has a mini scar but minimal skin excision

3) full abdominoplasty

Jay M. Pensler, MD
Chicago Plastic Surgeon
4.5 out of 5 stars 9 reviews

Alternative To Tummy Tuck With Muscle Repair? (photo)

+1

Thanks for the posted photos. My recommendations based only on photos and your posted information is a short scar full tummy tuck with aggressive recti plication. Best to see a few boarded PSs in your area to discuss in detail. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 61 reviews

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.