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T-incision Tummy Tuck?

I'm 58, and according to the surgeon, in good shape with an hour glass figure. My plastic surgeon says I need a T-incision Tummy Tuck to address excess fat above the belly button, but I can't find where anyone else has had it done that way. Do I really need this? I'm not sure why a T-incision below the belly button would be helpful in removing fat above it.

Asked 39 months ago by River in Ontario, Canada

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incision technique

Many options now in tummy tucks

A few years ago, the only common options for patients were a mini tuck or a full tummy tuck. Now, there are options for almost every anatomy and every problem. The "T" tummy tuck is a lesser tummy tuck than a full tummy tuck, and is usually used for patients who want to have a low incision but don't have enough excess skin and fat to do a full tummy tuck without having a high incision. The "T" represents where the old belly button hole was. Sometimes it comes down to... more

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Brent Moelleken, MD

Beverly Hills Plastic Surgeon

ASAPS ASPS

Many options in abdominoplasty: Fleur de lis or Inverted T

As you can see from the detailed responses left by my qualified colleages, there are many options for abodminoplasty. Fleur de lis (or French Lily) or Inverted T is called that because of its appearance. Please understand that what is above your belly button now will not necessarily be thiere after a tummy tuck. In a traditional tummy tuck this area is often transposed down to the level of the pubis. However, I am sure your surgeon chose this approach for a good reason and you may want to... more

Otto Joseph Placik, MD

Chicago Plastic Surgeon

ASAPS ASPS

There are two situations in which a T is needed

If a patient already has a vertical scar on the abdomen, it might as well be used to get more skin off in a tummy tuck along with the horizontal scar in the lower abdomen. This is often the case after "open" gastric bypass surgeries followed by massive weight loss. There are also some rare patients who have a long narrow torso where much more skin wants to come off side to side with a vertical scar than up and down with a horizontal scar. If they don't already have a vertical scar, I... more

Richard P. Rand, MD, FACS

Seattle Plastic Surgeon

ASAPS ASPS

T pattern Abdominoplasty: Massive Weight Loss and Choosing a Tummy Tuck Procedure. Fleur de Lis

Massive weight loss patients have excessive skin after they reach their weight plateau. In some patients, a typical lower incision abdominoplasty would not tighten the waistline so an alternative procedure can be performed in experienced hands. The surgery is named after the French Fleur de Lis, or triflower. This entails a vertical incision and a horizontal incision in order to tighten the waistline and reduce the abdominal bulge. This can also be performed selectively in patients... more

Raffy Karamanoukian, MD

Los Angeles Plastic Surgeon

T-Incision or Anchor Pattern Tummy Tuck

T-Incision or Anchor Pagtter Tummy Tucks A few patients have severe post-pregnancy skin and soft tissue excess that cannot be adequately corrected by means of a horizontal, suprapubic incision alone. In select patients, a vertical midline incision can be added to allow removal of skin excess in a horizontal as well as vertical direction. A great advantage of adding this incision is the ability to draw the waist inward as the tummy tuck is closed. This procedure is sometimes referred to... more

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Michael Law, MD

Raleigh-Durham Plastic Surgeon

ASAPS ASPS

A 'T' incision can be used in multiple instances...

A 'T' incision may be used in several instances. One is in the massive weight loss patient in which there is too much skin laxity in both the vertical and horizontal dimensions. Another instance where a 'T' incision may be indicated is in the thin patient with some skin excess (too much for a mini-abdominoplasty). The reason to add this additional 'T' closure of vertical closure in the midline is to close the original belly button skin opening that has now been pulled down lower.... more

Sanjay Grover MD

Orange County Plastic Surgeon

ASAPS ASPS

A T incision may be used if there is a lot of laxity requiring excision in two dimensions.

A T - incision may be used when there is a lot of laxity such as in patients who have lost extreme amounts of weight ( generally over 100 lbs) to remove skin both in the vertical and the horizontal direction. In these cases the horizontal incision goes from hip bone to hip bone along the lower abdomen and the vertical insion goes from the pubic area up to the breast bone. A small T incision can also be used when there is very little laxity in the abdominal skin. In these cases there... more

Susan E. Downey, MD

Los Angeles Plastic Surgeon

ASAPS ASPS

T-Incision may describe someone on the verge

In my practice, I will evaluate the excess skin both above and below the belly button to decide what is the most appropriate treatment. When there is excess skin below the belly button, but not above it, I will suggest a mini-tummy tuck. When there is a large amount of skin above and below the belly button I will suggest a full tummy tuck. When there is a large amount of skin below the belly button and moderate amount of excess skin above the belly button, I may not be able to pull the skin... more

Robert M. Freund, MD

New York Plastic Surgeon

ASPS

"T” incision is not for everyone, see a qualified plastic surgeon

I agree with the majority of comments posted regarding a “T” incision tummy tuck. Obviously, as plastic surgeons, we seek the simplest and safest procedure that will yield the best cosmetic outcome. The best scar is no scar at all! Thus, to place an incision resulting in a scar that is “T” shaped, there must be defined benefits to justify its use. The use of a “T” incision is for the surgical excision of skin and fat in both the vertical and horizontal... more

Stephen A. Goldstein, MD

Denver Plastic Surgeon

ASAPS ASPS

T incision sometimes a good option

The T incision helps when you have a tremendous amount of excess skin that cannot be addressed by the standard incisions of a tummy tuck. It's difficult to know if you need it without looking at you, but you should know that it is done and surgeons can achieve excellent results with this technique.

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Shahram Salemy, MD

Seattle Plastic Surgeon

ASPS

Inverted T usually only for large amount of skin excess

The inverted Tor an even more extensive option called the Fleur De Lis abdominoplasty are great operations for patients who have alot of excess skin. This is rare in most people, but is seen usually in patients after massive weight loss (~100lbs). Making the vertical incision helps to control the tension on the skin and remove excess skin in a horizontal as well as vertical direction. The vertical incision is not usually needed to remove fat. That can be done through liposuction combined... more

Edward S. Lee, MD

Englewood Plastic Surgeon

Inverted T scar only appropriate if you have a huge amount of excess skin

I have actually published about the inverted T tummy tuck (Plastic and Reconstructive Surgery Journal, volume 121, page 686, February, 2008). It is a very good operation for people who have lost more than 100 pounds (gastric banding or gastric bypass patients) and who therefore have a massive amount of hanging excess skin that has to be cut out. But it leaves long and possibly prominent scars. This does not sound at all appropriate for you, the way that you describe your body. At most, it... more

George J. Beraka, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Need careful analysis

Plastic surgery is simply applied anatomy, so you need to carefully analyze your anatomical problem. Fat alone is usually not an indication for the T-incision pattern abdominoplasty. The vertical limb of the T is required as a seam to reduce the horizontal excess of skin. If you truly have excess ffat above the abdomen, you might consider a two-stage procedure with liposuction to reduce the fat, then assess the skin laxity to see if you need horizontal skin excision as would occur with... more

Robin T.W. Yuan, MD

Beverly Hills Plastic Surgeon

ASPS

Detail regarding abdominoplasty skin patterns

River - Forgive the poor drawings below - but hopefully this will give you some insight. Typically "inverted T" pattern incisions for abdominoplasty are used to address excess skin above the umbilicus. And in my practice the skin excess usually has to be fairly dramatic (typical of massive weight loss patients who have successfully undergone gastric bypass surgery). The ability to remove excess skin above the umbilicus comes at a cost of additional scar as well increasing the... more

Steven H. Williams, MD

San Francisco Plastic Surgeon

ASPS

It is very rare to require a "T" incision.

My suggestion would be to get another opinion. It is very rare to require a "T" incision for abdominoplasty. Without pictures or examining you, it is hard to give more input for your particular case. However, unless you have an overabundance of skin and you are demanding the surgeon minimize the horizontal portion of the incision, you really should not need a "T." David Shafer, MD

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David Shafer, MD

New York Plastic Surgeon

ASPS

"T"-incision Tummy tuck

A tummy tuck (TT) or abdominoplasty is an operation that address the skin, fat and muscle of the abdomen. More recently it also includes the hips and into the back. Each TT procedure is customized to the individual including the incision choice and subsequently the scar. The "T" incision describes a scar that has 2 components, a low horizontal incision and a vertical incision in the mid line that extends below the belly button. It is commonly utilized when... more

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David Finkle, MD

Omaha Plastic Surgeon

ASPS

T incision Tummy Tucks are useful for significant skin laxity

The T incision is sometimes necessary to address significant horizontal laxity that some patients present with. Without a photo, its impossible to comment on your anatomy. However, if your surgeon feels that this extensive procedure is important for an optimal outcome, he probably knows what he's talking about.

Scott Sattler, MD

Bellevue Plastic Surgeon

ASPS

T- incision tummy tuck

There are 2 different types of an inverted "T" incision. It is important to know the difference: A Fleur de Lis incision Small inverted "T" from the old belly button site A large inverted "T" incisions is also known as a Fleur de Lis tummy tuck. This pattern of skin excision is used most commonly when a patient has an excessive amount of skin in the horizontal as well as the vertical aspects of the abdomen (such as a massive weight... more

David Bogue, MD

Boca Raton Plastic Surgeon

Extended abdominoplasty only occasionally indicated.

An extended abdominoplasty that combines a vertical with a horizontal incision is primarily for patients with massive excess of skin with poor tone. There are usually massive weight loss patients. For almost all other patients, excellent results can be obtained through a horizontal incision across the lower abdomen.

Vincent N. Zubowicz, MD

Atlanta Plastic Surgeon

ASAPS ASPS

Different Tummy Tuck incisions

Tummy tucks are extremely popular and effective way to reach contour the abdomen and torso. In our practice no two tummy tucks are the same. We customize each tummy tuck for that specific patient. Our first priority is to create a beautiful and curvy shape. Our second priority is to use the smallest and least noticeable scars possible. In our practice, the patients that received a T. incision, are the patients who already have a midline scar from a previous surgery. If you do not have a... more

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B. Pat Pazmino, MD

Miami Plastic Surgeon

ASAPS ASPS

T-incision or Fleur de Lis Tummy Tuck

The Fleur de Lis (French for Lilly Flower, the symbol of the French monarchy from its earliest days) is a fanciful way to describe a inverted T scar patterned abdominoplasty. By removing skin and fat both inferiorly and centrally, this operation can better contour the trunk in cases of extreme skin laxity without necessarily having to do a lower body lift and liposuction. However - the cost is not minimal. You are left with a scar BOTH from hip to hip but also with another from where the... more

Peter A. Aldea, MD

Memphis Plastic Surgeon

ASPS

Fleur-de-lis tummy tuck

The Fleur-de-lis tummy tuck is a well know operation, but it has limited indications. Most patients will get an excellent result with one of the "standard" horizontal scar abdominoplasty, and they will not have a visible scar across their abdomen. Because the ribcage margin is an inverted V, the area above the belly button will have more laxity than the skin below the belly button, but the amount of laxity is generally acceptable. In my mind, it is only reasonable to... more

Michael A. Bogdan, MD

Dallas Plastic Surgeon

ASAPS ASPS

More common with massive weight loss patients

I usually reserve a "T" type closure when I treat patients with massive weight loss. They often have laxity that is both in the vertical and horizontal component,

Steven Wallach, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Be careful.

Hello, While an "inverted T" closure can increase tightening and make it easy on your surgeon technically in some cases, it also increases the risk for skin necrosis (poor healing.) Get a few opinions before you have your surgery this way. Best Regards, John Di Saia MD