I asked how a doctor decides what kind of tummy tuck a patient needs, I got great responses but now I am left wondering about the scars, and what a modified tummy tuck is? I have flat abs but post kids I have stretch marks and loose skin, would doing laser pre op be better? and will the scar be low enough to wear a low bikini? I have attached pics, I'm planning on having surgery end year early 2012, When I had my breast augmentation I also had many questions and went to many consults. thank you.
Tummy Tuck, Mini, Modified? What's the Difference and How Different Are the Scars?
Doctor Answers (6)
What should I have done for my Stretch Marks?
Unfortunately, your problem is one that is the most difficult for us as surgeons to treat well. Stretch marks do not respond well to any current treatment available and you do not have enough excess skin to be a candidate for skin removal with surgery.
My advice to you may be difficult to hear....Don't Do Anything! You have a beautiful shape and tight abdomen, and a figure that most of my patients would love to have. So please don't make any unnecessary scars on your body by having surgery. Wait a few years and who knows what type of laser, ultrasound, or heat based non-surgical treatment for stretch marks we will have by then. Good luck, Erez Sternberg, MD (Jacksonville, FL)
Mini or full tummy tuck?
Thank you for the question and pictures.
Direct examination be necessary to give you good advice. However, based on your pictures I am doubtful that a tummy tuck would be indicated in your case.
Generally speaking, the mini tummy talk is an operation that produces very limited results and is very rarely indicated. It involves a shorter incision but does not address the majority of the abdominal wall issues present for most patients who present consultation. For example, the area of skin excised is quite small. The abdominal wall musculature is addressed below the umbilicus leaving the upper number wall potentially lax. The appearance of the umbilicus is not necessarily addressed sufficiently.
For most patients who have had pregnancies and/or weight loss a full abdominoplasty is necessary to achieve the desired results. Of course, there are downsides (including a longer scar and probably a longer recovery time) but for most patients the benefits outweigh the downsides. It is not unusual to see patients who've had mini tummy tuck surgery present for revisionary surgery. It is important for patients seeking abdominal contouring surgery to work with a well experienced board-certified plastic surgeon to obtain advice (based on good ethics and judgment) to improve their chances of a successful outcome and minimize the need for further surgery.
I hope this helps.
Tummy tuck, which kind, mini, full, modified
Only an in-person consultation could correctly answer your question, because it is impossible to know if your skin is really loose enough to do a tummy tuck procedure that will eliminate the stretch marks that you hate.
Alternatives: Palomar Lux 1540 erbium laser is FDA-approved for the treatment of stretch marks. 4-6 treatments help to blend them in. You can't get rid of them in the sense of erasing them, but the majority of patients think the treatment does some real good in terms of improved appearance and livability of the stretch mark appearance..
Now, re tummy tuck. If you can pinch up 8-10 cm of skin between your fingers above the belly button between the sternum and the belly button, you can probably do a full tummy tuck, getting rid of all the skin below the belly button. That is what a tummy tuck really does well. If you do have sufficient laxity, then a high-lateral tension technique tummy tuck, will allow the scar to be placed in the bikini line.
Actually any full tummy tuck, with dissection up to the point where the ribs meet in the midline, the xiphoid process of the sternum, should end up with the scar in the bikini line. It's just that if there is not quite enough laxity, then the hole where the belly button was will not come down far enough to be removed with the skin. It would be too tight, and so the hole has to sewn up as a small vertical, but visible, incision.
Mini tucks don't do the job. You end up with the belly button pulled down, the distance from pubic area to belly button shortened, too much tension on the scar which can make it ride up above the bikini or underwear line, all of which are cosmetically unacceptable.
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Tummy tuck types and scars
I agree that you have great shape to your post pregancy abdomen. You should be proud of the shape you are in.
You do have a moderte amounnt of stretch marks, they do extend above your belly button. It is difficult to tell from your photos how much extra skin you have, but I would estimate that you do not have a lot.
A tummy tuck can get rid of many of your stretch marks, but will not get rid of all of them. Any variation of tummy tuck does require a transverse incision at the lower portion of your abdomen. Full tummy tucks have an incision around the belly button as well. A mini tummy tuck does not have the incision around the belly button, but has much more limited ability to remove excess skin and stretch marks.
Form your pictures, it is clear that you like to wear narrow bikinis. I would be very worried that you would be unhappy with the final scars from the tummy tuck. The transverse incision may show above or below the bikinis you are wearing. A shorter incision may not show, but will not remove as much skin or stretch marks.
In short, I would not recommend a tummy tuck to you. Your abdomen looks great. I think the incision you get would outweigh the benefits in your case.
It may be that on physical examination, in person, I would change my position, but from your pictures, I do not see the benefit.
Tummy tuck options
From the pictures you posted it looks like your body recovered very well post-pregnancy. The only issue you seem to have is stretch marks and perhaps a small amount of skin laxity low on your abdomen. With regard to stretch marks, I'm afraid there are no good solutions. The only permanent solution is to surgically excise stretch marks along with excess skin. Your stretch marks are too high on your abdomen for this. Lasers, creams, ultrasound, etc have provlem all futile modalities with regard to the treatment of stretch marks. The small amount of skin laxity you have may be able to be excised with a low scar (just above the pubis) and without transpotiion of the umbilicus. This is the so-called mini tummy tuck. In your case, I think it's safe to say mini mini tummy tuck, if you're even a candidate for this. A laser treatment for skin tightening purposes may also be an option. Only a physical exam can determine the appropriate treatment, however. I suggest you find a board-certified plastic surgeon who performs body contouring procedures in order to get a more detailed opinion. Good luck!