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Full or Reverse Tummy Tuck for Upper Abdomen Laxity?

I had a mini Tummy Tuck 2 years ago, and now I'm unhappy with my upper abdomen area (above the belly button). I want a more smoother, tighter look. To correct this, my surgeon has recommended a reverse Tummy Tuck. I'm scared to death of how the scar is going to look since my breasts are set far apart (I had breast implants in 2000 as well). That's my main concern.

He also said he would recut from my mini Tummy Tuck and perform a full Tummy Tuck, but the results wouldn't be as accomplished this way as it would be from a reverse tuck. I'm really torn here and need some advice. I fully trust my surgeon, I'm just wanting to make sure that I make the right choice in which direction to pull my skin. I'm leaning towards the recut.

Doctor Answers (10)

Explanation of Reverse Upper Abdominoplasty

+2
A reverse Upper Tummy Tuck involves removing excess abdominal skin vertically upwards using incisions hidden in the inframammary folds underneath the breasts.  THERE IS NO INCISION MADE BETWEEN THE BREASTS. In general, this operation is best reserved for patients with fairly full or at least slightly droopy breasts, which serve to nicely conceal the inframammary folds. An important part of this procedure is the placement of permanent lifting sutures that elevate the lower skin edge, following removal of excess skin, to the upper skin edge in the inframammary fold. These permanent sutures ensure that the resulting surgical scar remains hidden within the inframammary fold.
A great advantage of this procedure is that the patient's original belly button is preserved, and thus there are absolutely no surgical scars that are visible when wearing a two-piece swimsuit or typical underwear (bra and panties). Additionally, because this procedure generally requires less skin undermining and thus less interruption of the normal blood supply of abdominal skin, more thorough liposuction of the waist and back can be performed at the same time.
Many patients having this surgery, therefore, undergo a reverse upper abdominoplasty combined with a lower 'mini' abdominoplasty, tightening of the entire length of the rectus abdominis muscles, and liposuction of the circumferential trunk - and keep the belly button with which they were born. I usually refer to this operation as 'reverse upper / modified lower abdominoplasty'.
A reverse upper abdominoplasty can be a good option for some patients. be sure to view many before and after photos and look at incision sites and scars which are camoflaged under the breasts and not across the chest between the breasts.


Raleigh-Durham Plastic Surgeon
4.5 out of 5 stars 42 reviews

Standard tummy tuck would work best in this situation

+2

Tummy tucks are a very popular and effective way to contour the abdomen. Like no two patients are the same, in our practice note to tummy tucks are equal. We spent a great deal of time evaluating the patient before the surgery to assess their physical condition and to understand their aesthetic goals. We then create a surgical plan that will help meet these goals. It is possible in your case to perform any revision to me to to correct the laxity in the upper abdomen. I would not consider a reverse tummy tuck for this area as it would add unnecessary scar onto your abdomen and could impair the blood supply to your abdominal skin.

To learn more about tummy tucks, see photos, and help you decide which one is best for you, please visit us at the link below:

Pat Pazmino, MD
Miami Plastic Surgeon
4.5 out of 5 stars 69 reviews

Traditional Tummy Tuck vs. Inverse Abdominoplasty

+2

Upper abdominal laxity can usually be successfully improved even with a "full' tummy tuck (abdominoplasty), but in some severe cases (usually after massive weight loss) a reverse tummy tuck may be suggested by the surgeon. However, it is very important to note that the scars from a reverse tummy tuck might not be advantageous, (they will run straight across the inframammary fold), and so I personally am very hesitant to suggest this procedure.

Manish Raj Gupta, MD
Toledo Plastic Surgeon
5.0 out of 5 stars 7 reviews

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I'm not a big fan of the reverse tummy tuck

+2

If you want the home run result, I think you will get it with liposuction or VASER of your whole torso, and convert to a full tummy tuck. Your torso seems the area where you carry your extra weight, so really thinning this area out will have a big effect on your overall look, including the sides and love handles. As for reverse tummy tuck, I find the scar is rarely acceptable and since gravity is always pulling downwards, the result is always half of what you want it to be. Pulling upward on your abdomen with your hands looks fabulous and like it would work great, but in real life it just isn't as powerful.

Lisa B. Cassileth, MD
Beverly Hills Plastic Surgeon
4.5 out of 5 stars 9 reviews

Reverse Tummy Tuck not advisable for your case

+2

Scrappy,

I would strongly advise against the reverse tummy tuck in your case. You're absolutely right about the scar in the middle - it is very obvious - connecting both breasts. Don't add an extra, visible and long scar if you don't have to.

I think you are a good candidate for a full tummy tuck. I would excise the mini-tummy tuck scar, lower the scar to the pubic hair line and recruit all that extra skin down again. You would need to have your umbilicus (belly button) pulled through a new opening in the upper skin, but this scar heals well and usually looks great.

Daniel Reichner, MD
Newport Beach Plastic Surgeon
4.5 out of 5 stars 9 reviews

Caution:Full Tummy Tuck after Mini could be a problem.

+1

If you had a mini tummy tuck usually the belly button base is cut and this takes away the blood supply form below.  When a full tummy tuck is done the belly button is cut all the way around form the skin and surrounding tissue.  The belly button could easily die.  This is the issue in your case.  The surgeon who you like very much can look at the op note and answer this question.  I have never like the reverse tummy tuck results and scar.  Your upper abdomen does not warrant that procedure.

Miguel Delgado, Jr., MD
San Francisco Plastic Surgeon
4.5 out of 5 stars 35 reviews

Reverse or Full tummy tuck after Mini Tummy Tuck

+1

In my opinion, given the limited information here in your photograph. I believe you would get an improvement with a full tummy tuck. You still may have some residual laxity in the upper most abdomen but I believe that is preferable to the results or risks of a reverse abdominoplasty.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 48 reviews

Full tummy tuck may be better choice

+1

Get a full tummy tuck and avoid the reverse. The full tummy tuck will tighten the muscles and pull down the loose extra skin. I think this is better than the reverse.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

Reverse Tummy Tuck can correct your upper tummy fullness

+1

Scrappy,

An upper tummy tuck or reverse tummy tuck through incisions placed beneath your breasts is the best solution for excess skin of the upper abdomen following a mini lower tummy tuck. The results can be excellent as long as you are healthy with good blood supply. I would not use this approach if you are a smoker, have vasculitis, or poor circulation.

Another option is laser liposuction. I have had good results with fat removal and skin tightening using SlimLipo laser liposuction.

See before and after pictures of SlimLipo of upper abdominal laxity and mini tummy tuck of lower abdomen.

Brooke R. Seckel, MD, FACS
Boston Plastic Surgeon
5.0 out of 5 stars 37 reviews

Reverse abdominoplasty may be logical but imperfect

+1

It appears that you do not have significant upper abdominal laxity or redundant rolls, only relative laxity. If your laxity is due to pregancy, then it is logical that there has been some stretching out of the upper abdomen and if you pulling the upper abdominal tissue upwards it should give your abdomen a flatter and more natural look. The reverse abdominoplasty must be weighed against the fact that in order to accomplish this adequately, the incision must often cross the midline from breast to breast. Some of this can be obviated in certain circumstances by liposuctioning the resulting bulge, however the most logical anatomical design is for the incision to go from inframammary fold to inframammary fold. For this reason, it is usually chosen only for those with significant upper abdominal redundancy.

Your mini-abdominoplasty did not do anything to the upper abdomen by design. Your scar is relatively high which helps the possible tightening of your upper abdomen (i.e. the higher the scar, the more you can dissect and effect the upper abdomen safely). I would suspect that the best approach would be to proceed with a full abdominoplasty (even though it is a less anatomically logical procedure, it does work) at the price of a slightly longer scar and a scar around the belly-button. If you still have residual laxity of the upper abdomen that is displeasing to you, you will have been satisfied that you did all you can from the traditional approach and the reverse abdominoplasty will be less demanding.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 8 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.