What is a reverse abdominoplasty?

'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 as a 'reverse upper' abdominoplasty.

This surgical technique involves removing excess abdominal skin vertically upwards using incisions hidden in the inframammary folds underneath 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'.

Plastic surgeons do their best to hide scars in surgery. In select patients with excess skin, fat, and tissue in their upper abdomen, the best place to hide a scar may actually be at the top of the abdomen instead of in the bikini area (as usually done in a regular tummy tuck).

An upside down tummy tuck, or a reverse abdominoplasty, will place the scar under the breasts, at the top of the abdomen, and will pull the skin of the abdomen up.

Patients who may be candidates include those who have had upper abdominal surgery and already have a scar in this position.

Could you be a candidate? The best way to find out is to be evaluated by a board certifed plastic surgeon and make sure that your surgery is personalized to fit your body and your aesthetic goals.

This is an operation to tighten the abdomen but takes the extra skin out under the breasts rather than in the bikini line area as in a traditional tummy tuck. This results in a "Golden Gate Bridge" scar across the upper abdomen and is quite unsightly. Consequently and appropriately, this operation is rarely done.

A reverse abdominoplasty is performed to treat laxity of tissues in the upper abdomen. The incisions are usually placed in the breast folds so that they are pretty well hidden. This is sometimes performed on patients that have had a previous abdominoplasty but still have upper abdominal laxity.