A mini tummy tuck and umbilicoplasty or a full tummy tuck for a petite mum? (photos)
Doctor Answers 11
Tummy tuck, umbilicoplasty, mini tt?
Thanks for posting your question. There's a lot of information in responding to you, as your situation demonstrates the nuances and variations in technique required in tummy tuck or abdominoplasty in order to provide you, as an individual, the best outcome possible.
What is the best outcome you can have? Simply: the smoothest abdominal wall skin, a natural looking umbilicus that allows bikini wear, and a low incision covered by underwear or swimwear which allows wearing of normal two piece gym or swim wear.
So let's break it down:
Firstly, anybody with any skin laxity at all above the umbilicus is not a candidate for a mini tt. Actually, very few people look good after a mini tt, it's only a very select group that do - those with perfect skin above the umbilicus, and with their laxity very low. The umbilicus must look good before surgery. These people exist, but they are rare. You are not a mini tt candidate as there is 360degree laxity around your umbilicus.
Second, umbilicoplasty is an operation which only works when you hardly need one. If there is significant laxity around the umbilicus, then if used, it looks odd and unnatural. You're not an umbilicoplasty candidate. Don't consider it, is my advice.
You are therefore a full abdominoplasty candidate, even though it looks like overkill for your very flat and slim physique. The challenge is getting a great outcome.
I'd like to see a picture of you at full term of pregnancy. This is really to understand the stretched distance between your rib cage and the umbilicus. If your pregnancy fullness was low, and the skin above the umbilicus not very stretched, then the skin at the level of the umbilicus will not be able to be moved down much.
I am quite sure there will not be enough skin laxity to get you to a full tt and low incision, so here is what my plan would be:
1. Full abdominoplasty via a very low incision.
2. Raise the abdominal wall flap centrally only, all the way to the rib cage. Make a small incision around the umbilicus, so leaving quite a small hole in the abdominal wall.
3. Score the Scarpa's fascia transversely at 1cm intervals between the umbilicus and the rib cage, giving maximum vertical extensibility and downward movement of the abdominal wall flap. I do this routinely in most cases, and it tensions the upper flap much better than not doing it. Then serially fix the upper flap to the abdominal wall. This maximises movement while reducing tension on the lower flap.
4. Measure how much skin I can excise from the lower abdomen - and excise it. We will not be getting the old umbilicus circular incision right to the level of the low transverse incision on the day, so we must accept that (or we will need to make a much too high transverse scar)
5. Create a new, small hole in the fixed abdominal flap and bring the umbilicus through it. Sew it into position. Keep it small. It can be made bigger later, but if too big initially it cannot be made smaller.
6. Close the existing umbilical hole transversely (it having been moved down).
This approach will meet all your goals except one. It will provide an optimal skin tension and appearance result. It will result in a natural looking umbilicus. It will leave you with a very low, easily hidden transverse scar.
What it will also leave you with is a not nice, but small, lower transverse scar between the new umbilicus and the low transverse scar, which is the closure of the circular umbilical incision which has now been moved down as far as I can get it. On the day, I just close it and don't try and make it nice. I just want to keep it small.
Then, you heal up, and around 6 months later, one of two completion strategies will be utilised at a small second procedure, usually done in the office under local anaesthesia only (although sometimes in the OR).
The skin will have loosened to an extent by then. So I can either remove the now looser skin between the umbilical scar and the low scar, and move the flap down to a full low position and excise the umbilical scar, therefore completing the procedure. Or, if the umbilical scar remains too high to get it out, either just revise it to a neat short transverse scar which is not disfiguring and which allows wearing two piece gear, even though it's visible, or undertake a process called serial excision, based on the principle that skin will stretch if under progressive tension, and which means every few months moving that umbilical scar down as far as skin tension will allow till its possible for it to be removed.
All these techniques are frequently used by me in abdominoplasty work. The goal is a pleasing abdominal wall appearance, a natural umbilicus, and a low transverse incision hidden by normal underwear, swim gear or gym gear. How we get there varies according the anatomy each patient presents to me with. Sometimes its easy, sometimes it's trickier. But it's all possible.
Hope this is helpful, and all the very best.
TT or umbilicoplasty?
Far more important than deciding if TT or umbilicoplasty is for you is the skill and experience of your plastic surgeon. Choose your surgeon rather than the technique and let him explain why one technique may be better than another and if you need a tummy tuck. Many board certified plastic surgeons provide a free first time consult and you should take advantage of that! See the below link on some suggestions on finding the most qualified Plastic Surgeon for you!
Petite mommy makeover
I think you'd be best suited with a mini tummy tuck and liposuction, just to tighten the skin a little bit, but not distorting the umbilicus. I too would worry that your scar would be too high if you tried to do a full. A lot of PSs don't have a lot of experience with mini's, so you may get a variety of answers, but it's just my opinion. You don't have enough skin or laxity to pull all the way down, so a mini is ideal. The umbo can be floated to help aid with your rectus plication, and possibly moved down a cm or so. This would help with the appearance of your belly button possibly, although if it doesn't that could be fixed as a second procedure in the office.
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Full Tummy Tuck or Mini Tummy Tuck
From the appearance of your abdomen in your photos, a full tummy tuck looks like it will give a better result than a mini tummy tuck. Of course, a better assessment can only be made inperson. The recovery may be a bit more intense, and yes, it's a longer scar, but a full tummy tuck treats the loose skin not only below your belly button but also above the belly button. Depending on exactly how much skin laxity you have, it may not be possible to remove the entire scar from the incision around your belly button. It is far better to have a low scar with a small vertical scar at midline from the belly button than a high scar without the small vertical scar. The small vertical scar tends to heal quite nicely and is barely noticeable, but a long scar high across your abdomen is highly noticeable. It is also very difficult to have a too-high scar revised. A tummy tuck scar that is too high limits the cut of the bikini or underwear you can wear (unless you don't care about hiding your scar). You only have one body. Get it done right the first time! Find a plastic surgeon who understands the importance of having a very low scar for those occasions where you want to wear a low-cut bikini, underwear, or jeans/pants/shorts. Even if you never end up wearing those types of clothing, at least you always have the option. As a female plastic surgeon, though I have not had a tummy tuck, I fully understand this concept. Believe it or not, some surgeons just don't get this concept! Best of luck with your tummy tuck transformation!
Thank you for your question and the photos. I would recommend you a full Tummy Tuck because it would give you better results. The scar line is a bit longer but it can be placed low so that it will not be visible. Best of luck
I know it's a big scar, but you'd do best with a full tummy tuck
The real issue is the extra skin in your upper abdomen and your belly button. A full tummy tuck will pull out as much skin as possible and put your belly button in better skin with no stretch marks. The main horizontal scar should be very low, but you may have a small vertical scar if your surgeon is unable to remove all of the skin from your pubic hair to above the belly button. Sadly, you will still have some stretch marks. You should do great though and will be rocking a bikini again in no time! Good luck!
Type of procedure
After looking at your pictures you appear to be someone with good muscle tone and therefore do not need muscle tightening. An excellent procedure for you would be a skin only full abdominoplasty with an umbilical trans position therefore obviating the need for an umbilicoplasty. The scar cab kept in the bikini line.
A mini tummy tuck and umbilicoplasty or a full tummy tuck for a petite mum?
If you have the mini abdominoplasty with umbilicoplasty, you will not see significant improvement in any upper abdominal laxity, but you will certainly look smoother and tighter in the lower abdomen. A full abdominoplasty will address the upper abdomen and the belly button. However, you may be left with a small vertical incision low on the abdomen resulting from the original umbilical incision. It fades over time and would not prevent you from wearing a bikini. Good luck!
Mini or full tummy tuck?
Hello and thank you for your question. Mini tummy tuck will give you a mini result leaving loose skin above your belly button even with an umbilicoplasty. A full tummy tuck will give you an excellent result with only one compromise. Because you have a high riding belly button (more attractive ) with only moderately loose skin above you will need a short vertical scar of about 3cm just above your LOW horizontal incision.
This is not an absolute but most likely. It will allow you to wear a bikini.
Peter Fisher M.D
Hi. From your photos it looks like you could be a candidate for either. They are similar except the mini has a shorter scar and no scar around the umbilicus. It has a better scar but doesn't remove as much skin so there may still be some laxity. You need to be examined to determine how muchskin laxity you have.
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.