Early Tummy Tuck/loose skin research - can skin be lifted close to under the breasts? (Photos)

Thank you for your question. The best approach depends on where the looseness is. If laxity is mostly below the belly button, a mini abdominoplasty can remove excess lower skin and maintain a natural, not overly tight, result. If laxity extends above and below the umbilicus, a full abdominoplasty (skin-only) with conservative redraping is more predictable, and your horizontal scar near the umbilicus can often be released or incorporated to improve contour. “Lifting skin close to under the breasts” is a reverse abdominoplasty via inframammary fold incisions—useful when upper abdominal laxity predominates or when combined with breast surgery—but it won’t address lower excess and replaces a bra-line scar with a lower one. Tell your surgeon you want a natural, not overly flat abdomen so they avoid over-tensioning, and plan with progressive-tension sutures to reduce rippling or seroma. You must have an in-person exam with a board-certified surgeon to determine where the laxity truly is, evaluate the effect of the periumbilical scar on blood supply, check for muscle separation, and choose between mini and full approaches based on your anatomy and scar preferences.

Considerate622652,A reverse abdominoplasty will tighten skin above your belly button more than below. Your photos demonstrate skin laxity from above your belly button down to your bikini line. I think you would get the best results from a traditional tummy tuck.
Dr Stein

Thank you for your photographs. Your overall best abdominal contour would come with a traditional abdominoplasty. There is an option, called a reverse abdominoplasty, where the incisions are made along the curve underneath the breasts and across your upper abdomen between your breasts, which allows you to lift the skin upward to smooth the upper abdomen. Most of your redundant skin is below your belly button and that would not be improved at all with a reverse abdominoplasty. A traditional abdominoplasty would improve your lower abdomen and a great deal of your upper abdomen as well. Have a detailed discussion with your plastic surgeon about your best option. Best wishes.

It is rare to see a good aesthetic outcome from a reverse "tummy tuck." As you have other aesthetic issues beyond the skin excess, you would only achieve a mediocre improvement by removing the skin alone. Your photos show a prominent budge in the central abdomen that would likely require a tightening of the muscles for improvement. Your photos also suggest that you may have an umbilical hernia and some fat excess. Seek a consult with a board-certified plastic surgeon for a more definitive recommendation.

Hi. What you are describing is a reverse tummy tuck. Unfortunately like most patients, you do not qualify for reverse tummy tuck. It seems that you have excess skin bellow your belly button and this cannot be addressed with a reverse tummy tuck. It also seems like you do have muscle separation and a possible umbilical hernia. These issues can only be addressed with a Traditional Tummy Tuck.
Please understand that doing what seems to be a smaller procedure with less scars does not translate to a more natural look. In most cases it translates to subpar results.
A TT with Muscle Repair is your best option for natural results.

Thank you for your question and photos. When you say: "I want to look natural", I think this is the natural look after pregnancy (in most women) and aging. We want to turn back the clock, make you look natural as you were before child bearing. First, a reverse tummy tuck is not a good choice in your case (matter of fact I still need to find one person after 30+ years in practice who would be a good candidate for this). Second, you do not have a skin only problem. You have excess fat on the abdomen, bulging of the abdomen (loose or separated rectus muscles), all of these need to be addressed if you want to look athletic and natural. Third, your belly button looks distorted (from your surgery) or might even have a small umbilical hernia. I would recommend a full tummy tuck with a low pubic bone level incision with liposuction of the abdomen, waist, hips, over the rib cage. See a board certified plastic surgeon experienced in advanced body sculpting techniques for an in person consultation/evaluation. Good luck.

You would do well with a high lateral tension abdominoplasty. Under no conditions should you do the 'reverse abdominoplasty' which is, in my opinion, a horrible procedure in almost all instances.

it is unusual to perform a tummy tuck thru an incision below the breasts in the infra mammary fold. When looking at your photos, you would not be a good candidate for this approach. The excess skin and fat of the lower abdomen would not be addressed with this incision..

based on your question, a reverse tummy tuck can be performed which uses an incision that is placed along the breast crease and elevates/removes skin from the upper abdomen. However, the indications for this surgery are quite narrow- usually thin patients with minimal/no diastasis, and skin laxity that is isolated to the upper portion of the abdomen. Based on your photos (where there is excess fat stores and the apparent skin quality) a traditional abdominoplasty with a low abdominal incision is going to give a significantly better result. Whether or not the prior surgical scar can be removed is dependent on how much laxity you have, which can only be confirmed on physical exam. If not fully removed, this would be re-located to a lower position on the abdomen. Consult with a well-qualified plastic surgeon, who can perform a detailed exam and give you a more thorough assessment of a surgical plan that is specifically tailored to you.
Based on the degree of ptosis (nipple position) and elongation/stretching of the breast, an augmentation alone is unlikely to give a result that you are happy with. The lift is needed to reset the shape and position of the breast on the chest wall with the implant providing the improved fullness (especially in the upper pole) similar to the example photo you provided. What type of lift is largely dependent on your individual measurements and goals. You should meet with a well trained plastic surgeon who will review your anatomy and goals and discuss the implant selection and lift that would be needed for your specific case.
Sean M. Fisher, MD Aesthetic Plastic Surgeon Seattle, WA

Hello!Thanks for sharing your question. The procedure you are referring to is called reverse abdominoplasty, when we remove the skin excess from the upper part of the abdomen right at the inferior breast fold. This procedure is ideal for patients who had most of the laxity above the belly button, have had or plan to have breast surgery with a scar at the fold and patients who don't wish to change the belly button.
Bringing the muscles together to the midline is optional but most patients benefit from it both cosmetically and functionally. Having a super flat abdomen depends also on the volume inside the abdominal wall and sometimes is hard to achieve in some patients, independently of the muscle approximation.
Regarding your previsou scar, a conventional tummy tuck might be sufficient to remove it, either completely or partially and hide the lateral tail near the groin, depending on the laxity of the skin.
Overall in your case, with the limited information, I consider a conventional tummy tuck will better address your abdomen including, skin tension on the lower abdomen, concealing of scars, abdominal wall repair and belly button quality.
Hope this helps!
Rafael Ramos Vecchio MDPlastic and Reconstructive SurgeonCoral Gables, FL