33 female, 5 years post-op 1st TT, am I a candidate for a full tummy tuck again? (Photos)

Hello
If there is significant swelling in the upper abdomen when you try to sit up while lying on your back with your legs straight, rectus muscle repair is required. Otherwise, it's not necessary. Only excess skin can be removed from the lower abdomen, and a belly button hernia can be repaired at the same time.
If there is serious rectus diastasis and repair is needed, the procedure can be done through a tummy tuck incision. After the belly button is freed through the belly button incision, the muscles are repositioned in the middle, and repair is done. Without tightening, all tissues are fixed in place with internal stitches, and only excess skin from the lower abdomen is removed. The belly button can be sutured back into its original position.

without the benefit of meal to examine you in person, I can tell you that I’ve had multiple patients that have had the same situation where they had a tummy a long time ago and then had a pregnancy afterwards and your pictures are very similar to what I would expect. What I have found very successful in these patients is to actually perform a mini tuck. So I would use the original incision, lift all the skin off of the abdominal wall, repaired the muscle separation and hernia and float the belly button down about an inch. Based on your picture, it would still be at a normal position in it would not look artificial and I don’t see that you have enough loose skin to do a full tummy tuck successfully.

Dear malibuu05,
based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. Flanks liposuction would give you a better shape. I would suggest you to consult a board-certified plastic surgeon because only after a thorough examination you will get more information and recommendations.


Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

I would first see a general surgeon and have your hernia evaluated. Sometimes these hernias will require a mesh and reconstruction. Muscle separation can be treated by retightening the abdominal muscles. You don't appear to have a lot of loose skin so a modified or mini tummy tuck could be performed.

In either scenario, you'll need to disarticulate the belly button from the skin to repair the hernia and complete the muscle repair above the belly button. This is not a bad thing though, because your belly button could look so much more natural than it does now. In my hands, I would re-advance upper belly skin as well (full tummy tuck). This will optimally tighten skin, and allow for a lower scar, which is too high on you.

An examination is needed to be certain, but liposuction with minimally invasive skin tightening like Renuvion could be helpful to your upper abdomen. A mini tuck could be done for the lower to tighten the muscles and remove excess skin. I would not suggest a full tuck for this will leave you with a vertical scar below the umbilicus.

In order to fully address the muscle separation and umbilical hernia a revision would be needed. This could be beneficial for you in that in addition to correcting those issues you can have scar revision in an effort to have thinner, less visible scarring.