5'4" and 104 lbs - Extended tummy tuck or full tummy tuck? (photo)

Question

I have seen 3 drs. All DBL board C. The last one said i needed an extended TT but said the scar would only go slightly beyond my hip (not around or the back) Is this an upsell or even necessary? He wants $23,000 for the ETT and another $20,000 for an implant with donut lift. Each DR has said different things but this one is the only one suggesting the ETT. Im 5'4" and 104 lbs. Can i just get a full? Isnt that what it is if its just on the front?

Robert M. Lowen, MD · Answer

Extended, depending on your definition, does not appear to be necessary. The incision needs to be long enough to treat the entire anterior abdominal surface and redistribute the excess skin, of which there is a lot, the excess being primarily in the lower abdomen.  The incision goes from one mid-axillary line to the other, the hinge point from which the anterior skin can be lifted and brought down and redraped without  a dog ear.
  Despite there being a lot of redundancy when you are sitting down, it is certainly not so evident when you are standing up; the point being, that you may not have enough upper abdominal laxity to pull down enough skin to remove the umbilical donor site.  The donor site may require closing as a vertical incision in the lower abdomen.
   The length of the incision as described sounds like just a surgical decision and not an "upsell". Such a decision on length of incision should not influence the fees charged, whatsoever.
  One doctor's usual tummy tuck may be another's "extended".  The main thing is that the scar not be visible in a bikini.  If the doctor marks the bikini with the patient pulling up the lower abdomen and then flexes the thigh to make sure the markings go in the crease between thigh and torso, and designs the incision within those markings, the scar will never be  visible post-op.
   With regard to terminology, a "full" abdominoplasty means dissection vertically up to the upper abdomen/rib area, as opposed to a "mini" which is dissection only up to the umbilicus.  Extended refers to the length of the horizontal abdominoplasty incision, which in my practice is from mid-axillary line from one side to the other.   Any "extension" would be posterior to this line, which is not commonly needed.  Extending it all the way around is a lower body lift.

Luis Suarez, MD · Answer

We would need to see additional pictures, specially, from your lower back to be able to determine if the best option for you would be a circular tummy tuck because of the condition of the skin is the same as you have in your abdominal area then the answer would be yes that would give you the best outcome. Additionally, the benefit of it is also it gives you an automatic butt lift. Otherwise, if you do have the same condition of the skin in the back, and you only do a limited incision, you can be left behind with dog ears, which is essentially skin protrusion past the incision line.

Gregory Lakin, MD · Answer

Thank you for your question. The decision between an extended tummy tuck and a full tummy tuck depends on the amount of excess skin and fat in the abdominal area that appears during examination. An extended tummy tuck addresses the flanks and extends the incision slightly beyond the hips, sometimes wrapping around the sides. A full tummy tuck focuses on the front of the abdomen. If your concern is primarily with the front of your abdomen, a full tummy tuck may be sufficient, while if there is excess skin in the flanks, an extended tummy tuck will be recommended. You may want to discuss this more with your surgeon during an in-person consultation to ensure the recommended procedure aligns with your goals.

Wayne I. Yamahata, MD · Answer

Your photos suggest that a standard tummy tuck would provide adequate skin resection. An extended procedure would allow resection of extra skin, especially above the hips and above the buttocks in the back. Whether there would truly be substantial benefit to the extended procedure would require a physical examination.

Ira H. Rex III, MD · Answer

There is no great definition regarding the difference between a regular versus extended tummy tuck.  In surgery, the plastic surgeon should extend the excision to give you the best result possible.  This is different and everybody.  Yes, you may need a longer incision, but if properly placed, the scar should fall under a bikini line.  The recovery really is not that much different.

Jeffrey M. Darrow, MD · Answer

Thank you for your photos. For your tummy tuck incision to lie flat and to avoid a bunching of skin out to the side, the incision has to be tapered.  If this tapering of the incision can be ended at or slightly inside your hip point, that’s to your benefit. However, if to give you the absolute best contour, the incision has to be extended slightly further, to avoid leaving you with a bunch of skin in that area, then an extended tummy tuck would give you the overall best result.  From your photographs, especially the one where you were slightly flexed, it appears the amount of redundant skin only goes to your hip point or slightly past it. Therefore, without the benefit of an examination of you, it appears a standard tummy tuck would give you excellent results. Best wishes.

Warren Schutte, MD · Answer

Thanks for the question. From photos, it appears that you are a great candidate for a standard Abdominoplasty. Due to the amount of skin laxity you have, an in person consult would be needed to see if a laterally extended abdominoplasty is needed. If you skin laxity extends laterally to flanks, it would be a good idea to extend.

George Marosan, MD · Answer

Thank you for your question and photos. Based on these photos, I would recommend a skin excision tummy tuck only (unless you have muscle separation by physical examination). Another option would be Renuvion skin tightening first, with VASER release first. This will avoid an abdominoplasty incision but might not get as much skin tightening. See a board-certified plastic surgeon experienced in advanced body sculpting techniques for an in-person consultation/evaluation. Good luck.

Gerald Minniti, MD, FACS · Answer

Prices can vary and are based on the surgeon's prerogative, so that's not up to debate. Surgical procedures should be specific to the patient's anatomy. Having said that, your breasts are not ideal candidates for a circumareolar/Benelli/donut lift. You have too much skin excess and too little skin elasticity. You will have all the usual unpleasant side effects of that surgery applied to a breast that needs more: wide areola, thick scarring, pleating around the areola, a flattened breast mound, persistently low areola and persistent glandular sagging. You will need a lift that includes a vertical scar to allow the changes that need to be made to accommodate the implant and get a very attractive result. As for your belly, you just need a tummy tuck, wherever the scar ends, probably just past the front of the hips, unless you want skin tightening of the waist area.

Paul E. Chasan, MD, FACS · Answer

Thank you for your question.  You are an excellent candidate for standard tummy tuck, breast augmentation and donut mastopexy. You should be able to have an excellent result without the need for extending beyond the hip with your abdominoplasty incision.  Best wishes to you.

5'4" and 104 lbs - Extended tummy tuck or full tummy tuck? (photo)

Answers (16)

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