Enough skin for tummy tuck? (photo)

Question

I’m 39, 5’9” and 147 Ilbs. II have had two singleton pregnancies and a twin pregnancy and am done having kids. I’m signed up for a mommy makeover with a top surgeon who specializes in body surgery, but I’m having second thoughts about the tummy tuck. I have minimal lose skin and a high belly button/long torso. PS said I have significant diastasis and need repair above and below the navel which I agree with based on what I can feel. He said I’d have an inverted t scar or free floating vertical scar depending on how much skin he can pull down. I really want my scar to be low and and am worried that the risk of a high scar or vertical that might not be covered in a bikini bottom might not be worth it. But, I’m tired of having to suck in my stomach 24/7 to not look pregnant and feel like I can hold my insides in. I also struggle with low back pain lifting weights. Thoughts?

Ira H. Rex lll, MD · Answer

From your photographs, it seems you are a very good candidate for a tummy tuck.  That would be about the only way you could tighten the muscle which has been so stretched out.  I am pretty sure would have a vertical incision at the umbilical donor site.  This may be at the bikini line.  So it comes down to your decision, a flat belly or a small additional incision.  Good luck whatever you decide!

Donovan Rosas, MD · Answer

Concerns about the appearance of the abdomen are very common among patients consulting with a plastic surgeon. Just like every patient is different…so too is every abdomen. Different problems require different solutions. Your board certified plastic surgeon is uniquely trained to identify the problems as well as the appropriate solution.

The abdomen is commonly addressed via liposuction or abdominoplasty (“tummy – tuck”). Which procedure is best is dependent upon the source of the problem.

Excess fat deposits underneath the skin can be addressed via liposuction. Liposuction will not address any other issues and may worsen the situation if there are other factors at play (such as skin excess and muscle laxity, see below)

Commonly patients concerns are centered around issues of excess skin as well as fat. A third factor, which is often overlooked by most patients is abdominal wall muscle laxity (typically seen in post partum mommies).  The tummy tuck, also known as abdominoplasty is a surgical procedure designed to eliminate excess skin and fat and tighten the muscles in the abdominal wall to create a smoother and slimmer contour. The tummy tuck is designed to target areas of the abdomen that have not responded to diet and exercise, making it particularly popular among people that have a lot of loose or sagging skin around the abdominal area due to significant weight loss, as well as women with excess skin and stretched abdominal muscles following pregnancy and childbirth.

Based upon your photos and narrative, you are a reasonable candidate for abdominoplasty. Questions of scar placement and skin laxity are difficult to answer without an exam. However,  patients will often have to weigh the costs of scars against the benefits of abdominal rehab (skin excision/muscle tightening).

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Guler Gamze Eren, MD · Answer

Hi from Istanbul!Thank you for your question.Regarding on your photos you have muscle laxity and not much excess skin in the abdomen.Floating belly button technique can be suitable for you. With this technique you will not have a scar around umblicus, muscle repair will be done and excess skin will be removed above pubis. Only concern of this technique is lowering the level of your umblicus position. It will be still in a normal position because you already have a highly located belly button.Best luck !

Gary M. Horndeski, MD · Answer

In your case, since you are not planning future pregnancies, I recommend abdominoplasty with mesh reinforcement.  The mesh creates a more hourglass figure by compressing the abdominal wall resulting in early satiety and helps maintain a reduced weight.  I do not believe you have enough skin to do a full tummy tuck without the scar ending up high.  You may undergo a partial resection of the skin lower with a low scar and move the umbilicus down a few centimeters.

Best Wishes,

Gary Horndeski, M.D.

Gerald Minniti, MD, FACS · Answer

This has to do with the hole in the skin where it was attached to the belly button. The concept that most surgeons have been trained on is that the hole has to come out with the excess skin, otherwise an additional scar is need to close it. If a surgeon feels that the movement of skin is insufficient to transpose the hole down far enough, the will say 'you don't have enough skin' for a full tummy tuck, which is nonsense. This same concept is also why so many women end up with the long transverse scar too high on the abdomen. All of this can be avoided with a change in priorities: the long scar placement should be paramount and positioned in the same place for everyone, and the hole should be ignored and closed vertically if it can't be removed.

Enough skin for tummy tuck? (photo)

Answers (8)

Answer: Partial resection

Answer: Partial resection

Answer: 'Enough skin' is an antiquated concept

Answer: 'Enough skin' is an antiquated concept

Recommended reading

Everything you need to know about Tummy Tuck

Our mission is to create a world where every investment in modern beauty is Worth It.

Enough skin for tummy tuck? (photo)

Answers (8)

Answer: Partial resection

Answer: Partial resection

Answer: 'Enough skin' is an antiquated concept

Answer: 'Enough skin' is an antiquated concept

Browse related questions

Recommended reading

Everything you need to know about Tummy Tuck

Our mission is to create a world where every investment in modern beauty is Worth It.