Enough skin for tummy tuck? (photo)

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!

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).

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 !

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.

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.

Dear thoughtful,

Thank you for your pictures. I understand your concerns. Having aesthetic surgery always involves a trade off a trade-off of a healed incision versus better contour. I agree that you do not have enough skin, despite your muscle laxity to have a traditional tug. If you decide to go this route you're going to end up with a small to medium size vertical incision. You may be a candidate for an umbilical float procedure, which also removes excess skin of the lower abdomen as well as tightening the muscle. That procedure would minimize, if not, eliminate the possibility of a vertical incision.

You definitely need to see several board certified plastic surgeons for, an in person consultation.

Best wishes,

Earl Stephenson, Jr, MD, DDS, MBA
ESJ Aesthetics

Given your history and significant diastasis, a full abdominoplasty with muscle repair is likely the most effective option. It typically involves a transverse incision with umbilical repositioning.
While scar position depends on your anatomy, experienced surgeons aim to keep it low and well-hidden. Muscle repair can also improve core strength and reduce back pain.
Though scar concerns are valid, the long-term benefits often outweigh the risks.

From the photos a standard tummy tuck is recommended. This will address excess subcutaneous fat and skin as well as correct the abdominal wall laxity. Discuss your concerns with your surgeon about scar placement. The small inverted T or vertical incision will fade over time but your improved shape will remain.