Are there different techniques to a reverse tummy tuck?

Either of the above techniques will work fine.,personally I’m not into the quilting stitches but I would leave the decision up to your surgeon.

Dear thechester,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. 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

My best guess is the majority of plastic surgeons have never done a rivers tummy tuck except maybe once during the residency in case one of the attendings happened to do one. it’s not a common procedure at all and it isn’t a very good procedure.
If it had merits and did a good job people would do it on a regular basis.Undermining is done whenever undermining is needed.
Almost every form of tummy tuck includes undermining. One of the difficulties or limitations of the reverse tummy tuck is that it is not possible to undermine all the way down to the groin while a regular tummy tuck can undermine from the groin all the way to the breast.
If you had a procedure with an undesirable outcome and you want us to make an assessment or give you a recommendation then you should consider posting proper before and after pictures.
Talking about different ways of doing it obscure procedure that is rarely performed doesn’t make much sense. It’s an outdated procedure that very few people perform.
If you had a bad outcome then either consult with plastic surgeons for second opinions on how to correct it and if you want input on it from this community then you should probably include pictures.
The tension placed on the incision and how close it’s placed to the breast and the possibility of the breast being pulled down is all interrelated with multiple variables. Simply undermining or not undermining is not what makes the difference. how much skin is removed is far more important then how far the undermining goes. The tension holding up the abdominal skin flap also needs to be anchored to the chest wall so it doesn’t pull on the breast skin.
Best,
Mats Hagstrom MD