Disappointed in the Results of Mini Tummy Tuck - looking for Advice

Conventional wisdom is to either pull just from the belly button down for a mini tummy tuck.  OR pull the entire abdomen down, make it really tight and create a new belly button - full tummy tuck.  But there is a hybrid surgery where we float the belly button down to a lower spot without creating a new one.  We get way more tightness but still use the mini incision.

 A mini TT is just that, a mini.  Some need to have a full TT so more skin can be removed, and the tightness is greater.  In addition, the muscle can be tightened in several locations if needed.  The full TT is just more of a complete procedure.  The mini is for those with small issues, and a good muscle.

As far as I am concerned, there are very limitied indications for a mini-tummy tuck. Mini tummy tucks work only on a small subset of patients who have a flat and firm upper abdomen, a lax lower abdomen, a relatively high naturally located belly button, and a relatively small amount of redundant skin in the lower abdomen. If a patient does not meet those criteria, then a mini-tummy tuck is the incorrect procedure. In my practice, most patients fall into one of two categories:

1) Good skin but too much abdominal fat: these patients are good candidates for liposuction.

2) Lax abdominal wall musculature and loose abdominal skin: these patients are good candidates for full abdominoplasty.

Based on your photos it appears you still have some loose skin and stretch marks of your lower abdominal area.  It's too early still to have anything surgical done, but after six months or so, if you're not happy you  may want to consider a revision to remove more skin. It appears as if you may have been suited to a full tummy tuck, but this is difficult to determine without examining you in person.

Be patient for now and communicate with your plastic surgeon your concerns.

Best wishes,

Dr. Bruno

It is far to soon to be evaluating your results. Without seeing the nature of your problem before surgery it is unrealistic to suggest that a different procedure should have been performed. What is concerning is that you feel that you "did not get what you paid for". The procedure performed and you agreed to,  likely has produced the early changes that it was designed to achieve.  Only you and your surgeon can comment on what dialogue took place before surgery. Carefully reconciling your expectations with what any surgery can accomplish is an essential step before surgery. At this point, let your body heal completely and reassess if you want to consider more surgery.

From the few pictures provided, your lower abdominal skin will likely never be without wrinkles when you lean forward. This skin appears to have a large number of stretch marks and  does not have the elasticity and contraction features of younger skin. A full tummy tuck would have achieved more vertical tightening of your skin but likely still would not have removed all of the damaged skin. Leaning forward would still result in crinkling of poor quality skin.  A full tummy tuck would have been more costly,  required a scar from hip to hip, you would have a scar around your belly button, possibly a vertical scar in the midline of your lower tummy because of your relative high location of your umbilicus and a longer recovery time. If you were willing to accept all of  these trade-offs,  then a full tummy tuck may have been a better choice.

Dr. Mosher

While you look good standing straight, there does appear to more skin laxity than you would like when you are leaning forward.

I agree with the other commentators that for most moms a full abdominoplasty allows much better correction.

Patients never complain about the somewhat longer tummy scar or the scar around the umbilicus that come with the full procedure. However, they will always complain if the tummy isn't tight enough when a more limited procedure has been done.

The other important point here is that patients are often more forgiving of a less than perfect result when their expectations have been well managed by their surgeon. Perhaps you expecting a result that this operation cannot deliver.

I do few mini-tucks. As I say to patients who request it, "mini procedure, mini result."

mini tummy tucks are often disappointing if patients are expecting much more than a scar revision of a C-section.

We perform very few in our practice.  Almost all women who need their fascia tightened up to the umbilicus also need it tightened up to the breast bone.

For this reason, we perform this tightening in almost all women who have a mini tuck, and term this procedure the hybrid abdominoplasty (hybrid tummy tuck).

While it's hard to really comment without seeing your before photos, what I tell my patients is that most women (not all, but most), especially those who have had kids, do better with a full tummy tuck.  The reason for this is that we can tighten the entire length of the muscles that have been stretched from pregnancy, and we can also remove more loose skin in most cases.  The only real downside is a slightly longer incision as well as an incision around the belly button, and I think most of us would agree that our patients rarely are bothered by this.  In your case, I would give it some time and speak with your surgeon about your concerns so that when everything has healed he can give you some options for improvement should it be needed, but right now the best approach is just time and allowing your body to heal.

In my opinion, the mini tummy talk is an  operation that  produces very limited results and is very rarely indicated. It involves a shorter incision but does not address the majority of the abdominal wall issues present for most patients who present consultation. For example, the area of skin excised is quite small. The abdominal wall musculature is addressed below the umbilicus leaving the upper number wall potentially lax. The appearance of the umbilicus is not necessarily addressed sufficiently.

For most patients who have had pregnancies and/or weight loss a full abdominoplasty is necessary to achieve the desired results. Of course, there are downsides (including a longer scar and probably a longer recovery time) but for most patients the benefits outweigh the downsides. It is not unusual to see patients who've had mini tummy tuck  surgery present for  revisionary surgery.

It is important to work with a well experienced board-certified plastic surgeon to obtain advice (based on good ethics and judgment) to  improve your chances of a successful outcome and minimize the need for further surgery.
I hope this helps.

Hello,

Mini tummy tucks do much less than many women would like. I commonly recommend more surgery to the patient requesting a mini and do fewer of them than I have in the past.

 

Best Regards,

 

John Di Saia MD