Which procedure would correct the appearance of bulge in my upper abdomen area? (photos)

Question

Upper ab fix? I'm very active, yoga daily, 56, 5'5, 125lb. Had a lower TT/muscles tightened in 2014. Hug bulge at top under my chest! It has gotten worse over the years. Any options other than a TT revision? I probably should have done a full tummy tuck but was always in excellent shape and I always weighed between 115-125 after having my daughter in 1999. My lower tummy tuck was in 2014 and no matter how flat my stomach is, I always have the extra fat bulge under my chest.

Joel Patrick Maier, MD · Answer

Given the fact that you’re abdominal muscles are tight, converting to a full tummy tuck (which includes muscle repair with associated downtime, risk, drains etc . . .) is not indicated. This leaves you two options: liposuction can flatten this area, but will not tighten the skin like your lower tummy. You can add more skin removal with umbilical transposition done at the same time of liposuction (local only, no drains and similar down time) which will address the skin laxity. You will have a scar much like you mini-tummy tuck but a bit longer and a umbilicoplasty (belly button repositioning) with a possibility of a vertical scar in the lower tummy. Which option depends on how concerned you are with some (but not dramatic) skin laxity in the upper abdomen but liposuction is the simplest and effective way to flatten the area. Thank you.

Miguel Mota, MD · Answer

Hello. Excellent question. You so not seem to qualify for a full tummy tuck, but there is a way to correct this issue. A reverse mini tummy tuck. With a reverse mini tt we can get rid of the excess skin and fat on the top part of your tummy. This will definitely correct the bulge under your breasts. We can also perform muscle tightening to the upper abdominal wall muscles if necessary. The scar would be at the breast folds. In some patients we can get away with having two distinct scars, one under each breasts. This may the case for you. In other patients with more excess skin in the middle we need to connect the scars so that there is one scar that goes from breast fold to breast fold.

I believe this is your best option. It can also be paired with liposuction of the area as well for even better results like the link bellow.

Hope this helps,
Dr. Miguel Mota

I believe this is your best option. It can also be paired with liposuction of the area as well for even better results like the link bellow.

Hope this helps,
Dr. Miguel Mota

Daniel Barrett, MD · Answer

Dear regirl,
I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Ira H. Rex III, MD · Answer

Primary photographs, it seems that liposuction and a second tummy tuck is the best way to go. Perhaps you are a major consideration would be that the umbilical donor site would be just a little below your new bellybutton. Basically, he would have a vertical scar which is visible with most two-piece bathing suits. There is such a thing as a reverse tummy tuck, but this would create a long second scar in your breast fold. A physical exam by a plastic surgeon would go far in helping you make a decision of which procedure is best for you.

Arif Eroglu, MD · Answer

Hello; fat in the upper abdomen and especially, in the area above the ribs; there is skin laxity and an orange peel appearance. This appearance; can be achieved by reducing the fat in the upper abdomen field; by the support of Vaserlipo; with Renuvion J Plasma; by applying on skin tightening; can be fixed or; with an incision that have made at the loose upper abdominal breast line; by implementing on Reverse Abdominoplasty; can be tightened.

Ronald J. Edelson, MD · Answer

Did you have just a mini tummy tuck? If so that would explain the bulge and your dissatisfaction. If you only had a mini tummy tuck it can be converted to a full tummy tuck and your result will be much better

Connie Hiers, MD, FACS · Answer

That area can be treated with liposuction to remove the excess fat and then with Renuvion to help tighten the skin in the upper abdomen.

Camille Cash, MD · Answer

In order to address your concerns and improve your contours a revision is needed.  A standard tummy tuck with muscle repair will remove excess skin as well as correct abdominal wall separation.  See a board certified plastic surgeon to learn more.

Mats Hagstrom, MD (license on probation) · Answer

For almost all women who’ve had pregnancy related changes or enough weight loss to have abdominal skin laxity a full tummy tuck is the better procedure.
In reality, very few people are truly good candidates to have a lower or mini tummy tuck only.
Your alternatives are to do a full-time tech, which should’ve been done initially or to do a reverse tummy tuck Which is generally not considered a procedure. 
Different providers have different opinions and certainly different levels of skill and experience.
Finding the right provider not only increases the chance of having quality outcomes, but also greatly increases the chance of having the correct procedure recommended to you.
Best,
Matt Hagstrom MD

Which procedure would correct the appearance of bulge in my upper abdomen area? (photos)

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