I need full muscle repair and hernia repair but sagging skin is only centered. Would that be a full or mini tummy tuck? (Photo)

Question

I’m getting conflicting answers. At a consult i had the doctor said the cut would be from inner hip to inner hip, but others have told me that upper muscle repair isn’t doable with a “mini tuck” Pictures for reference. Pictures when i let my stomach go and when i tighten it

Gary M. Horndeski, MD · Answer

The key component to
a tummy tuck is repair of the fascia, not the muscle.  The fascia is the support layer that provides
mechanical strength when the muscles are not contracting.  If you have a hernia, frequently mesh is used
to augment the hernia repair.  You have
not stated your age or whether you desire future children but the technique I
recommend, in women who do not desire future pregnancies, is abdominoplasty
with mesh reinforcement.  This requires a
full abdominoplasty and the mesh is used to run side to side to create more
hourglass figure.  From your photographs,
you have significant lower abdominal bulging, which would benefit from mesh.  A mini tummy tuck would not correct this
degree of bulging.       Best Wishes,Gary Horndeski, M.D.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your
question. Based on your photograph, you are a better candidate for a full tummy tuck
with liposuction.  This can be done
through a low and short incision, all completely below the bikini line.  The belly button can be designed to look
natural and have no scars on the exterior.  
Your muscles can also be plicated resulting in a flat abdomen.  Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.  The most important
aspect is to find a surgeon you are comfortable with. I recommend that you seek
consultation with a qualified board-certified plastic surgeon who can evaluate
you in person.
Best wishes and good luck.
Richard G. Reish, M.D. FACS
Harvard-trained plastic surgeon

Kenneth Hughes, MD · Answer

Based on your picture it looks like you can benefit from a full tummy tuck, an in person consultation would be best for a detailed exam and evaluation.always see a board certified PS.

Daniel Barrett, MD · Answer

Dear chicken10,based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. I would suggest you to consult a board-certified plastic surgeon because 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 Surgeon

Cara Downey, MD · Answer

You have rectus diastasis that extends past your belly button, so my suggestion would be a full tummy tuck. There is a technique of “floating the umbilicus” while still doing a full rectus repair beneath and you may be a candidate for that, but you would be somewhat limited on the amount of skin you could remove. I don’t consider that technique a “mini” just a version of a full, but it would save you a scar around the belly button.

Leo McCafferty, MD · Answer

You might be a candidate for a 'floating umbilical' tummy tuck.  This essentially involves an incision as described by the physician you saw in consultation but would not require an incision around the umbilicus.  The muscle repair and loose skin can be addressed through this incision.  It is difficult to say without examining you, but looking at your pictures you may very well benefit from a full abdominoplasty.  The only difference between the floating umbilical and full abdominoplasty would be that in addition to the horizontal scar you would have the circular scar around the umbilicus.  A mini tummy tuck (based on your photographs) would not be appropriate.   I recommend you see a board-certified plastic surgeon specializing in abdominoplasty.

Johnny Chung, MD, FACS · Answer

Thank you for your question.  Plication of the upper abdominal muscles is definitely possible through a mini tummy tuck incision.  It’s difficult to determine whether or not you need a mini tummy tuck versus full with just a photo. I recommend finding a board certified plastic surgeon near you for a consultation and ask to see his/her before and after photos. Most surgeons do not plicate the upper abdomen with a mini but some do. Good luck with your surgery.

Robert S. Houser, DO · Answer

We all have tricks for doing various types of muscle repairs either with a "mini" or a "full."  In reality, your scar will be low (can't guarantee short -- what's short to me may be long to you) and you need your belly button fixed.  The belly button fix means moving it in to new skin where there are no stretch marks -- and that's a full tummy tuck.  The downside is that you might have a vertical scar in your low abdomen where your belly button used to be, but I doubt it - your skin looks pretty stretchy!  Maybe try a couple more in person consults.  Good luck!

Ken Dolynchuk, MD · Answer

Thanks for your question and photos. Actually it appears that most of your muscle is intact above the umbilicus. The scar may extend from iliac crest to iliac crest in either a mini or full tummy tuck. The difference is in how high up under the skin the dissection goes in order to remove more skin at the bottom. If the surgeon who recommended a mini tummy tuck was aware that you need lower muscle repair and was willing to do it with less skin resection in the vertical direction I think you’d be happier. Good luck.

Frederick G. Weniger, MD, FACS, MBA · Answer

Thank you for your question as well as providing photos. It appears you are correct when stating muscle repair is necessary for the best results you can expect. With that being said, every surgeon has a different idea of what a "mini tummy tuck" is. I refer to a mini tummy tuck as excising a little excess skin that's below the umbo with no muscle plication associated with the surgery. If dissection for muscle repair is necessary, that would be a full abdominoplasty is necessary. In order for you to expect the best results, I would recommend a full abdominoplasty. Visit a Board Certified Plastic Surgeon to discuss a more detailed surgical plan specific to your needs. Good luck and best wishes!

I need full muscle repair and hernia repair but sagging skin is only centered. Would that be a full or mini tummy tuck? (Photo)

Answers (11)

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