Do I have enough skin to be removed? (Photo)

Ideally, when doing the “pinch test” to determine what skin can safely be removed from a patients lower abdomen, the thumb is placed just above the top of the pubic hair and the fingers just above the belly button. If you can easily approximate the thumb and finger, all the tissue between can be removed. You may not have that much laxity to your skin, but still wish to keep the horizontal part of your incision as low as possible so your surgeon realizes the belly button opening won’t be able to be removed and would be closed as a small vertical scar. One other option is to have your tummy tuck incision slightly higher up your lower abdomen, which would make it easier to approximate the upper and lower skin, without the need for the T part. Have a detailed discussion with your plastic surgeon about which would be best for you. Best wishes.

Hello Sashy87, thank you for your question regarding your upcoming mommy makeover and concerns about the amount of skin available for removal.

From your description and the photos provided, it appears that the core issue affecting the contour of your abdomen is the weakened lower abdominal musculature. This is common among women post-pregnancy, and addressing this through muscle repair is essential for achieving a more toned and flat abdomen.

Muscle Repair: Your rectus abdominis muscle, which has likely been stretched or separated due to pregnancy, needs suturing from the xiphoid process down to the pubic region. This will help tighten your abdominal wall and correct the bulge that typically persists when the muscles have loosened.

Skin Removal: Concerning the skin removal, while you do have some excess lower abdominal skin, it’s not excessive. This is why your surgeon has recommended an inverted T tummy tuck. This procedure involves a horizontal incision across the lower abdomen (similar to a traditional tummy tuck) combined with a vertical incision. This vertical component helps remove and tighten vertical excess skin and is particularly useful in cases like yours where horizontal skin laxity alone is not sufficient.

Vertical Scar: The small vertical scar below your belly button that your doctor mentioned will likely be where your belly button was repositioned. This is a common aspect of the inverted T technique and helps in managing the excess skin without creating excessive horizontal tension.

It’s understandable to feel anxious before such a transformative procedure. However, based on your surgeon's approach, it sounds like they have tailored the procedure to suit the specific conditions of your abdominal anatomy—focusing on muscle repair and appropriate skin removal.

Discuss all your concerns with your surgeon prior to surgery to ensure all your questions are answered and you feel comfortable moving forward. This planning and communication will help achieve the best possible outcome for your mommy makeover.

I hope this explanation helps ease your anxiety and provides clarity on what to expect from the surgery. Good luck with your procedure!

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic Surgeon

Hi, thank you for sharing your question. What other options were given to you? Your surgeon may have given you this option because you may not have enough skin laxity however, the best way to determine this would be in person. You do have other options available if you want to avoid a vertical scar.

You are a good candidate for a tummy tuck. It looks like there is some muscle stretching in the mid-lower abdomen, and you have loose skin above your belly button. While surgeons always discuss the possibility of a vertical scar if the belly button hole does not reach down, you will still benefit. Also, while it is possible to not have a vertical scar, if you do need a vertical scar, the trade-off for a flat, smooth tummy is still valid.

Dear sashy87,
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. Flanks liposuction would give you a better shape. 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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Thanks for your question! Yes, you will have enough skin and yes, you will have a vertical incision. That usually heals very nicely. Best of luck!

It is certainly difficult to make a decision without an examination, but it seems you are a candidate for an abdominoplasty and scar as your doctor has described, or possibly just lower abdominal skin excision. It often depend on the patient's expectations as far as skin tightening above the bellybutton.

It is very important that you are comfortable and confident moving forward with cosmetic elective surgery. Looking at a lot of before and after photos of your surgeon's work is important as well, assuring that you like their work. You do have enough laxity for a tummy tuck but you only have minimal laxity (that is why you'll likely have a small vertical scar from umbilicus down). In the end, it is your decision to move forward or postpone.

Hello; Due to not having enough skin in the upper abdomen area; Doctor thought that; he could not perform for a full tummy tuck procedure. However, if there is no extreme weakness or diastasis in abdominal muscles; it is not necessary to do an entire tummy tuck. There are no excessive wrinkles or looseness in your upper abdominal skin zone. Therefore, the abdomen after Vaserlipo; with Mini Tummy Tuck; you can obtain pretty good results.

Once your muscles are tightened, you will have excess skin which can be removed with the tuck. You should do very well with a tuck. Perhaps you may not need the vertical scar.