Considering TT after twins. What would you recommend? 4'10 102lbs. I have diastasis & loose skin and an umbilical hernia(photos)

I hit the gym reg but can't fix this. I have no stretch marks to get rid of, just lose skin. I want a very low scar as I wear low bikini bottoms,(not string). I've had several consults with different opinions. I have a high BB, one suggestion was floating the BB but another dr said not a a good idea due to hernia. I can't find much info in this procedure. I have been told I would most likely need a vertical scar. I don't want an over tightened look or horrible looking BB. What would you suggest?

Doctor Answers 19

Considering TT after twins. What would you recommend? 4'10 102lbs. I have diastasis & loose skin and an umbilical hernia(photos)

I do not float my belly buttons. I believe a small vertical scar with a good button above  is a better option to allow for optimal tightening and a low horizontal tummy tuck scar.

Memphis Plastic Surgeon
5.0 out of 5 stars 3 reviews

Tummy Tuck after having twins

Based on the information and the photos you provided, you would benefit from a tummy tuck to tighten your stomach muscles. This can be done in conjunction with a hermia repair if you choose to have it corrected. During a tummy tuck procedure the belly button is repositioned in the correct place since there is removal of skin around it.  The belly button scar is circumferential (around the belly button) and fades over time so that is unnoticeable. The scar from the tummy tuck procedure is hipbone to hipbone but is placed about 2-3 inches below the belly button so that you can wear a bikini. I advise you to see a board-certified plastic surgeon and discuss your concerns with him/her as well as viewing before and after photos. Good luck with your decision.


You are and excellent candidate for and abdominoplasty using the traditional technique but because your belly button is high-riding and you don't have a tremendous amount of excess skin in your upper abdomen this will impact the final position of the scar across your lower belly. Using progressive tension sutures when closing can help to keep your scar lower, and additionally leaving a vertical component can also be done if necessary. When there is not enough excess skin to close the incision in the traditional way or the scar would be too high the floating umbilical technique can be used but the overall skin removal is much less, and therefore less tight. I personally would opt for the traditional abdominoplasty if your scar ends up a little higher than you like with your bikini, buy a new bikini.

Stacey Folk, MD
Denver Plastic Surgeon
5.0 out of 5 stars 21 reviews

Considering TT after twins. What would you recommend? 4'10 102lbs. I have diastasis & loose skin and an umbilical hernia(photos)

Based on your photos, it appears to me that your primary issue is the muscle laxity from your pregnancy. You also have some loose skin, but no excess fat. If you want to avoid a small vertical scar from the original belly button location, the belly button can be floated and look quite good. The umbilical hernia will be repaired while the abdominal muscles are tightened. The  skin will also be tightened, and the excess skin will be removed. You should get a greatly improved contour. I hope this helps, and good luck!

TT after Twins

Hello and thank you for reaching out. Unfortunately, all of the work outs and gym time will not get rid of the loose skin, nor will it tighten your muscles back to what they were prior to carrying your twins. The only option to get a flat, smooth abdomen is a full tummy tuck. A hernia repair is not a problem, and should be repaired before the muscles are corrected. Tightening muscles over damaged tissue does not work out well. Even if there is a hernia present around your belly button, it can be repaired and the umbilicus relocated with no problem. The scar should be low enough that wearing your favorite low cut bathing suit will not be an issue either, and the vertical scar would require a physical exam to determine if it is needed or not. Every surgeon has their own techniques, which is why you are receiving so many different answers. Be sure the surgeon of your choice is board certified and meets all of your needs. Best Wishes. 

Considering TT after twins. What would you recommend? 4'10 102lbs. I have diastasis & loose skin and an umbilical hernia

Based on your photos alone it appears you have muscle separation that can be corrected with a tummy tuck. Consult with a board certified plastic surgeon. 


Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 414 reviews

Mini vs full tummy tuck

Thank you for your question.  Based on your pictures it appears that you have a significant amount of skin laxity above your belly button.  A mini tummy tuck and floating the belly button will lower the position of your belly button on your abdomen.  With a full tummy tuck the skin on your abdomen should be much tighter. The trade off for a full tummy tuck is the umbilical scar.  It is possible to repair your hernia with either procedure. In my opinion and without an exam I think you would be benefit from a full tummy tuck.  Get a few more in office consultations and then you will be able to make a more informed choice.  Good luck!
Dr Rast

Jon E. Rast, MD
Kansas City Plastic Surgeon
5.0 out of 5 stars 28 reviews

Compromise will be necessary

There is a limit to how low you can pull upper abdominal skin during tummy tuck. It depends on how much skin the patient has. Your upper abdomen skin will not reach very low. For this reason either a high abdominal incision or a low abdominal incision with a vertical scar will be needed.  
Floated belly buttons do not look pretty. NOT RECOMMENDED.
You will need to decide which compromise is more acceptable to you.
Operation itself is worth it. 

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 21 reviews

Tummy Tuck with an umbilical float is a good procedure in the right patient

A tummy tuck or abdominoplasty is a procedure that consists of 3 basic elements:

  1. Skin removal
  2. Muscle tightening
  3. Fat removal
Since every person is shaped differently, each tummy tuck procedure is customized to fit that individual.  There are many different types of tummy tucks, all with different names and emphasize different aspects of the procedure.  It is very important that you are FINISHED with child bearing before undergoing this procedure.  If you would become pregnant after a tummy tuck, the result will be ruined and you will be left with a long scar and your plastic surgeon will be left with your money!  And I mean permanently fixed, not BCP or IUD's!

Based on the photos presented and the history of the hernia, I would recommend a tummy tuck with an umbilical float.  The scar can be placed VERY LOW on the abdomen and the hernia can be fixed through the same incision. Your belly button will sit a little lower on your abdomen, but still in a normal location and there will be no scaring around the belly button.  This can be done as an outpatient, and now with the addition of the long acting local anesthetic, Exparel, minimal post op pain with a quick recovery.  You will probably need one drain that can be removed after 1-2 weeks.  Help at home with the twins will be needed.

Good Luck!

David Finkle, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 70 reviews

Considering TT after twins.

You can't be sure without an exam, but just from your photos it appears a full TT with muscle and umbilical hernia repair and a low scar without the vertical component should be easily possible, and should give you a great look So if you see a consultant who isn't comfortable with that plan, you should find someone who is. Floating the BB is a valid technique, but not a choice for you as there is far too much upper abdominal skin laxity for that variation to work. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.