Can You Lift the Tummy Instead of Doing a Tuck?

I'm 47 and very fit but have a bit of a pooch below my navel. I don't want a tummy tuck. I had two babies but my stomach went back to being flat. Just the past couple of years I've been getting a little bulge – I feel like it's being caused by gravity and fair, thin skin. If I pull up my skin from below my breasts my stomach is flat. Meanwhile, I would also like to have breast augmentation done. I keep thinking, couldn't the surgeon just pull up the skin when I get the BA? Is this possible?

Doctor Answers 10

Candidate for a modified abdominoplasty

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A reverse abdominoplasty is rarely done any more.  I have performed this from time to time on patients who already have incisions under their breasts, from a previous breast reduction.  It may be a good choice for a patient who has multiple medical problems, redundant fat above the umbilicus and not a good candidate for a normal abdominoplasty.  If your fullness is just below the umbilicus you would be a better candidate for a limited incision or modified skin only abdominoplasty.  

Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Lifting the Tummy? #tummytuck

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So this is really a question that can be better answered with you standing in front of me so I can assess your tummy. There are a multitude of reasons why or why not you may need or not need a full tummy tuck, vs mini tummy tuck or just liposuction. You separate the idea of lifting the tummy and tucking it. They are one and the same. So you either need a full tummy tuck with tightening of the abdominal muscles or a mini tummy tuck. The details of each should be explained by your surgeon. Unfortunately many times patients want a result without  surgery and incisions and it simply is just not possible in most cases. Seek a surgeon who is certified by the American Board of Plastic Surgery that you trust and like and they will help you decide what procedure best matches your desires based you your physical qualities. Best of luck!

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 53 reviews

Reverse Tummy Tuck

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The scars and results of the tummy tuck would not be as good as a traditional tummy tuck.  It would also probably detract from your breast augmentation results.  A tummy tuck is still the best option for abdominal skin laxity.  All the best.

Reverse tummy tuck is only indicated in patients with extraordinary amount of redundant skin after massive weight loss.

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The scars and abdominal contours after a reverse abdominoplasty where the incision is made across the chest under the breasts are always of poor quality relative to the formal lower abdominal abdominoplasty.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 41 reviews

Reverse tummy tuck

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Great question.  There are not many situations where the reverse tummy tuck works.  What you are describing might.  Your surgeon who examined you can tell you best.  

There are some things to consider.  You need to accept that the scar will likely extend across your chest, including the area between your breasts.  Even a great scar may not look ideal.  The scars across the sternum have a higher risk of becoming hypertrophic or keloid compared to other areas. It is possible that if you have very little skin excess in your upper abdomen that your surgeon could remove two separate portions leaving the central area untouched.  

The impact on your breast augmentation should also be considered.  The supportive tissue at the IMF (inframammary fold) that holds your implants from dropping down may be affected.  This could result in your implants shifting lower over time.  The tension from the reverse abdominoplasty may also pull on the IMF, making it look unusually low if not well anchored.

Most of the time I would imagine that a low, well hidden scar in the suprapubic region and small incisions on the breast for the implants would best hide your scars giving you a better overall result.  However, you might just be onto something.  Discuss your idea with your surgeon to find out.

Rodger Shortt, FRCSC
Toronto Plastic Surgeon
4.9 out of 5 stars 83 reviews

Reverse Tummy Tuck with Breast Augmentation

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What you are referring to is known as a reverse tummy tuck. That can be a reasonable choice when the loose skin is largely above the belly button. The only issue is the scar which must cross the sternum between the two breasts. But if that is not a major issue, then a reverse tummy tuck could be a good option for you. Having a breast augmentatin done at the same time is possible but there is the concern of having two open pockets across the inframmary fold line in which an implants sits in the upper pocket. It may be more prudent to do them separately. 

Reverse tummy tuck

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Yes, you can have the skin pulled upwards instead of downwards, but the scar crosses from right to left across your breast bone. It might show with deeper neckline clothing.  The scar fights gravity instead of going with gravity which often makes a worse scar.  Its also harder to reach the lowest part of the muscles to sew them to flatten out the "poochy" area.

As for doing a breast augmentation at the same time, it is not necessarily the best idea to use the same incision to place an implant and do another procedure like a tummy tuck (infections from the tummy tuck could pass to the implants for example).

Best to see a board certified plastic surgeon to discuss your options and customize just the right procedure for you. Good luck!

Deborah Ekstrom, MD
Worcester Plastic Surgeon
4.7 out of 5 stars 39 reviews

Reverse tummy tuck

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You ask a very important and astute question. The typical abdominoplasty where the abdominal oft tissue is displaced inferiorly is really not anatomically correct. During pregnancy, the abdominal soft tissues are stretched centrifugally with maximum stretch centrally. This means that correction of the stretched skin should really be downward below belly button and upwards above the belly button. A reverse tummy tuck does exactly that by pulling the soft tissues towards the breasts. The challenge is to hide the resulting scar under the breast and to prevent a gathering of the soft tissue between the two breasts. However, it is theoretically possible and you should address this option with your surgeon.

Robin T.W. Yuan, M.D.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Tummy tuck with Breast Augmentation

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A woman's body continues to change over time. There are several factors that can contribute to the "belly bulge." Pregnancy, flucutations in weight, and age all play a role. Externally, the skin continues to stretch and any excess fat may be noticeable. Internally, the muscles become more lax and are not as toned. The combination of lost muscle tone with loose skin results in the bulge.

If the bulge is confined to below the belly button and there is minimal to no muscle laxity, a mini tummy tuck may be all that is required. In women who have had previous pregnancies, the muscle is usually stretched and requires tightening. This internal corsett combined with skin tightening restores a woman's natural curves to achieve the coveted hour glass appearance.

Combination procedures such as tummy tuck with breast augmentation is very common. Assuming that you are healthy enough to undergo surgery, a combination procedure may be a good option. Consult with a board certified plastic surgeon to discuss your different options.

Scott Farber, MD
Boca Raton Plastic Surgeon
4.8 out of 5 stars 21 reviews

Reverse Tummy Tuck

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A tummy tuck is indicated for people with excess skin and fat of the belly, basically.  There are several ways the tummy tuck can be performed and each has a different indication.  These included the mini tummy tuck, full tummy tuck, and reverse tummy tuck.  It is impossible to know without a full history and physical examination which would best suit you.  Occasionally, when a woman has excess abdominal skin isolated to the area above the navel, a reverse tummy tuck can be performed to excise that excess skin via incisions that are hidden under the breasts similar in location to a breast lift incision.  A breast augmentation or other breast procedure may be able to be performed at the same time.  

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.