HELP! Mini tummy tuck vs full tummy tuck? Lollipop vs doughnut lift with implants?

Question

Currently consulting on these procedures. What might be the better option for me. I'm worried about "dog ears" and sonething called a "SpongeBob tummy tuck" - tummy tuck that results in a square like shape instead of an hour glass shape. I like my hips & booty. My goal would be to flatten my tummy and balance out my hips with a lift and implants.

W. John Bull, MD · Answer

I would need to see more photos from the side and with your arms down, but the procedures you have listed seem like options. Unless you have additional skin laxity I would think a mini tuck with liposuction and possibly some muscle plication would give you a flatter tummy and still maintain your curves. The goal is to make your curves better not eliminate them! I don't think anyone plans to do a SpongeBob tuck! I would make sure the surgeons you are seeing are board certified in plastic surgery and are comfortable performing these procedures. As far as your breasts are concerned, you do have options, if you want to restore more volume above the nipple, I think a periareolar mastopexy(doughnut lift) and implant is a good way to achieve that but only if the lift is less than 4 cm. If you need more than 4 cm, I would consider the lollipop lift, which can also be done with an implant if you want/need more volume. I find many women are interested in a little more volume and the only way to achieve this predictably is with an implant. Please talk to your surgeons and make sure you are comfortable with them as well.

Jed H. Horowitz, MD, FACS · Answer

Abdominoplasty will address loose skin, excess fat and muscle weakness “diastasis recti”. This weakness tends to enlarge the waist in many women. After pregnancy if your belly button has a bulge or sticks out, it may be due to an umbilical hernia. Both of these conditions are corrected during a Tummy Tuck, which will bring in your waist line. On the other hand if only a small amount of skin is redundant in the lower tummy you may only need a fairly simple “mini-tuck” rather than the more extensive standard Abdominoplasty – which corrects all the conditions noted above. I prefer to use a #shortscar technique, #LollipopScar or #DonutLift”  with breast augmentation rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant scarring.  The procedure is done on an outpatient basis under intravenous sedation and local or general anesthesia. As mentioned above there are a variety of techniques for these operations.  Lollipop lift (vertical lift), donut (periareola) lift, Benelli lift, crescent lift, anchor lift  (inverted T ). Most commonly, we prefer the lollipop or donut lift because of the shape, small scars and easier healing. Although the “anchor-shape” or inverted “T” incision is still more popular in the United States, it represents an older technique with extensive scarring and a less optimal result in many cases. These newer techniques are utilized in the vast majority of cases, the rare exception being extremely large breasts. The nipple-areola complex is repositioned higher, the excess skin is removed, and the breast is reshaped in a pleasing contour and in a more normal position.

Richard Baxter, MD · Answer

In general, a mini tummy tuck improves skin laxity only in the lower abdomen. It is hard to tell from the picture if you have any laxity above the belly button, so an in-person evaluation is necessary. A Benelli donut lift works well when only a minimal lift is needed, and works especially well with implants because the additional volume and projection counteract the tendency for the breast to flatten with that type of lift.

Stefan Mark Szczerba, MD · Answer

It's a bit hard to give you complete advice without seeing you in a arms down pose and from the side.  From what I can see on your photos, I'd recommend just implants on your breasts.  I am not sure a breast lift is needed and if it is needed after the implants are in you can decide that later.  A full TT versus a mini TT is usually a tough question in patients as thin as you and I recommend a visit in person with experienced plastic surgeon.  If you have just a little skin to pinch out I would do a miniTT.  If the estimated skin to remove with a miniTT leaves you wondering if more can be taken out, then I recommend a full because that will give you the tightest outcome.   Best Wishes!!

Robert W. Kessler, MD, FACS · Answer

Thank you for the photo. It is helpful in answering your question. Although raising your arms lifts the nipple position and makes the abdominal skin appear tighter as well. A formal evaluation will be necessary to give you a more accurate answer but from this image I believe a "lollipop" lift with an implant will give you a very nice result.As far as the tummy tuck is concerned your question is insightful. You have a very nice shape which can be enhanced with a high lateral tension abdominoplasty. This technique removes more skin from the side of the abdomen than the middle which gives more definition to the waist. I have to admit I have not heard of the Sponge Bob tummy tuck but i get the visual.You should do beautifully with these procedures. Seek out a board certified plastic surgeon to evaluate you and offer guidance.Good luck and I hope this was helpful.

Zachary Farris, MD, FACS · Answer

Thank you for your question.  A side view would be helpful as it's difficult to tell the degree of loose abdominal skin on your photo.  As for the breasts, implants with a limited lift (donut) would do.  Be sure to consult with an experienced board certified plastic surgeon.  Good luck!

Jaime Campos Leon, MD · Answer

Hello, thanks so much for your inquiry and for your picture, I would say that more than a picture is needed, or even better a physical examination in order to give you an accurate advice. For what is seen in your photo, you would do well with either a benelli or a lollipop incision for your breast lift. As for the tummy tuck, I always advise to have the full with helps to get rid of the extra skin on the sides too and your abdominal muscle wall would be constricted given you a smaller waist too. Of course it has to be combined with liposuction in order to ensure the hourglass shape that is too appealing.  Please make sure that you and your surgeon are on the same page. Don't forget to discuss all your concerns, options and expectations thoroughly. Have a safe and pleasant PS Journey!Respectfully,Dr. Jaime Campos-LeonBoard Certified Plastic Surgeon

Robert Singer, MD · Answer

There
are a variety of surgical procedures or combinations that can produce good
results in patients with abdominal laxity, depending on multiple factors
including their anatomy and degree of desired improvement: A mini tummy tuck,
an umbilical float modified tummy tuck, a full abdominoplasty. Each of these
can be performed with or without liposuction. They produce different degrees of
improvement.Similarly,  implants  with a "doughnut" (circumareolar) lift, and a  "lollipop" lift will produce different cosmetic results and  amounts of elevation of the drooping breast tissue..

Following the advice of anyone who would presume to tell
you  exactly what to do and how to do it based on a single photo with your arms up and more importantly without taking a full medical
history, examining you, feeling and assessing your tissue tone, discussing your
desired outcome and fully informing you about the pros and cons of each option
would not be in your best interest. Find a plastic surgeon that you are
comfortable with and one that you trust and listen to his or her advice. The
surgeon should be certified by the American Board of Plastic Surgery and
ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS).
You should discuss your concerns with that surgeon in person.

Robert Singer, MD  FACS

La Jolla, California

Derby Sang Caputo, MD · Answer

Thank you for your question and the photo. You are a good candidate for  tummy tuck and lipo, this can give you great curves. Best of luck

Arian Mowlavi, MD, FACS (license on probation) · Answer

You are a great candidate for a mini tummy tuck and lollipop (vertical mastopexy); You do not have stretch marks around your belly button that need to be removed thus eliminating need for a full tummy tuck; instead you need contouring of your flanks and sides with liposuction and a conservative tuck of your abdomen using a mini tummy tuck; the definitive breast lift and augmentation is provided by the lollipop (vertical mastopexy). Please see examples below.

HELP! Mini tummy tuck vs full tummy tuck? Lollipop vs doughnut lift with implants?

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