This is the most common question I receive when discussing abdominal rejuvenation. In order to explain the difference we first must understand the anatomy of the abdominal wall and what happens as we age and the changes that occur with weight gain. First the skin. The skin quality can range from normal to very lax and redundant. It can retain much of it's elasticity or it can be stretched and have lost the ability to retract. We see this loss of elasticity after considerable weight gain then loss or often after pregancy. The telltale signs of lax skin are stretch marks (stria). Simply put, these stria are tears in the deeper layer of the skin called the dermis. If there are a lot of stretch marks and the skin is loose, then there are few options other than to remove the excess skin. If we remove the fat beneath, the skin will not retract and will simply hang loose. Skin excision is required when the skin is loose and has lost it's elasticity. If this loose skin is mostly below the belly button then a mini tuck is appropriate. For those with loose and lax skin that extends above the belly button, a full tummy tuck would be a better option. Next we have to consider the deeper layer, the fat. If there is little fat and this is mostly located in the lower abodmen, then a mini tummy tuck is appropriate. If there is more diffusely located fat and there is a lot of fat above the belly button then in order to achieve a good result one would need either direct excision (full tummy tuck) or liposuction. If just using liposuction with loose or lax skin then there will be drooping of the skin. A full tummy tuck is preferred.Finally, we must consider the underlying muscles. With weight gain and with pregnancies there can be weakening of the abdominal wall muscles. There can even be changes that can not be corrected with exercise. Usually correction of these changes require a full tummy tuck. Your surgeon can help you decide after a physical examination. In general, if the general contour or shape of the abdomen is acceptable to you then there is likely little need to address the muscles and a mini is the right choice. In summary:A mini tummy tuck usually includes removal of some lower abdominal skin (below the belly button which remains in place), some fat and is done through a ~6-8 inch incision. It does not require drains after surgery and recovery is fast (~1 wk). Occasionally this can be done under local anesthesia, but most often it is done under general anesthesia.A full tummy tuck (abdominoplasty) involves removing considerable excess skin (usually well above the belly button), fat, tightening of the abdominal muscles and is performed through an incision from hip to hip. Most often it requires drains, although there are opportunities to avoid these. The recovery is usually 2-4 weeks and heavy lifting is avoided for 6 weeks. General anesthesia is required. Both procedures are performed as outpatient surgery. I hope this helps
