Mini Tummy Tuck with Liposuction Better Than Tummy Tuck Alone?

I had three pregnancies, the last being twins. I weigh 144 pounds and I'm 169cm tall. I am considering a Tummy Tuck and my surgeon suggests a Mini tummy tuck with a float belly button, as I have minimum loose skin above the belly button. He will do Liposuction above and below the belly button and the sides. Do you think this will give me a better result?

Doctor Answers 15

Personally, no.

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First, I don't like the "float' part. I have seen this and the umbilicus is very low and doesn't look good.

Next, a mini tummu tuck is designed to correct abdominal wall weakness only between the pubis and umbilicus. The incision is usually similar to a full tt.

For the record, a mini-tummy tuck + lipo + modified tummy tuck.

Based on your description, especially with large twins, I can't imagine that your muscle layer DOESN'T need repair above the umbilicus. Without the repair, you are at risk for bulging, even with the fat lipoed.

I would seek a second opinion and be sure that the doctor is certified by the American Board of Plastic Surgery.


Mini tummy tuck vs. full tummy tuck

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It is almost a certainty that after having had four children the deep layer ("muscles") called the fascia is ripped. This causes a bulge in the abdomen. Almost always, this bulge extends well above the belly button. For an optimal result, this bulge must be tightened.

The problem with the mini tuck is that the fascia is not tightened above the belly button. That creates a "mini tuck look" where the bottom of the abdomen is flat, and the top bulges out. This is an unappealing look approaching a deformity in many patients.

If minimal extra skin is present, a hybrid tummy tuck (R) can be performed. This involves full tightening of the fascia through a small lower abdominal incision.

If considerable skin excess is present, a full tummy tuck or a version of the full tummy tuck will be necessary. It would be the extraordinary patient who had four children who did not require a full tummy tuck for the best result.

We do not like the belly button float technique. It involves disconnecting the belly button and pulling it down until the skin is tight. It creates an odd flat, low belly button, an uncorrectable problem.

For the patient with medium amounts of extra skin, they will need to decide between a full tummy tuck with a low incision and a vertical scar, or a higher scar with no vertical component.

Lipo usually worsens skin looseness, so if loose skin is already present above the belly button and no tightening is performed, the loose skin will get worse. Lumpiness and a cellulite-type appearance is particularly a problem when lipo is performed with loose overlying skin.

On one hand, the vast array of procedures now available is daunting (not just mini tuck and full tummy tuck any more); however it does offer the patient many more choices, never a bad thing.

Remember always to shoot for the best possible result, not just the result that is cheaper, saves two or three days of recovery, is combined with a gimmick, etc. That is if you want the best possible result.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 194 reviews

Lipo and tummy tuck?

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In order for you to get rid of the stretch marks above your belly button you will require a full tummy tuck.  If you also have some abdominal laxity which will require sutures to be placed to tighten your core.  You certainly appear to be in good shape, but my recommendation is to go with a full tummy tuck.  I would speak with a plastic surgeon and relay your concern about limiting the length of the incision.  The only way to know if this is possible, is to meet with a plastic surgeon and have a full physical exam performed.  Also be careful about combining liposuction of the skin that will potentially be elevated of its blood supply. Good luck!

A mini tummy tuck with "floating " of the belly button can give the experienced surgeon good

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exposure to the upper abdoman, which you would need in order to address the laxity of the abdominal wall muscles after multiple childbirth.  Basically, the mini tuck removs less skin, focusing on the lower abdoman.  In combination with liposuction above the navel, a very nice result can be achieve.  If the muscles need to be repaired, the belly button can be detached at its deeper atrtachement so that the rectus muscles can be tightened all along the abdoman.  This would be necessary for someone who probably has loose muscles from prior pregnaancy.  Of course, if there is too much skin laxity, you might be better off with a full Abdominoplasty.  You would need to have a consultation with a surgeon skilled in these operations to help determine what the best option would be in your specific situation. 

Michael H. Rosenberg, MD
Mount Kisco Plastic Surgeon

Candidates for mini tummy tuck with liposuction

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Based on the information you provided, it is difficult to determine whether you are a good candidate for a mini tummy tuck with liposuction. A photo would be helpful to diagnose your issues and concerns. Many women who have experienced pregnancy, especially with twins, would benefit significantly from a full (standard) tummy tuck.  It is important that you understand the difference between the 2 procedures. A full tummy tuck involves repair of the rectus muscles which have been stretched due to pregnancy, as well as, removal of the loose excess tissue which results in a tightened abdomen area. This procedure provides a long lasting result and outcome which improves the overall body contour. A mini tummy tuck only involves improvement of the lower abdomen area below the belly button. This issue may result in a flattened lower portion of the abdomen, causing the upper abdomen to become the ultimate concern afterwards. Bulging of the muscles from diastasis may cause the patient to be dissapointed in the end. I would recommend consulting with a board certified plastic surgeon to discuss the best and safest possible options for you. Liposuction is usually included with a tummy tuck procedure to help improve body contours. It may depend on the quality of the skin and the severity and complexity of the case. Good luck!

Different types of tummy tucks for different women

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The type of tummy tuck really depends on your individual anatomy, but in general if you have had multiple pregnancies, the muscles of your abdominal wall have stretched and loosened, and should be tightened during your procedure. You surgeon needs to evaluate your skin, fat, and abdominal wall muscles, and then design the procedure that will work the best for you. This may very well be just a mini-tuck with liposuction, but my guess is that your muscles need to be addressed as well.

Good luck!

Dr. Salemy

Shahram Salemy, MD, FACS
Seattle Plastic Surgeon
4.9 out of 5 stars 155 reviews

Floating belly button is not great

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Most women who have had multiple kids are usually not great candidates for a mini-tummy tuck and liposuction. Often they have a diastasis( weakness) of the midline muscles that need to be treated from top to bottom. A mini will not give you exposure for the upper abdomen. Floating the belly button usually does not look great. They often look too low.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Customize your tummy tuck to your needs

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The fact that your plastic surgeon has evaluated you means his or her suggestion is probably right. In general, your history of 3 pregnancies and twins suggests that you need a procedure that:

  • tightens lax abdominal wall / muscle support;
  • removes loose skin, particularly from the lower abdomen, and
  • addresses any excess subcutaneous fat in the remainder of the abdomen.

If you need all three and the operation your surgeon plans helps all three, you're set.

A mini-abdominoplasty is not done the same way by all surgeons. The term doesn't tell us what will be addressed and how. It can include almost everything a standard abdominoplasty includes, but with a shorter scar. It can be much more limited. In my practice we try to adapt the procedure to each individual patient. Ask your surgeon for clarification if you're not sure.

Sutton Graham II, MD
Greenville Plastic Surgeon

Mini Tummy Tuck with Liposuction or Tummy Tuck only

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Allow me to join the chorus of my colleagues expressing extreme skepticism and urging caution.

We RARELY IF EVER see a woman who delivered 4 children and especially twins whose rectus abdominal muscles have not been splayed sideways as a result. I have never seen such a woman among the thousands I have examined.

If you undergo a mini tummy tuck without full correction of the muscle separation / diastasis the outcome will AT BEST be average but would commonly be below average and disappointing.

An umbilical float tummy tuck is usually done in women who do NOT need muscle repair and whose amount of skin looseness is confined to the lower portion of the tummy. Some of the looseness is pulled down and removed and the belly button is divided across its connection just above the muscles and moved lower. The problem with float procedures is that as the height of the belly button is reduced it begins to look abnormally and frankly, weird. This is seen especially when more than just a little bit of skin was removed thereby lowering the belly button significantly. (Imagine how preposterous a belly button located at the rim of your pants or panties would look...)

Since I did not examine you - I really cannot state with certainty that your surgeon is wrong. But - it would not hurt to confirm that this procedure was HIS/HER suggestion and not yours and if so get the opinion of ANOTHER plastic surgeon before proceeding.

I hope this was helpful.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Both a full tummy tuck and simultaneous liposuction of the abdomen will give you the best results

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It is very unlikely that any thing but a full abdominalplasty will give someone like you who has had three children and weights l45 pounds, a good result. I would encourage you to find a plastic surgeon who combines that with liposuction of the abdomen and fixation of the superficial fascia to the deep muscular fascia. This will minimize the discomfort, speed up your recovery and do away with the need for a drain. This is a newer procedure which I have been doing with much better, actually awesome results. This can be combined with liposuction of other areas and surgery of your breast at the same time.

Carl W. "Rick" Lentz III, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 17 reviews

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