What are some possible procedures to remove upper abdominal fat roll? (photos)

Thank you for the question. It appears that a tummy tuck revision combined with liposuction is indicated. If you willing to have the vertical scar associated with a FDL, then FDL can remove excess skin and tighten you further. I wish you the best of luck. Vasileios Vasilakis, MD. Double board-certified, fellowship-trained plastic surgeon, Houston. TX.

Thank you for your question. Based on the picture you appear to be good candidate for a reverse Tummy tuck. I would suggest to be treated by board certified plastic surgeon with experience in this procedure, to get the best desired results.

Respectfully,
Dr. Emmanuel Mallol Cotes.-

Dear micaella13,
it is hard to tell for sure without an examination. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Just based on your photos, you probably would need the full vertical abdominoplasty to tighten all the areas. Just doing the vertical component won't remove all the lower excess skin.

From the photos it appears you are a candidate for a revision of your tummy tuck. It is best to wait 9-12 months after surgery before considering a revision. For a FDL typically the vertical and horizontal incisions would be involved in order to blend the contours. I encourage you to return to your surgeon for an evaluation and discussion of your options.

Some people form skinfold on their upper abdomen typically at the edge of the rib cage or just below their breast.

It represents connective tissue bands that anchor the skin down to muscle fascia.

It’s the same line of connective tissue that creates a folder in the mid back on many people.

During a tummy tuck the skin and fat layer is separated from the muscle wall. If this dissection or separation of tissue plans is done high enough to release the connective tissue bands than that skinfold gets treated as part of the tummy tuck. It requires continuing up onto the rib cage almost up to the inframammary fold.

If the tissue separation stops short of that than the upper skinfold is not incorporated with the skin tightening part of the procedure.

For patients who have skinfold on the upper abdomen the tummy tuck should ideally be modified with dissection going up higher onto the chest wall until the a band of connective tissue has been severed.

In your case you still have horizontal skin laxity. When that’s the case sometimes converting the procedure to including a midline scar or fleur-de-lis pattern is one option.

Different plastic surgeons have different ways of approaching these procedures.

Some of the horizontal skin laxity can be incorporated laterally in an extended or wraparound tummy tuck as an alternative to a fleur-de-lis.

In some patients a vertical incision is simply needed to get all of the vertical and horizontal skin laxity treated.

Lastly there is a procedure called the reverse tummy tuck some plastic surgeons use and this can treat the upper abdominal scan the fold.

I’m not sure I would consider that in your case but it is a potential option.

As is almost always the case the key is to find the right plastic surgeon and everything falls into place.

It’s certainly nice when patients can have one procedure and be done with it and not be left inquiring about secondary or revision procedures.

Follow up with your provider to see what he or she hast to say or alternatively schedule multiple in person consultations with other providers in your community to get a better assessment and better understanding of different treatment options.

Lastly it is important to recognize that the skin fold on your abdomen is not at all related to fat distribution but it is purely related to skin laxity and in particular skin laxity that creates a fold because of underlying connective tissue bands that anchor the skin to the muscle wall in an exact anatomic location. For that reason Liposuction will most likely not give her a significant improvement because the problem is related to skin laxity and a skinfold not an abnormal fat distribution.

Good luck,

Mats Hagstrom MD