Surgeon pushed for full tummy tuck. Is this wrong? (Photo)

Question

Hello, I’ve been told by a surgeon that I “absolutely need a full tummy tuck” because I’m a mother of two and I don’t have a csection scar. I’m not happy with this generalized assesmsnt. I’m on my ideal weight since a year (116lbs/5’2). I have very minor lower belly sagging, I only require minimal muscle repair in the lower abdomen and I’m not covered on stretch marks. My surgery goal is to “have a subtle athletic look with a flatter abdomen.” Is this not attainable with a smaller incision?

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding whether you need a full tummy tuck; let's examine the different types of tummy tucks. A full tummy tuck would require an incision, dissection to the sternum, muscle plication, mons lift, and removal of excess skin from the pubic region to above the belly button. This surgery would also include belly button reconstruction. Anything short of that is not a full tummy tuck. During a mini tummy tuck, sometimes muscle plication is performed. However, it is unlikely to be performed up to the sternum. During the mini tummy tuck, only a minimal amount of skin is removed from the pubic region up to the belly button—hybrids of full tummy tuck to the mini tummy tuck range in spectrum from the procedures mentioned above. Therefore, if you want muscle plication, you need some form of a tummy tuck, whether it's a minimum or complete tummy tuck. In my opinion, you would achieve the best results with a full tummy tuck with muscle plication, pubic lift, pubic reduction, elimination of excess skin and fat to the pubic region to the belly button, and umbilical reconstruction. That would yield your best results.
You will compromise your results if you cannot live with a tummy tuck scar. If you want a shorter scar, the results from your tummy tuck may not be as optimal. Another option to consider if you do not want a tummy tuck scar would be to undergo VASER Hi-Def Liposuction with Morpheus8 treatment. During VASER Hi-Def Liposuction with Morpheus8 excess abdominal fat Is removed. The VASER heats the skin from underneath, and the Morpheus8 maximizes skin contractility. This would avoid a tummy tuck incision, but it would not also eliminate skin and would not repair the muscle. However, the benefit of the VASER and Morpheus8 is there would be no tummy tuck scar. The choice is really up to you. I hope this helps answer your question regarding whether you need a full tummy tuck. 
VASER hi def abdominal sculpting or etching is a technically difficult procedure.  Your plastic surgeon must know his abdominal wall anatomy. When seeking revision VASER hi def abdominal etching, please seek an experienced, board certified plastic surgeon with significant experience performing the VASER hi def procedure.  Not all plastic surgeons own a VASER machine and most plastic surgeons do not perform the VASER hi def procedure. Do your research.  Make sure your selected plastic surgeon has performed at least 100 VASER hi def abdominal etching surgeries and have the before and after pictures to prove it.  Carefully examine their before and after pictures and check their reviews on RealSelf.   If you cannot find an experienced, VASER hi def plastic surgeon in your neighborhood, consider traveling, if you must. Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, Certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and ​member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.).)

William Andrade, MD · Answer

Hello, if your only concern is your lower abdomen, a mini tummy tuck may be all that is required to achieve your desired look.   There are many variations on mini tummy tuck procedures (whether the muscles are tightened, liposuction performed, scar length, pubic mound debunking, etc) so it is essential to get in-person opinions to determine your best option.  It is reasonable to get more than one surgical opinion before considering any operation.  Thank you for your question.

Tommaso Addona, MD · Answer

Thank you for your question.
In my opinion, a mini abdominoplasty will give you the best results. This procedure does as you described by correcting the muscles and eliminating the excess skin leaving you with a smooth, flatter contour. I recommend speaking with a board certified plastic surgeon to discuss your goals and concerns.

Leila Kasrai, MD, FRCSC · Answer

A full tummy tuck is recommended for patients with loose skin, excess fat and/or abdominal muscle separation in the above the belly button. While you don’t appear to have much excess fat, you do appear to have some loose skin above your belly button. That is why your surgeon may have recommended a full tummy tuck. However, you can always seek the opinion of another surgeon.

Stefan Mark Szczerba, MD · Answer

I think a "Mini" Tummy tuck may be great option for you!  Was the plastic surgeon familiar with or comfortable with the Mini option??  Obviously, with the full tummy tuck, you will get a really, really tight tummy however your pictures and description make it seem like a mini Tummy tuck could really accomplish most of what you are looking for.  Perhaps a second opinion is appropriate ??

John Michael Thomassen, MD · Answer

You have no business having a tummy tuck.  If anything a little lipo would suffice.  Why would placing a scar across your lower abdomen be indicated?

Daniel Barrett, MD · Answer

Dear rettedgui,
based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. Flanks liposuction would give you a better shape. I would suggest you to consult a board-certified plastic surgeon because 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

Finny George, MD · Answer

Hi, thank you for sharing your question. Based on the photos, you seem to have lower abdominal skin laxity which can be treated with a mini tummy tuck. I would also consider the addition of liposuction to create tone. I hope this helps.

Ronald J. Edelson, MD · Answer

As a plastic surgeon I have let patients talk me into a mini tummy tuck only to have them be dissatisfied with the result. Most plastic surgeons eventually learn this lesson. A mini tummy tuck is a compromise operation with a high dissatisfaction rate. Perhaps your surgeon has been burned by enough unhappy mini tummy tuck patients who are dissatisfied and blame the surgeon . It’s happened to me.