Help! Loose skin on upper Abdomen but too subtle for a TT? (Photo)

Question

Hi I have loose skin on my upper abdomen. I went for a mommy makeover consult with a great surgeon. He felt I was too thin and didn’t have enough laxity to justify such a huge operation. Fair and appreciate the honesty. So what can I do? He didn’t suggest any lasers. He leans more surgical. Does anyone have any suggestions. I am 40 this year and have a 2.5 year old and 11 month old. So I had back to back babies. 5’2 and 113 lbs. Thanks.

Gary M. Horndeski, MD · Answer

I have seen patients like you before. One reason is the breasts have moved down with the pregnancies. Unfortunately, you have not provided a photograph of your breasts. However, there is a breast lift technique I recommend called The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. This pulls the upper abdomen up and is somewhat similar to a reverse tummy tuck but it does not cross the midline.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

J. Timothy Katzen, MD, FACS · Answer

Hello AmericanBeautyQueen. Thank you for your question regarding the suitability of a tummy tuck for your condition.

From your detailed history and the photos provided, it is clear that your concern lies with loose skin on your upper abdomen, which is a common post-pregnancy issue. There are generally three primary indications for considering a tummy tuck, or abdominoplasty: excess abdominal skin, excess abdominal fat, and weakened or separated abdominal muscles (rectus diastasis).

Upon reviewing your situation, the primary issue appears to be excess skin. Abdominoplasty is indeed the most effective method for removing loose skin, which neither lasers nor liposuction can address adequately. In fact, liposuction might exacerbate the problem by removing fat and potentially worsening the skin's laxity without addressing the excess skin itself. Similarly, non-invasive treatments like CoolSculpting are not designed to tighten skin and thus would not be effective for your needs.

Given that your skin laxity results from genetic factors and the physical impacts of back-to-back pregnancies, a tummy tuck would be the recommended solution to achieve a firmer, more aesthetically pleasing abdominal profile.

I hope this response provides a clear understanding of why a tummy tuck is the most appropriate option for addressing your concerns about loose abdominal skin. If you have any more questions or need further clarification, feel free to ask.

Good luck as you consider this procedure. I'm here to help you navigate these decisions with your health and cosmetic goals in mind.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic Surgeon

Finny George, MD · Answer

Hi, thank you for sharing your question. Upper abdominal skin laxity can be treated with reverse abdominoplasty. Non-invasive methods are not likely to adequately address this amount of laxity, however, you can also consider radiofrequency skin tightening. An in person evaluation is always best to determine the ideal procedure for you.

Chet Mays, MD · Answer

Thank you for your inquiry!  An in-person consultation would allow me to determine what would be your best option.  We love to meet with you to discuss your concerns.  Schedule a consultation with a Board-Certified Plastic Surgery to help you reach your goals.

Daniel Barrett, MD · Answer

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

Arif Eroglu, MD · Answer

Hello; excess skin; localized to the upper abdomen. On the skin of the lower abdomen; there is no slack. Therefore, reverse tummy tuck; it would be much more suitable for you. With an incision made in both sub maternal folds; by removing only the skin from the upper abdomen field; the problem can be seriously solved. The biggest problem is; under the breasts and in the midline, on the sternum; remaining surgical scar.

Ramin Behmand, MD, FACS · Answer

This is an excellent question. There are two factors that pose challenges for a conventional tummy tuck in your case. Firstly, most of your excess skin is located in the upper abdomen, which wouldn't be a significant issue on its own if it weren't for the second concern. Secondly, your belly button is positioned relatively high. Considering these factors, a traditional tummy tuck would either result in a high-positioned scar or a vertical scar where the belly button was repositioned. Neither of these options would likely meet the goal of feeling comfortable showing your abdomen.

The factors that disqualify you from undergoing a traditional tummy tuck are precisely the reasons why a non-traditional approach is feasible for you. This alternative method involves performing a floating belly button tummy tuck. In this procedure, an incision is made low in the bikini line, excess skin is removed, and any muscle separation is addressed both above and below the belly button. Rather than detaching the belly button from the skin, it is released from underlying attachments and moved down approximately 1.5 to 2 inches, creating a natural position similar to where most people have their belly buttons. This technique eliminates the need for a scar around the belly button. Although some residual skin laxity may remain, the improvement is typically significant. Finally, the use of quilting sutures helps prevent upward migration of scars during the healing process.

Dr. B.

Payman Danielpour, MD, FACS · Answer

I think that you will benefit only from a tummy tuck.
I have performed many for mommies with the same body and they are thrilled.  Non invasive procedures will not work.

Best of luck

Harry T. Haramis, MD, FACS · Answer

Agree- you don’t have a lot of lax skin, everyone will get some skin bunching sitting or bending over, even after surgery.

A traditional tummy tuck would tighten skin, however, you may wind up with a higher horizontal scar or a low scar with a small T vertical extension.

In borderline cases, you have to weigh the scar and procedure vs results you desire and decide if it is worth it. Unfortunately, noninvasive skin tightening procedures are usually limited in results.

Further consultations are recommended to discuss your best options, expectations, etc.

Connie Hiers, MD, FACS · Answer

I would suggest considering minimally invasive skin tightening like Renuvion or BodyTite to improve your loose skin with tiny incisions and not a lot of down time.