Creepy crepey skin and the unrelenting attack of gravity! Could I be a good candidate for a reverse tummy tuck? (Photos)

Thank you for sharing your story and goals so openly. It’s very common to feel this way after pregnancy, prior surgery, and natural changes over time, and your concerns are all valid and understandable.
For your abdomen, a reverse tummy tuck can be an option, especially for patients who already have upper breast scars that could potentially be used. That said, it is a more specialized operation, and the improvements are generally limited to the upper abdomen. In your case, with rippling from prior liposuction and some overall skin laxity, I would want to carefully evaluate whether a reverse approach would truly give you the smooth, natural result you’re looking for, or if combining fat transfer with skin tightening might be a better option.
For your breasts, after a prior lift, it’s very possible to refine the shape with a revision and add gentle fullness using fat transfer from areas like the flanks or buttocks. Fat can restore softness and contour, but the increase is usually subtle. If you’d like more reliable upper pole fullness, an implant may still be worth discussing in combination with a revision.
For your arms, mild laxity in the upper arms and bra line area can sometimes be treated with less invasive approaches (liposuction with skin tightening or energy-based devices), while more advanced cases benefit from a surgical lift. From your description, it sounds like you may be somewhere in between, so we’d review all of your options together.
You have realistic expectations and are open to a tailored plan, which is the ideal mindset. At consultation, I’d assess your skin quality, tissue elasticity, and proportions, then design a strategy that gives you a smoother, more youthful contour while keeping scars as minimal as possible.
Warm regards,Dr. Sibel Atalay, MDBoard-Certified Plastic Surgeon

Hello, and thank you for your question regarding creepy, crepy skin, the relentless attack of gravity, and whether you’d be a good candidate for reverse tummy tuck. Thank you for your history and your pictures. Based on the pictures you provided and not a physical examination, I think you would be a candidate for a reverse tummy tuck. Most of your excess skin is above the belly button. If these abdominal skin rolls were below the belly button, you would benefit more from the traditional horizontal or even high-lateral tension tummy tuck, or abdominoplasty. Most of your skin is loose above the belly button; therefore, the reverse tummy tuck may be the ideal abdominal surgery for you. During your reverse tummy tuck, you could do liposuction of the flanks and buttocks and transfer some of the fat to your breasts. You did not include pictures of the arms, so I am unable to comment on the arms. However, you could undergo a brachioplasty, arm lift, or arm reduction. There are many different types of arm reductions, including the crescent, mini, modified, longitudinal to the elbow, and complete to the wrist. Based on your age and your skin after liposuction on your abdomen, most plastic surgeons would probably suggest a formal arm lift rather than just arm liposuction. Therefore, most plastic surgeons would recommend a reverse tummy tuck to include fat transfer from the flanks and buttocks to the breast. And you may also consider an arm lift, arm reduction, or brachioplasty either at the same time or as a secondary surgery. Good luck. I hope I’ve answered your question regarding crepy, creepy skin, the honor landing, the relentless attack of gravity, and whether you’d be a good candidate for a reverse tummy tuck or abdominoplasty.
If you have any more questions regarding tummy tucks, abdominoplasties, or abdominal liposuction, contact an experienced plastic surgeon. Since the tummy tuck surgery is a big procedure, please seek an experienced, board-certified plastic surgeon with significant experience in performing tummy tucks. Do your research. If you cannot find an experienced tummy tuck plastic surgeon in your neighborhood, consider traveling out of state. Sincerely, Dr. Katzen, MD, MBA, FACS, FICS. ( Plastic Surgeon, President of the American Society of Bariatric 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, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

Based on your photos, I believe a traditional abdominoplasty with incision at the lower abdomen (well covered with traditional undergarments and bathing suits) would be best. It sounds like you might benefit from a revision of your breast lift, possibly small implants as well. Brachioplasty (arm lift or tuck) sounds like an option. All of this is, of course, contingent on a thorough consultation.

The gold standard for loose skin in the belly is a standard tummy tuck through a low abdominal incision. Patients that have breasts incisions can consider a reverse tummy tuck, but in my opinion, this can only effectively be done in patients that primarily have excess skin ABOVE their belly button. This looks to be the case for you; however, the pictures don't show your lower belly completely. If you have minimal skin excess in lower belly, and this area if flat, then yes you can consider a reverse tummy tuck which is done through infra-mammary incisions. For your breasts, you likely need a re-do lift to tighten and lift. Adding more volume likely won't lift sufficiently. And excess skin in arms, usually the best option to see the most significant results is an arm lift. The nonsurgical skin tightening options just dont make much of an improvement in my opinion. The drawback to the arm lift is the scar, which can you review pictures only to see if the benefits outweight the drawbacks in your case. good luck!

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

From the limited photos a standard tummy tuck would be the recommendation. This would remove the excess skin as well as correct abdominal wall separation. The result would be a flatter, tighter tummy. If a revision to the breast lift is needed that can often be combined with the tuck. A reverse tummy tuck is not as commonly done. You would need an in person evaluation to determine if you are a good candidate as well as learn the benefits and risks of the procedure.