What can I do to enhance the appearance of my rib and underarm areas? (photos)

The only way to give you good results is to completely redo that tummy tuck. Way too much skin was left behind by your previous surgeon, you might even need to be converted to a fleur de lis tummy tuck (hard to tell from the photo). In addition your scar could use some improvements as well.

Hello
You seem to have both horizontal and vertical excess skin. You could have achieved better results with an FDL-type tummy tuck. Currently, I would first recommend Vaserlipo for your back and underarm areas. Afterwards, depending on the existing skin excess, a Back Lift can be done. For the excess fat and skin in your upper abdomen, a revision tummy tuck in the form of Lipoabdominoplasty can be performed.

You will need to wait at least 4-6 months to allow all of the tissues to soften and settle before planning on revision surgery. To enhance the appearance of your rib and underarm areas, a few surgical options could help address excess skin or fat. One option is a circumferential upper body lift and liposuction which extends your existing scars from your breast reduction around the back under the bra strap. This procedure removes loose skin and tightens the area, providing a smoother and more defined contour. This approach focuses on improving both the rib and underarm regions in a comprehensive way.


For the abdomen, there is skin laxity and excess fat, so a fleur-de-lis tummy tuck could be effective to remove excess skin both vertically and horizontally. Consulting with an experienced plastic surgeon will help you determine the best approach tailored to your specific needs and goals.


Dr. Krishna Vyas, MD, PhD, MHS
Harvard, Johns Hopkins, & Mayo Clinic Educated
Double Fellowship Trained
Aesthetic Plastic Surgeon
New York, New York

I completely understand your concerns—after a breast reduction and abdominoplasty, it’s common to notice changes in the rib and underarm areas that weren’t as visible before. Fat grafting can help create a smoother transition if there's hollowness or unevenness. If small pockets of fat are causing irregularities, a bit of liposuction can refine the shape. Treatments like Renuvion or BodyTite for skin laxity can improve tightness without additional surgery. Scar revision may also help if tightness or folds are an issue. Strengthening the obliques and upper body can subtly enhance definition and posture as well. You’re not alone in this—refinements after surgery are very common, and there are great options to help you feel more confident in your results.

From the posted photos a revision will be needed to address the excess fat and skin on the upper abdomen. A fleur de lis incision is best when there is a greater amount of skin laxity in this area. I've included a video that discusses various approaches for the tummy tuck.

Thank you for your question and including pictures. The best fix for both of your concerns is a circumferential upper body lift. This is done through your existing scars under your breasts, extending them around your back under your bra strap. The loose skin below this scar would then be pulled up and removed. You would also likely benefit from pulling the loose skin laterally and removed through a vertical scar. But, I would address this after the upper body lift to see if it is still needed.