Do I need a tummy tuck?

Question

I feel no matter how much I work out I don't get the six pack definition. Here are some pictures. Please give me advice on what are the things I need to consider with the surgeon to have a bikini tummy after the surgery. How can I avoid the vertical scar and have lower incision? How do I get more app definition?

Arif Eroglu, MD · Answer

Hello,
You have significant skin excess and horizontal skin lines in your upper abdominal area. There may also be looseness in your abdominal muscles. I recommend Lipoabdominoplasty for you. During this procedure, your surgeon can create an abdominal "six-pack" appearance using internal sutures. A properly performed Lipoabdominoplasty will not leave a vertical incision scar on the lower abdomen.

Carlos Mata, MD, MBA, FACS · Answer

Thank you for your question. Based on your photos, a tummy tuck would be the best option to have a bikini-ready abdomen. Despite your workout routine, the loose skin on your abdomen prevents your six-pack definition to be visible. A tummy tuck will remove this excess skin and gives you a smoother and tighter abdominal contour. Also, a tummy tuck can tighten the abdominal muscles if there is any muscle separation to provide a firmer, flatter appearance. Liposuction can also be added to remove any remaining stubborn fat in the abdominal area or waist, enhancing the definition of your abdominal muscles and creating a more sculpted look. The standard tummy tuck technique leaves a horizontal incision low on the abdomen, typically placed below the bikini line. Discuss with your surgeon the placement of the horizontal incision to ensure it is low enough to be easily hidden by swimwear.

J. Timothy Katzen, MD, FACS · Answer

Hello, and thank you for your question regarding whether you need a tummy tuck to achieve abdominal definition. Based on your history and pictures, you appear to have minimal excess abdominal skin or fat, and your main concern seems to be enhancing muscle definition rather than removing loose skin. In your case, a tummy tuck is likely unnecessary. Instead, most plastic surgeons would suggest VASER Hi-Definition liposuction to outline and enhance your abdominal muscles for a more defined look.

The VASER Hi-Definition liposuction technique targets specific areas, outlining the borders of the rectus abdominis muscle. Most women interested in this technique request definition along the central vertical line, called the linea alba, and sometimes the lateral lines, or semi-lunaris lines. This procedure can even add horizontal definition to create a toned, six-pack effect. The degree of definition can be tailored to your goals, making it essential to discuss these details with an experienced, board-certified plastic surgeon.

Good luck with your journey toward achieving your desired abdominal definition! I hope this answers your question regarding the best approach to a toned, bikini-ready look.

Sincerely,
Dr. J. Timothy Katzen, MD, FASMBS, FICS

Charleston Chua, MD · Answer

I use tummy tuck as a tool to improve two factors: the separation of your core muscles due to weight gain, pregnancy, or otherwise unexplained separation (rectus diastasis) and to remove excess skin. An examination by a surgeon will be able to determine if you have a rectus diastasis. We are now learning about the benefits of repairing rectus diastasis such as improved core muscle function, improved posture, less back pain, etc. If you do not have a rectus diastasis, then liposuction plus a skin tightening modality your surgeon is comfortable with will be sufficient. Finally, if you proceed with a tummy tuck then the surgeon can opt to perform a 'modern abdominoplasty' which keeps your belly button attached to your skin rather than your abdominal wall while pulling down on the skin in order to avoid making the incision around the belly button. This does force the belly button to sit lower than you're used to but an experienced surgeon will find a good balance between skin tightening and aesthetic belly button placement. New techniques with fat grafting into muscle under ultrasound guidance is emerging as a method in which to bulk up muscle, and in terms of your question, the six pack.

Emmanuel Mallol Cotes, MD · Answer

Thanks so much for your inquire,

Whether or not you "need" a tummy tuck is a personal choice based on your goals, comfort, and lifestyle. Here are some factors to consider that can help determine if a tummy tuck might benefit you.

If you loose skin  or abdominal weakness on your abdomen that doesn’t improve with diet or exercise, a tummy tuck can effectively remove this excess skin, creating a smoother, flatter appearance.

If your main concern is a small amount of fat rather than loose skin,  options like liposuction with skin tightening treatments may be effective. However, liposuction alone doesn’t address skin laxity or muscle separation.

If you’re leaning toward a tummy tuck, a consultation with a board-certified plastic surgeon can help assess your specific anatomy and goals.

Sincerely, Dr. Emmanuel Mallol

Leila Kasrai, MD, FRCSC · Answer

Based on your photos, it appears that you have loose skin above your belly button and possibly some excess fat. A full tummy tuck may be suitable as a result.

Robert M. Wald, Jr., MD · Answer

You appear to be a candidate for liposuction alone or possible mini tummy tuck with liposuction. it's difficult to determine exactly what is best for you without a in person evaluation. A tummy tuck removes all the skin and fat below the umbilicus and leaves a long horizontal scar low on your abdomen. If all this tissue can not be removed, a low vertical scar would be present. I would advise seeing a plastic surgeon and going over your options.

Chet Mays, MD · Answer

Thank you for your inquiry! We would love to meet with you in person to discuss your surgical options. Schedule a consultation with a Board-Certified Plastic Surgeon like myself to help you reach your goals and create a surgical plan.

Gerald Minniti, MD, FACS · Answer

Your bellybutton suggests your abdomen was larger at some point in your life; pregnancy or weight gain? You also appear to be fairly lean in the abdominal area. It is exceedingly difficult to give you good advice with photos alone. However, here are some reality hits. Although every surgeon and their mother will offer you some sort of 'skin tightening' modality with liposuction, whether it's Vaser, laser, Renuvion (J Plasma), or some off label adjunct like Morpheus 8 or Profound RF, these devices will never actually shrink or tighten skin more that a few millimeters. If a skin removal procedure is being considered (it requires some scar somewhere), the realities of those sorts of procedures need to be understood. A 'mini tuck' (with its alluring name designed to calm the prospective patient) is a surgery for very few people and can only tighten skin below the belly button. The reverse tummy tuck removes only upper abdominal skin, leaving a scar below the breasts (unlike the mini, it does improve the belly button appearance though). The full tuck is a transformative surgery addressing muscle, fat and skin. When done correctly, the long scar is low (2 inches from the labial cleft), but leaves a virtually invisible 1-2 inch vertical scar in most people. If you really live in Newport Beach, you are sitting in the lion's den of plastic surgery, but that doesn't mean you will find the best procedure for you (if there is one); too much competition among providers breed dishonesty to attract patients. Good luck.

Gary M. Horndeski, MD · Answer

Unfortunately, your photographs are somewhat limited. It would be nice to see the position of your breasts. It appears from some of the photographs that most of your excess skin is above the umbilicus with less below the umbilicus. It may be possible to do a breast lift which lifts your upper abdomen and do a mini tummy tuck to pull the lower abdomen. This may hide the scar lower in the pubic region and the scars around the breasts will be hidden in the inframammary fold. You may also want liposuction to give you more definition.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

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