Can a regular tummy tuck tighten upper abdominal perfectly? Only reverse tummy tuck can?

Question

I read many about tummy tuck can only pull lower abdominal skin and upper abdomen still can look loose. Is this true ?

Anita Patel, MD, FACS · Answer

I think you're referring to a mini tummy tuck, not a full tummy tuck. Full tummy tucks tighten the abdominal skin from top to bottom, meaning from the lower border of your sternum in the middle, and the borders of the ribs along either side, all the way down to the pubic area below. Mini tummy tucks, on the other hand, by definition only tighten the skin below the belly button. Reverse tummy tucks are useful if there is only laxity above the belly button, and one does not mind having scars along the breast folds. Full tummy tucks are by far the most common, since the majority of patients have laxity above and below the belly button.

J. Timothy Katzen, MD, FACS · Answer

Dear Cauliflowerisaflower,

Thanks for your question about whether a standard tummy tuck can effectively tighten the upper abdomen. A typical tummy tuck does indeed address the entire abdomen, not just the lower part. During the procedure, we work on the tissue up to the sternum, which allows us to tighten skin on the lower and upper abdomen.

A reverse tummy tuck primarily targets loose skin in the upper abdomen and is usually only needed for specific cases, like significant weight loss or aging.

So yes, a regular tummy tuck should help tighten your upper abdomen, but always discuss your specific needs with your surgeon.

I hope this helps and I wish you the best.

Sincerely,

Dr. Katzen

Donald Groves, MD · Answer

Hello and thank you for your question. Of course, no procedure is perfect regardless of what anyone says, but the appropriately selected procedure can certainly be life-changing.
Regarding traditional abdominoplasty (tummy tuck)- this is by far the most common option to improve abdomen/trunk contour, and a great procedure for patients with excess abdominal skin and fat, especially when it is located in their lower and mid abdomen. During this procedure, the skin and underlying fat is dissected off from the underlying abdominal muscles, pulled down to make things tight, and the excess is resected (cut away) and everything is then sutured closed with a low horizontal scar that is hidden in the bikini line. Because the dissection is carried all the way up to the level of the ribs, this procedure also addresses excess skin and fat located centrally in the upper abdomen. 
Regarding a reverse abdominoplasty (reverse tummy tuck)- this procedure places the incision across your upper abdomen along both inframammary folds and connecting the two. It is beneficial for patients who have little to no lower abdomen and periumbilical adiposity (excess skin and fat), and whose main issue is just focal excess skin and especially subcutaneous fat in the upper abdomen, just below their ribs. It is great if combined with a breast procedure, to help minimize the scars. Most patients do not have their excess fat only located up by their ribs though, so this is rarely a reasonable option to achieve an aesthetic contour. 
With all that said, it is always difficult to provide tentative surgical recommendations, especially without any photos or personal description provided. To see what would be the best individualized option for you, I recommend for you to come see me or another plastic surgeon for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) for your specific case. I hope this helps!
Best wishes,
Dr. Donald Groves
Plastic Surgeon

Daniel Barrett, MD · Answer

Dear cauliflowerisaflower,
generally speaking, a tummy tuck can tighten upper abdominal muscles. 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

Gary M. Horndeski, MD · Answer

Yes, a tummy tuck can extend up to the costal margin and pull down the upper skin very well, not just the lower skin. If you are not planning future pregnancies, I recommend abdominoplasty with mesh reinforcement. The mesh creates a more hourglass figure by compressing the abdominal wall resulting in early satiety and helps maintain a reduced weight.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Anna Steve, MD · Answer

A full tummy tuck is the best option for treating excess skin above and below the belly button. A mini tuck is unable to treat excess skin above the belly button and a reverse tuck actually has less ability to remove excess skin above the belly button.

Ronald J. Edelson, MD · Answer

A reverse tummy tuck doesn’t work as well as a standard tummy tuck. I never do them. You’ll get a far better result with the standard tummy tuck

Camille Cash, MD · Answer

There are different options for a tummy tuck.  A mini tummy tuck will address the lower abdomen but does not correct the area above the belly button.  A standard tummy tuck will address both upper and lower abdomen for excess fat, skin, and abdominal wall laxity.  For patients with excessive loose skin in the upper abdomen, for example after major weight loss, a fleur de lis approach can be used.  I've included a video on the different approaches that I hope you find helpful.

Connie Hiers, MD, FACS · Answer

Without a lot of excess skin from weight loss being present, a regular tummy tuck does tighten the upper abdominal skin. The reverse tummy tuck sounds good but does not deliver results well. Sometimes, it just pulls down your breasts.  I would suggest avoiding that choice unless you find someone who actually does this procedure and has done a fair number with good results. Done poorly, it is a disaster.  If you have had a great deal of weight loss, the vertical component can be added to the tummy tuck to deal with excess upper abdominal tissue.

Mats Hagstrom, MD (license on probation) · Answer

The impact of a tummy tuck is dependent on how far a surgeon that takes the procedure. The process of separating the skin and fat layer from the underlying muscle facia is called undermining. During a mini tummy tuck undermining is typically done as high as a belly button. On a full tummy tuck undermining is typically done up to the rib cage. It’s possible to undermine all the way to the inframammary fold of the breast well on top of the ribs. Individuals who have skin laxity on the very upper part of their abdomen should have the procedure adjusted so that the skin is incorporated eliminating the need for a reverse tummy tuck.
It all depends on how the procedure is designed, which depends on what each person needs. There’s going to be inherited differences and different plastic surgeons have different levels of skill and experience, as well as philosophies levels of safety and conservativeness when it comes to surgery.
Sometimes attempts at getting perfect outcomes is a balancing act that can potentially increase complication rates.
The right plastic surgeon should be able to balance all of these variables correctly to give you a safe high-quality outcome based on a quality assessment understanding what the procedure can, and cannot accomplish for each individual. Sufficiently experienced provider should have enough before and after pictures to be able to show you multiple examples of previous patients, who had similar body characteristics to your own. An experienced plastic surgeon that should have hundreds or even thousands of before and after pictures to choose from and should have no difficulty showing of the before and after pictures of at least 50 previous patients. Should be no guessing game in regards to what results will look like when you’re in the hands of the right provider.
To find the right plastic surgeon I suggest patients and multiple in person consultations. 
Best,
Mats Hagstrom, MD.

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