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

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.

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

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