Alternative To Tummy Tuck With Muscle Repair? (photo)

I'm 29 5'4 125 lbs. Have two pregnancies 16 months apart the second pregnancy was twins. I have 3 finger speration of my stomach muscles. I have no extra skin or stretch marks below my navel, I do have a little extra skin above my navel. What is the best option for me. when I pull my skin towards my chest from my navel everthing looks good. It looks better to pull up then down.what options do i have. I would like to stay away from a full tummy tuck due to the look of the navel and scar.

Doctor Answers 14

Abdominoplasty with Umbilcial Float

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You are an ideal candidate for an abdominoplasty with an umbilical float.  This is a fairly common tummy tuck technique that I use about 25% of the time. There is NO UMBILICAL SCAR and the length of the scar is limited, the rectus abdominis muscles are also repaired.  I can't be sure, but it appears you may also have an umbilical hernia from the photograph, a physical examination would be necessary to confirm this.  The hernia can also be repaired with this technique. Here are the highlights of an ABDOMINOPLASTY WITH AN UMBILICAL FLOAT:

  • Low, very low, position of horizontal scar
  • Limited length of horizontal scar
  • No umbilical scar
  • Umbilicus (belly button) moves about one inch down
  • Umbilical hernia repair
  • Separation of rectus muscles repaired
  • C-Section scar removed
  • Small amount of skin removed from lower abdomen
  • Fat removal from entire abdomen including hips
  • Extra skin above navel pulled tight

You have great shape now and this procedure will make you look even better, probably 6-pack abds!!!  The scar will be completely hidden in any type of clothing, bathing suit, panty, thong, etc.

Call and shop around until you find a Board Certified Plastic Surgeon in your area with experience using this technique.  Also, before you undergo this procedure I would recommend not becoming pregnant again, as this would ruin the result of the procedure.  Good luck!

Omaha Plastic Surgeon
4.9 out of 5 stars 83 reviews

Alternative To Tummy Tuck With Muscle Repair? (photo)

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Thanks for the posted photos. My recommendations based only on photos and your posted information is a short scar full tummy tuck with aggressive recti plication. Best to see a few boarded PSs in your area to discuss in detail. 

Best tummy tuck for me

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I would probably recommend a modified abdominoplasty with a short scar above the pubic hair region and a small skin resection just to clean up above the c section scar and then do a muscle repair thru that limited scar.

Rick Rosen, MD
Norwalk Plastic Surgeon
4.8 out of 5 stars 28 reviews

Options for better looking abdomen

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Your options for a better looking abdomen depend largely on your desires and goals.  These options include:

1) Liposuction plus mini tummy tuck

2) Mini tummy tuck plus endoscopic muscle tightening

3) Mini tummy tuck plus reverse tummy tuck

4) Full tummy tuck

I suspect many patients including yourself might prefer just a small mini tummy tuck and liposuction.  Doing so would not improve the appearence of your belly button and would not address the abdominal muscle.  The second option would be a small mini tummy tuck with endoscopic muscle plication.  This would also improve the abdominal muscle issue but would still leave the belly button without rejuvenation.  The third option would be mini tummy tuck plus reverse abdominoplasty.  This would correct all of the issues but requires a plastic surgeon that is experienced in doing the reverse tummy tuck.  Finally, the last option is a full tummy tuck.  Since you do not have a lot of excess skin you would likely end up having the location of your current belly button close as a small vertical incision in the midline somewhere between the new belly button location and the horizontal incision at the bottom.

All the best,

Dr Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 reviews

Floating Abdominoplasty (FAB)

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Floating abdominoplasty uses a small incision in the lower abdomen to allow for the tummy to be tightened and shaped. No incision around the belly button is needed. Through the incision, excess skin is removed and muscles can be tightened. The belly button is temporarily detached during the surgery to allow for this. You experience muscle tightening from sternum to pubic area. After the belly button is reattached (and moved down if necessary) the incisions are sutured. Liposuction can be performed if necessary to eliminate excess fat.

Please see an experienced board certified plastic surgeon for a physical examination to determine which treatment would be most suitable. A floating abdominoplasty may help you. Good luck.

Mini tummy tuck with abdomenal tightening

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I would recommend a mini-tummy tuck, diastasis repair throught the mini tummy tuck access with tapering lipocontouring of the abdomen and an unbilicoplasty to improve the appearance of your umbilicus.  The scar would not be much different from what you have now and it would leave you with a nice flat belly.  I would steer aweay from reberse tummy tuck as it will ruin the appearance of your breasts over time.  I hope this helps!


All the best,


Rian A. Maercks M.D.

Choosing Between Types of Tummy Tucks

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Yours is a common situation in which you don't have enough of an abdominal problem (loose skin) to justify the scar from a full tummy tuck  and a partial or mini-tummy tuck would probably leave you a little wanting. (better but not perfect) In these cases, I think the patient's attitude towards the scar in the determining factor. It is a choice between which you would despise more...a long horizontal scar and a belly button scar but with the most flat and tight stomach that you can get or a small low horizontal scar and no bellybutton scar but with some residual loose skin around the bellybutton. In either case, a full muscle repair would be done.

Answer to question regarding abdominoplasty or not

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Despite the pregnancies you have maintained a reasonably good abdominal contour.  This makes the decision to proceed with an abdominoplasty more difficult.  As you are aware, an abdominoplasty will remove excess skin/fat and also tighten your abdominal muscles.  The muscle separation that you mention will not improve without surgery.  Your options, in my opinion, are as follows:

1. Do nothing and be thankful that you have maintained a fairly well-shaped abdomen.  If the C-section scar bothers you a revision could be completed.

2. Do a "mini-tummy tuck" with the primary goal being to tighten the diastasis.  The rectus muscles can be plicated/tightened all the way up to the xiphoid (sternum) through a small incision, although endoscopic assistance is sometimes required.  This approach would only remove a small amount of skin and should not be expected to significantly improve the skin laxity.  This approach is used primarily to address the "pouch" or looseness in the abdomen from the diastasis.  Lowering or "floating" of the umbilicus is not something that I would recommend.

3. Do a full tummy tuck.  This would address the loose skin and the loose muscles.  It does, however, leave scars around the umbilicus and in the lower abdomen.  Only you can decide if this is a reasonable trade-off.

Good luck.  Be sure that you wait a minimum of 6 months after your last pregnancy before making any decisions and undergoing surgery.

Eric T. Emerson, MD, FACS
Charlotte Plastic Surgeon
4.7 out of 5 stars 29 reviews

Tummy tuck without umbilical scars

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Often after pregnancy we see a significant diastasis or separation of the abdominal muscles, and only modest skin laxity. In our office, a mini tummy tuck, one without an umbilical scar, will allow correction of the muscle from chest to the c-section scar and reduce the limited skin laxity only. Mini tummy tuck means different things in different practices, so ask questions carefully.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Mini or full tummy tuck?

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Thank you for the question and pictures.  Given your history you should be proud of the appearance of your abdomen.

Unfortunately, you won't like my answer but I think you have 2 choices:

1. Do nothing surgically  and accept a nice looking abdomen that you have maintained despite a twin pregnancy.

2. Have a full tummy tuck operation  choosing  your surgeon carefully to achieve the best possible umbilical and abdominal scar possible.

I think in your quest to avoid scars you will meet surgeons who will offer you a mini tummy tuck operation...In my opinion, the mini tummy talk is an  operation that  produces very limited results and is very rarely indicated. It involves a shorter incision but does not address the majority of the abdominal wall issues present for most patients who present consultation. For example, the area of skin excised is quite small. The abdominal wall musculature is addressed below the umbilicus leaving the upper number wall potentially lax. The appearance of the umbilicus is not necessarily addressed sufficiently.

For most patients who have had pregnancies and/or weight loss a full abdominoplasty is necessary to achieve the desired results. Of course, there are downsides (including a longer scar and probably a longer recovery time) but for most patients the benefits outweigh the downsides. It is not unusual to see patients who've had mini tummy tuck  surgery present for  revisionary surgery.
It is important  for patients seeking abdominal contouring surgery to work with a well experienced board-certified plastic surgeon to obtain advice (based on good ethics and judgment) to  improve  their chances of a successful outcome and minimize the need for further surgery.

I hope this helps.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.