Full or Reverse Tummy Tuck? (photo)

  Due to the fact that you probably already have the IMF scars from the breast reduction and you do have upper abdominal problems, you may be good candidate for reverse tummy tuck.  However, this can be a tricky procedure if the IMF is not strong enough to oppose the tension from the tummy flap.  This sometimes has to be reinforced to prevent IMF migration.  Find a plastic surgeon with ELITE credentials who performs breast lifts and tummy tucks hundreds of times a year.  Kenneth Hughes, MD Los Angeles, CA

When the lower abdominal skin is good but there is looseness in the upper part, a reverse tummy tuck might be an option. Since you already have a scar along the bottom of the breasts from the reduction, it would not add much of a new scar. It would have to be anchored to prevent the scar from pulling down.

The true reverse abdominoplasty is seldom done any more. The scar is simply too long and covers the center of the chest, where a low cut dress or swimwear might reveal the incision.

The reverse abdominoplasty done through the existing breast incisions is a weak, but occasionally helpful, technique.

Your pictures show looseness in the upper and lower abdomen, so it would be best to perform a full abdominoplasty or a modified full abdominoplasty, depending on existing incisions, umbilicus to pubis distance etc. that could be determined at the time of consultation.

I am not a huge fan of the reverse tummy tuck. I do not like a scar over the upper abdomen. If skin is truly your issue then just go for the traditional tummy tuck and I think you will be very happy with your result. The reverse tummy tuck is much more rare. I have only done that in patients who have prior scars in those areas from previous surgery. That is just my personal preference.

Hello 'lucygooseynomore', thanks for your question.  There are significant risks and very few indications for a reverse tummy tuck, where the incision is under your breasts and the soft tissue is elevated superiorly rather than pulled inferiorly.  For one, this pull acts against gravity, leading to a higher recurrence rate.  In addition, the results are more unpredictable, and can lead to a hypertrophic and noticeable scar between the breasts when wearing a swimsuit.  The reverse tummy tuck also does not do a good job of addressing soft tissue laxity or muscle stretch below the umbilicus, and can lead to devascularization and necrosis of soft tissue in patients who have had prior abdominal surgeries with lower scars.  The only time that I think a reverse tummy tuck would be of benefit is in a patient with predominantly upper abdominal laxity who has no prior lower abdominal surgical scars and does not mind having a potential scar in the cleavage region.  Based on your photo, I would recommend a traditional tummy tuck where the scar can at least be hidden by your pants or a bikini bottom.  Be sure to consult with a board-certified plastic surgeon who should be able to further discuss your options with you.  Good luck!

-Dr.92660

You may be one of the few asking who is a candidate for a reverse abdominoplasty, but without seeing a full abdomen photo, I can't really make a recommendation.

Many patients who ask about mini-TT are poor candidates because it addressed only the lower abdomen, and most patients have issues above and below the navel. 

I can see the laxity in the upper abdomen, and it may well be a sequella of the liposuction. If there are no problems involving the lower abdomen, a reverse TT may be a good choice, especially since you already have incisions over most of the area from the breast reduction. 

A proper recommendation can only be made at a consultation. All the best. 

Thank you for the question but you may consider posting additional photographs that show you your full abdomen, for better advice. Generally speaking, the “reverse” tummy tuck procedure  is very rarely performed because it addresses the upper abdominal wall area only and can be associated with problems such as distortion/lowering of the inframammary folds of the breasts. 

For more precise advice, seek consultation with well experienced board certified plastic surgeons in your area. Ask to see lots of examples of their work and communicate your goals clearly.

 Best wishes.

Reverse tummy tuck, while not as common can help tighten the upper abdomianl skin.  It appears that most of the irregularity is up near your ribs.  With the scarring that occurs from previous liposuction, the skin sometimes has a more difficult time "stretching out" and redraping.  A tummy tuck from below may have a tougher time stretching out that upper abdominal skin.  Best to have a consult with a board certified plastic surgeon to advise you after an examination.  I hope this information is helpful.

We don't use a reverse TT very often, but it sounds like you might be one of the few patients that can benefit from it. My reverse TT patients have all been extremely pleased with their results. The scar was originally designed to go under both breasts and then a scar connected those across the breastbone. I abandoned the part of the scar across the breast bone years ago and only use the two scars under the breasts. It is a fairly quick procedure with an easy recovery. Just make sure you choose a surgeon that has some experience in this unusual technique.