Loose skin - reverse or TT or both? I really don't want the upper scar (Photos)

Thank you for your question regarding whether to choose a reverse tummy tuck, a traditional tummy tuck, or both, especially considering your concerns about the upper scar.

Based on the details you've provided, I think you'll do great with a traditional tummy tuck (TT) and you don't need a reverse tummy tuck. A standard tummy tuck should be sufficient to remove the excess skin and slim down your upper abdomen, achieving a smoother contour from the lower ribcage to the pelvis. This procedure focuses on tightening the abdominal muscles and removing excess skin and fat, which seems to align well with your goals of enhancing your figure while avoiding additional scars above the breasts, which are typical with a reverse tummy tuck.

Additionally, to enhance your results and give you an even more contoured figure, liposuction of the superior iliac crest (the upper pelvic area) can be an effective adjunct. This targeted liposuction can help refine the waistline and blend the contours seamlessly from your tummy tuck.

It's important to have a thorough consultation with a board-certified plastic surgeon who can assess you in person. Discuss your aesthetic goals and concerns, particularly about scarring and the extent of the procedures. A good surgeon will help you understand the potential outcomes and tailor the surgical plan to best suit your needs while minimizing unwanted scars.

Remember, every patient's body and surgical outcomes can vary, so choosing a surgeon who listens to your concerns and clearly explains what can realistically be achieved is crucial.

Sincerely,
Dr. Katzen

Dear misskpx,
based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. Flanks liposuction would give you a better shape. I would suggest you to consult a board-certified plastic surgeon because 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

In your case a full tummy tuck (traditional tummy tuck) might be the most suitable option. A full tummy tuck can address both the upper and lower abdominal areas, removing excess skin and tightening the abdomen.The surgeon who performed your liposuction suggests a combination of a reverse and mini tummy tuck, but if the upper scar is a significant concern for you, it's important to communicate this clearly. Each surgical approach has its pros and cons, and the key is to find a balance between achieving your aesthetic goals and the extent of surgical intervention you're comfortable with.

It's crucial to discuss your concerns and preferences in detail with a board-certified plastic surgeon, preferably in person, so they can provide a tailored recommendation based on your specific case, skin condition, and the results of your previous liposuction.

Hello, I am Dr. Salvador Garcia, if you have a lot of sagging from the shoulder upwards, the treatment is Reverse TT with a scar in the center of the bust, if you have sagging from the shoulder downwards, the treatment is a TT.

Thank you for your question and photos. You do have an athletic frame and would do very well with a full abdominoplasty. You already have a lower abdominal scar and this will be lowered to the pubic bone level and groin crease. Might need muscle plication, but this is determined through a physical examination. I agree with you, I would not proceed with a reverse abdominoplasty. See a board certified plastic surgeon experienced in advanced body sculpting techniques for an in person consultation/evaluation. Good luck.

I have had several cases where a previous lipo patient was converted into a full tummy tuck. A standard tummy tuck is the right choice. You don’t need a reverse tummy tuck

Don't do the reverse tummy tuck. Many times, the heavier abdominal tissue just pulls down on the breasts and this long scar is harder to hide. Better results are obtained with the full tummy tuck.

From your photos a standard tummy tuck is advised. This should adequately address the excess skin both above and below the belly button. It would not need to be combined with a reverse tummy tuck. See a few board certified plastic surgeons for consultations to listen to varying opinions.

I’m not sure why you had Liposuction first since your problems are primarily related to skin laxity.
Getting an understanding of your history in regards to potential weight loss or previous pregnancies would help put a lot of things into context.
I generally do not like patients to have liposuction before doing skin surgery. The liposuction creates a diffuse network of scar tissue that limits, pliability or stretchiness of the skin and fat layer. This will inherently limit how much skin can stretch and be successfully removed during the tummy tuck later.
I see no reason why you should have a reverse tummy tuck.
Do think you might need an extended tummy tuck because you have a significant amount of skin laxity and I’m guessing this skin laxity is not just limited to the front of your abdomen.
it would’ve been better to move forward with the tummy tuck first and if you still had an issue with subcutaneous fat, you could’ve had a touchup liposuction procedure.
Most likely you never needed liposuction at all and a tummy tuck by itself would’ve been the only operation you need.
I generally recommend patients have multiple in person, consultations before selecting a provider or scheduling surgery.
The importance of finding the most talented provider in your community is critical in order to increase the chances of having high-quality outcomes and minimizing the chance of disappointment or dissatisfaction.
During each consultation, ask each provider to open up their portfolio and show you their entire collection up before, and after pictures of previous patients, who had similar body characteristics to your own.
Inexperienced provider should have no difficulty showing you the before and after pictures of at least 50 previous patients.
Being shown a handful of pre-selected images, representing the best results of a providers career is insufficient to get a clear understanding of what average results look like in the hands of each provider or how many of these procedures they’ve actually done.
If your provider is recommending, have reverse, tummy tuck, ask them to show you all of the previous patients who had that procedure and see what the results look like.
Without seeing images of previous work, I would never consider scheduling surgery.
There’s no correct number of consultations needed to find the provider.
Being certified and plastic surgery with the years of experience does not mean somebody has mastered one single procedure, or is good and all procedures or any procedure.
There is a substantial difference in skill and experience among providers.
Having proper credentials is a bare minimum, but really says nothing about somebody’s inherent, skill or experience.
Considering how much variation there is among plastic surgeons I generally recommend patients consider having as many as five consultations, and sometimes more if the situation or procedure is complex or unusually difficult.
Recognize it is the patient responsibility to properly vent the provider.
I’m wondering if you were the one requesting liposuction or if your provider was the one encouraging you to have that procedure rather than a tummy tuck?
Perhaps you should have a few more consultations to help find the best provider or see what procedure comes up as being the one most providers recommend.
Reverse tummy tuck surgery is not a common operation for good reason.
Best,
Mats Hagstrom, MD