Would a tummy tuck be the best procedure to give me permanent results? (Photo)

Question

Hi. I am 55 years old. I weigh 107 and I am 5ft tall. I have had 2 cesarean sections leading to lower abdomen adhered scar tissue and a shelf. I also have loose skin above the belly button. I am in great physical shape but no amount of exercise will help with the loose skin. What procedures will be best for permanent results. I have tried lasers and nothing works.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question and for providing your history and photo. Based on your photo and history, a tummy tuck (abdominoplasty) is an excellent procedure for addressing the concerns you’ve described, including the loose skin above the belly button and the adhered scar tissue from your cesarean sections.

During a tummy tuck, the excess skin and fat are removed, and the abdominal muscles are tightened, which will address the loose skin and create a smoother, more toned appearance. However, given your petite size and the amount of skin laxity, it’s important to note that you may not have enough excess skin to completely eliminate the previous position of your belly button. This means you will likely have a small vertical scar where your original belly button was, as it cannot be completely removed during the surgery. This is common for patients with less significant skin laxity, and your surgeon can strategically position the scar to minimize its visibility.

The benefits of a tummy tuck for your case include:

Smoothing the lower abdominal area: The shelf and adhered scar tissue from your cesarean sections will be corrected.
Tightening loose skin above the belly button: The tummy tuck will pull and flatten this area, which lasers and non-surgical options cannot achieve permanently.
Improved overall contour: Combined with muscle repair, this procedure will enhance your abdominal aesthetics and provide permanent results, provided you maintain a stable weight.
It’s crucial to consult with an experienced, board-certified plastic surgeon who can evaluate your anatomy in detail and create a tailored surgical plan. Your surgeon will ensure the best approach to minimize scars and optimize your results.

With your great physical shape and dedication to fitness, you are an excellent candidate for a tummy tuck, and this procedure will help you achieve the long-lasting results you’re looking for. Good luck with your transformation journey!

Sincerely,
Dr. Katzen

Chet Mays, MD · Answer

Thank you for your inquiry! You have excess abdominal skin making you a great candidate for an Abdominoplasty procedure at your current weight. We would love to see you in person and help you reach your goals. Schedule a consultation with a Board-Certified Plastic Surgeon like myself and we can create a surgical plan for you!

Arif Eroglu, MD · Answer

In patients with loose skin and stretch marks on the upper abdomen, finding an effective solution can be quite challenging. Given your situation, a full tummy tuck would be difficult to perform, while a mini tummy tuck would not provide the desired improvement in the upper abdomen. A reverse tummy tuck could help address some of the concerns in this area, but it may not fully resolve the issue. Treatments such as laser, radiofrequency (RF), or plasma will not deliver the expected results. Instead, I recommend a combination of PLA injections (such as Lanluma or Sculptra) and Thermage FLX, which can help improve skin quality and firmness in a less invasive way.

Leila Kasrai, MD, FRCSC · Answer

A tummy tuck would be the most effective procedure to give you the most predictable results for loose skin.

Luis Suarez, MD · Answer

Because you’ve had pregnancies in the past the best and only solution with having the best results is a tummy tuck, since you’re abdominal wall gets distended with pregnancies and their separation of muscles the only procedure that would successfully fix the area would be through skin removal and muscle repair you’re an excellent candidate for a traditional tummy tuck.

Daniel Barrett, MD · Answer

Dear Alli_20,

it is hard to tell for sure without an examination. 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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Ira H. Rex III, MD · Answer

I do not think this case is straightforward.  I would need to be able to examine you more closely.  The C-section scar is probably very easy to fix with excision and closure.  This would usually give a  nice flat result.  The loose skin above your bellybutton may be improved with an incision around your bellybutton and pulling the skin downward.  You may have to accept a vertical scar perhaps a few inches below the new bellybutton site and a longer scar about at the C-section site.  So you do have some options, but would need a good examination by a plastic surgeon and a discussion of your expectations.

Gary M. Horndeski, MD · Answer

Unfortunately, you have not provided photographs of your breasts. You may benefit from a breast lift. I recommend The Bellesoma Method to reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided and the nipple sensation (in 95)%) is maintained. This technique also pulls up the upper abdominal skin and will allow you to have a mini tummy tuck to revise your c-section scar. It does not appear you have enough skin for a full tummy tuck. I would need more photographs to give you a more accurate answer.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Rajaie Hazboun, MD, MBA · Answer

Thank you for posting your question here!My answer will be based on the limited information and pictures provided , for a detailed and personalized plan please consult with a plastic surgeon in person .
It is hard to tell based on this singular picture if you will require muscle plication and should you need it then a traditional tummy tuck will likely be the answer but keep in mind that since your belly button is high and you have little skin laxity in the lower abdomen you will likely end with a small vertical scar in addition to the lower scar and the stretch marks above your belly button will remain but the redundant skin will be pulled tighter. As for the skin redundancy above the umbilicus this can actually be dealt with through a reverse tummy tuck, that being said this will not remove all the stretch marks and will not address the shelf you have at the bottom .so there is always a trade off based on which surgery you pick , I would encourage you to discuss your options with your surgeon and come up with a plan that will address the issues that you consider a priority .I hope this helps, best of luck!

Azita Madjidi, MD, MS, FACS · Answer

Skin laxity will not improve by any surgery, redundant skin will. Stretch marks are a  tear in the elastic part of the skin. There is no treatment for stretch marks besides removing them. From the picture, your stretch marks are mostly above you umbilicus so even a tummy tuck will not make them go away. However, the skin may be pulled down and make the stretch marks less noticeable but at the price of a little vertical scar in the lower abdomen.

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