Seattle girl asks: abdominoplasty only option? (photos)

Post 3 pregnancies, last one four+ years ago, no more in future. Regular exerciser and eat well. I can see remnants of nice belly there but no matter what I do it remains flabby and pouchy (being short torso'd doesn't help). I have diastasis recti also. Is TT only option? Mini TT no go? How low/small could scar be if I'm short torso'd? Thx!

Doctor Answers 9

A candidate for abdominoplasty

Thank you for the question and photos. Based on the information you provided, you seem to be an excellent candidate for a full tummy tuck. Even when your healthy diet and vigorous exercise fail to do the trick, a tummy tuck will deliver tangible and highly impressive results. A mini tummy tuck may be useful if laxity and excess skin are concentrated below your navel. However, if you desire a thorough correction of muscle separation, flabby skin, and bulging of the upper abdomen, then a full tummy tuck provides the most effective solution. An in-person examination with a board-certified plastic surgeon is always the best way to assess your needs and obtain a reliable medical advice. Best of luck! Dr. Michael Omidi.

Beverly Hills Plastic Surgeon
5.0 out of 5 stars 92 reviews

A tummy tuck would be needed with your history of pregnancies and diastasis

but you could probably get by with an extended mini-tuck rather than a full abdominoplasty but surgeons use terms that mean different things so make sure you are getting what you want... you have extra skin and that must be excised, you have diastasis and that should be repaired,  and if you have excess fat, that should be suctioned and all of this is included in my mini-tuck.  Would strongly suggest you have your belly button floated as well.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Seattle girl asks: abdominoplasty only option?

You look like you are in good shape but no diet or exercise will tighten your skin, remove your stretch marks and bring the separated muscles back together.  A tummy tuck will do those things.  The trade off is a bikini line scar.  You are going to be very tempted to go with a mini tummy tuck and I would caution you about that.  Based on your photos, I think a mini would compromise your long turn results.  I've been in practice 25 years now (can't believe I'm that old!) and have had to convert a number of my minis from years ago to full tummy tucks.  I have learned (the hard way, of course) that very, very few patients are best served with a mini.  Also, I do not obsess about scar length.  Restricting the length of the scar can compromise the contour.  Scars fade.  Suboptimal contour persists.  Good job staying in such great shape with three young children.  It can't be easy!

Lisa Lynn Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 72 reviews

Seattle girl asks: abdominoplasty only option

I have to agree with the full tummy tuck option as being your best option. I believe doing a min tummy tuck would leave the upper abdomen skin more loose than the lower and also would not allow the diastasis repair from the rib cage to the belly button to be performed. As to the length of the scar, that is determined by the amount of skin that needs to be removed. The more skin that needs removing results in a longer scar.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews

Seattle girl asks: abdominoplasty only option?

Thank you for your question and photos. Based on the photos, you will need a full tummy tuck with a modified technique. I prefer to use the VASER for body sculpting at the time of the TT. I place my incision at the level of the pubic bone, not much longer than a C-section scar and with special instrumentation, the diasteis needs to be fixed from the breast bone to the pubic bone. See a board certified plastic surgeon experienced in advanced body sculpting techniques for an in person consultation/evaluation. Good luck.

George Marosan, MD
Bellevue Plastic Surgeon
4.8 out of 5 stars 38 reviews

How to choose the right type of tummy tuck

Given the presence of stretch marks and likely diastasis, you will get the best result with a tummy tuck. There are several variations on this however, so a consultation is the best way to determine the best option for you. It may be a mini tummy tuck, mini with umbilical float, full tummy tuck with T-closure, and so forth. The link below has more detailed descriptions of these.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 52 reviews

Seattle girl asks: abdominoplasty only option?

Thank you for the question and pictures. You have done a nice job demonstrating your concerns.  In my practice, I would offer you a full tummy tuck operation;  any lesser operation, including mini tummy tuck surgery will likely leave you with an outcome that you will not be pleased with.
Generally speaking, the “ideal” patient for tummy tuck surgery is one who has completed pregnancies, is psycho socially/emotionally/financially stable, has an excellent social support system surrounding him/her, is capable of arranging enough recovery time, does not smoke and who has reached a long-term stable weight.
 In my opinion, the mini tummy tuck 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 the vast majority of patients who have had pregnancies and/or weight loss a full abdominoplasty is necessary to achieve the desired results.   When the time is right, seek consultation with board-certified plastic surgeons who can demonstrate significant experience helping patients achieve the types of outcomes you would be pleased with.   You may find the attached link and video, dedicated to tummy tuck surgery concerns, helpful to you as you learn more. Best wishes. 

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Seattle girl asks: abdominoplasty only option?

Thank you for the question.A diastasis recti is fixed during a tummy tuck procedure. When deciding whether to do a mini or full tummy tuck it's important to see where the excess skin, and diastasis recti, are located. Most women who have had several pregnancies do better with a full tummy tuck, because it flattens the abdominal wall and removes excess skin above and below the belly button. A mini tummy tuck only flattens the tummy below the belly button and removes less skin. A mini tummy tuck performed in the wrong patient can leave their lower tummy looking flat, but leaves a bulge at the top of their abdomen. And in person examination is needed to give definitive recommendations, but it appears that you would benefit from a full tummy tuck operation.Patient to see board-certified plastic surgeons anytime you're are considering body contouring surgery.

Austin Hayes, MD
Portland Plastic Surgeon
5.0 out of 5 stars 32 reviews

Abdominoplasty only option?

There are a variety of tummy tucks that can produce a good cosmetic result in the appropriate patient: a mini tummy tuck, a modified with an umbilical float, or a variety of a full abdominoplasty, all of which may, or may not, include tightening of the muscle and liposuction. Generally if there is significant loose skin above the umbilicus (belly button), a full tummy tuck will result in a greater correction and better outcome.  The mini has a limited transverse low scar whereas the… SHOW MORE full tuck has a longer transverse scar  and an additional scar around the belly button. The low transverse scar of both types of tummy tucks can be placed to be hidden by a bathing suit bottom. Keep in mind that following the advice from a surgeon on this  or any other website who proposes to tell you what to do based on two dimensional photos without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS)  that you trust and are comfortable with. You should discuss your concerns with that surgeon in person. Robert Singer, MD  FACS La Jolla, California  

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

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.