Do I need a T-incision tummy tuck?

A few years ago, the only common options for patients were a mini tuck or a full tummy tuck.
Now, there are options for almost every anatomy and every problem.
The "T" tummy tuck is a lesser tummy tuck than a full tummy tuck, and is usually used for patients who want to have a low incision but don't have enough excess skin and fat to do a full tummy tuck without having a high incision. The "T" represents where the old belly button hole was. Sometimes it comes down to whether the patient would prefer a "T" incision with a very low incision, or a higher incision with no "T".
Other options include a reverse abdominoplasty done through breast lift incisions, endoscopic tummy tucks, a hybrid abdominoplasty (short incision, full tightening of the fascia), and several different mini-tucks, all depending on the nature and location of the excess skin and fascia.

Dear River,

Your situation raises an important question regarding the necessity of a T-incision for your tummy tuck procedure. A T-incision, often associated with a fleur-de-lis tummy tuck, is typically recommended for individuals who have undergone significant weight loss and have considerable amounts of both vertical and horizontal excess skin. This method can be quite effective for sculpting and defining the abdominal area more extensively than a traditional abdominoplasty, which primarily addresses horizontal excess skin.

Given your description as being in good shape with an hourglass figure, it's essential to clarify with your surgeon whether the T-incision recommendation aims to address excess skin and fat above the belly button in a manner that a standard tummy tuck might not. It's somewhat uncommon for patients who do not have a significant history of massive weight loss to require a fleur-de-lis abdominoplasty, but each case is unique.

It's crucial to understand the rationale behind your surgeon's recommendation, as a T-incision or fleur-de-lis abdominoplasty introduces a vertical scar, which some patients might find less desirable. I encourage you to seek additional opinions from other board-certified plastic surgeons. This will provide you with a broader perspective on the most appropriate procedure for your specific anatomical needs and aesthetic goals.

In many instances, my patients achieve excellent results with a full or extended tummy tuck, avoiding the need for a vertical scar while still obtaining a flat and contoured abdomen. Consulting with multiple surgeons will help ensure that the approach you choose aligns with your expectations and desired outcome.

Please feel free to reach out for further discussion or clarification on your options. Your satisfaction and understanding of the recommended surgical plan are paramount.

Sincerely,

Dr. Katzen, Plastic Surgeon

Thank you for your question. To provide a valid medical opinion I will need to see pictures of you body from different angles. I would suggest to be treated by board certified plastic surgeon with experience in this procedure, to get the best desired results.
Respectfully,Dr. Emmanuel Mallol Cotes.-

The fleur de
lis abdominoplasty removes excess skin in the transverse and vertical
dimensions.This leaves the patient with
a vertical scar.The full abdominoplasty
only removes excess skin in the vertical dimensions.The vast majority of patients who
require a vertical incision during abdominoplasty have undergone massive weight
loss.Occasionally, patients who already
have a vertical incision can benefit from this approach to avoid longer
transverse incisions.We rarely see patients outside of
these groups who require T incisions during abdominoplasty.It’s important to realize that no two
patients are ever exactly alike.For
this reason, it’s important to evaluate the amount of excess skin in both the
transverse and vertical dimensions.It’s
also important to evaluate the underlying muscle tone and the amount of
subcutaneous and intra-abdominal fat that’s present.In your case it’s virtually
impossible to make a specific recommendation without pictures or a physical
examination.For this reason, it’s
important to discuss your concerns with your plastic surgeon.In some cases, a second opinion may also be
helpful as well.

As the abdominoplasty procedure evolves the incision lines change and go back to some of the original techniques.  That is, not all tummy tuck patients are alike and sometimes a customized approach must be made to accommodate the patient and achieve the best cosmetic result.

The T incision is sometimes necessary to address significant horizontal laxity that some patients present with. Without a photo, its impossible to comment on your anatomy. However, if your surgeon feels that this extensive procedure is important for an optimal outcome, he probably knows what he's talking about.

An extended abdominoplasty that combines a vertical with a horizontal incision is primarily for patients with massive excess of skin with poor tone.  There are usually massive weight loss patients.  For almost all other patients, excellent results can be obtained through a horizontal incision across the lower abdomen.

As you can see from the detailed responses left by my qualified colleages, there are many options for abodminoplasty.
Fleur de lis (or French Lily) or Inverted T is called that because of its appearance.
Please understand that what is above your belly button now will not necessarily be thiere after a tummy tuck. In a traditional tummy tuck this area is often transposed down to the level of the pubis.
However, I am sure your surgeon chose this approach for a good reason and you may want to explore these in greater detail.
I general use the T incsion in patients with a pre-existing incision there or with patients who have so amany stretch marks that a scar there will barely be visible.
However where the two sides meet the pubic incision generally has a higher potential for delayed healing. If you pursue this approach, you should absolutely abandon smoking for a minimum of 4-6 weeks prior to your surgery.
In the end, I would defer to your surgeon's opinion because he had the benefit of examining you!
Hope this helps!

A 'T' incision may be used in several instances. One is in the massive weight loss patient in which there is too much skin laxity in both the vertical and horizontal dimensions.
Another instance where a 'T' incision may be indicated is in the thin patient with some skin excess (too much for a mini-abdominoplasty). The reason to add this additional 'T' closure of vertical closure in the midline is to close the original belly button skin opening that has now been pulled down lower.

Massive weight loss patients have excessive skin after they reach their weight plateau. In some patients, a typical lower incision abdominoplasty would not tighten the waistline so an alternative procedure can be performed in experienced hands. The surgery is named after the French Fleur de Lis, or triflower. This entails a vertical incision and a horizontal incision in order to tighten the waistline and reduce the abdominal bulge.
This can also be performed selectively in patients that have a midline incision from a previous surgery such as a gastric bypass. There are a lot of alternatives to tummy tucks and experience really counts in choosing the right incision with your plastic surgeon.