You need complete muscle repair. This can be done through a mini tummy tuck incision!
Hello from Miami!
Thank you for your message and your photo. From your history and description of your tummy, it sounds like you would benefit from a complete muscle repair- a repair above AND below the belly button.
Although somewhat more difficult than a regular tummy tuck, this can be done through the small incision of a mini tummy tuck. We have performed this complete muscle repair through inicisions as small as 5.5 inches.
The best way to find out what procedure would be best for you is a personal consultation where the surgeon can examine you, assess the looseness of your muscle and skin and review your options with you. Be sure you work with a board certified plastic surgeon with a great deal of experience in body contouring and the wide variety of tummy tuck techniques.
You need a full tummy tuck for your best result.
From your photograph and your description, you have not only an umbilical hernia, but also fairly broad diastasis (stretching and widening) of your rectus sheath (the fascia or "gristle" that envelops the rectus or 6-pack muscles) that extends well above your umbilicus. You also have enough loose skin (or WILL, once the diastasis is repaired) that both endoscopic and mini tummy tucks will fail to adequately address.
I must respectfully state that yours is not even a "borderline" case or a "close call!" You require a full tummy tuck for the best cosmetic result! I agree with Dr. Rand's assessment of the other two doctors' advice. Sometimes it's a case of trying to say what they think you want to hear, but it could also be a case of "If all you have is a hammer, then everything is a nail." The doctor suggesting a mini may not be a fully-trained ABPS-certified plastic surgeon, and capable or comfortable only with a mini (perhaps this is not even a hospital or accredited surgical center case?), and the doctor suggesting an endoscopic approach may be trying to accomplish too much with a limited-application technique (but probably is a fully-qualified plastic surgeon, perhaps a younger one?) Either way, I believe you will waste money and be quite disappointed with anything less than a full tummy tuck with hernia repair and diastasis plication (muscle repair or fascial repair). Get another consultation or two if you have any doubts. Best wishes!
Best abdominoplasty technique for you
It seems, from your picture, that you do not need a full tummy tuck. You don't have enough laxity above the belly button. It can be difficult to appreciate the amount of loose skin you have below the belly button in a picture like the one you posted. If you have significant skin below the belly button, then mini-abdominoplasty with plication of the muscles of the upper abdomen should be done. If you have NO loose skin, then you can do a endoscopic type of abdominoplasty where just the muscles are tightened.
For your situation, you will most likely get the result you are looking for from a full tummy tuck. This allows for the best repair of the muscles as well as removing all the excessive skin. A mini will not address upper abdominal laxity and the endoscopic is only for muscle repair without skin removal.
You need a full tummy tuck
You are the a good candidate for full tummy tuck. You have sever diastesis and the rectus muscle should be repaired all the way up to xiphoid. Your have higher risk of belly button loss.
Full tummy tuck is your best option
From your history and the photos you provided, I think full tummy tuck with repair of the umbilical hernia would be your best option. Mini TT will not tighten the muscles and will leasve you with a bulge that you will not like.
Full tummy tuck for most patients.
Your instincts are correct: anything less than a full tummy tuck in your situation is not going to give you complete correction of your problems. Your umbilical hernia would be corrected at the same time. Be sure to go to a Board Certified Plastic Surgeon and look at results of his/her past patients with similar problems as yours.
Three different techniques can be used in performing a tummy tuck: skin removal, liposuction, and muscle wall plication. What you need is dependent upon what you have and what you want to accomplish. An endoscopic abdominoplasty can tighten the muscle wall from pubis to xyphoid as well as reduce fat volume with liposuction. A miniabdominoplasty does the same but also removes a small amount of skin in the lower abdomen. A full abdominoplasty does the same but removes a large amount of skin from pubic region to above the belly button. And finally a reverse abdominoplasty removes skin from under the breasts and can combine muscle tightening with liposuction. Hope this helps. To learn more visit our blog on our website.
Only a full abdominoplasty will help.
Endoscopic abdominoplasty does not work and I don't know anyone doing it. Mini will not correct upper diastasis.
A full tummy tuck should fix all of your problems and I am sure you have plenty of excess skin. None of the other two will fix everything.