Thank you for your question regarding what to do about sagging skin underneath the breast area after significant weight loss. Congratulations on your weight loss. During a tummy tuck, an incision is made in the lower abdomen. Dissection is carried up to the rib cage. This allows the tissue to be freed up and also allows the skin to be pulled up and thus tucked. The extent of the dissection over the ribs is either up to the bottom of the ribs or about two centimeters above the edge of the ribs. The areas that you are grabbing on the side of the breasts will not be affected by a tummy tuck. A further dissection is carried upon the abdomen to address these areas. The blood supply to the abdominal flap is compromised and the abdominal skin could die during a tummy tuck. Therefore, the area that you are concerned about may not be addressed during a tummy tuck. If you want the area on the side of the breast to be taken care of, you have two options. I would either suggest liposuction of the upper torso or a torsoplasty. A torsoplasty includes an incision from the armpit down the side of the chest or an incision across the back. Either of these procedures will take care of this area you are pinching. Another alternative may be a reverse tummy tuck where an incision is made underneath your breast. The problem with this on you is that it will not really address your main target, the lower abdomen. Nonetheless, discuss these options with your plastic surgeon. I hope this helps to answer your question regarding what to do with loose hanging skin under the bottom of the breast after significant weight loss and whether this area would be addressed during a traditional tummy tuck.
