Lipo or Tummy Tuck with an Upside-down T?

I recently had a Tummy Tuck consultation with a plastic surgeon. I'm 5'3, 110 lbs, and I want a full Tummy Tuck, but might end up with an upside-down T. The other option was aggressive Liposuction on the abs and flanks, Vaser Liposuction, and lower skin excision. Which option is better for me? Why would I end up with an upside-down T?

Doctor Answers 10

Without a picture it is hard to give specific advice

Without a picture it is hard to give specific advice. With abodminoplasty, there are many options. The inverted or up-side-down T is only necessary if there is not enough loose skin between your belly button and the low incision. It is rarely necessary to do this. In most cases, this skin can be excised (removed) without much difficult. Good luck with your surgery.

New York Plastic Surgeon
4.9 out of 5 stars 75 reviews

There are many options available

When considering to proceed with a surgical procedure you must feel comfortable with the plan and the surgeon. From the sound of your question you are not excited and are looking for another option. Perhaps you should seek another opinion before making a decision. The inverted t incision works well for removing lots of excess skin however the trade off is the incision.

Other options include incisions up your sides or an incision completely around your body. It really depends upon your individual goals and your anatomy as well as what works in your plastic surgeons hands. I try and avoid the T; however, it does address mid line and flank skin laxity and if this is a concern it certainly is an option.

Charles Perry, MD
Sacramento Plastic Surgeon
4.6 out of 5 stars 24 reviews

Avoid "aggressive liposuction"

Overdone liposuction will potentially cause damage to you that is not correctable and won't tighten your skin as well as a tummy tuck.  There are many scar patterns availablefor tummy tucks and usually we try to avoid a vertical as often as possible. 

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Tight skin with long scar or less fat?

You are 5'3'' and weigh 110 pounds, so I assume your problem is not a big abdomen with a lot of fat.

I assume what you want is tight skin, but not having a lot of excess skin, the surgeon is worried the skin over the belly button will not reach all the way to the pubis.

Ask him how long the vertical scar will be. In my experience, I have found that 99% of the time, even when the skin does not reach the pubis, using the skin bordering the umbilicus as the "vertical element" of the upside down "T" is more than enough. This is only about an inch long, and can be excised later when the tissues relax.

The amount of tightening you will get from Vaser, or Laser lipo and a Mini Tummy Tuck will not make you happy. I know from experience, mine and others.

Ricardo L. Rodriguez, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 94 reviews

Different versions of the upside down T scar for abdominoplasty

There are a couple of things to consider here. Usually, when we refer to the upside down T scar, it is a vertical line extending all the way from the navel to the horizontal scar which is low. This is done only for massive weight loss patients, which doesn't sound like you. The other version is a short, vertically oriented scar from closing the hole where the belly button was. This occurs because most often we remove all of the skin between the navel and the pubic area, which means that the skin above the belly button has to stretch all the way down to cover it. If this skin won't stretch enough, the the other alternative is to have the horizontal scar too high. In this instance, a short vertical T is a good tradeoff.

One thing to be wary of is claims about skin tightening from all of the various technologies with liposuction (smart, cool, laser, vaser, etc.) None of these does as much as a tummy tuck so it that is what you need there are no short cuts.

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

Have not been impressed with "upside down" results

In my opinion, few women are good candidates for the "upside-down" procedure you refer to. Most patients can get excellent results with the traditional horizontal lower abdominal scar, possibly with a small vertical extension if the skin laxity is not great enough to allow advancement of the point just above the belly button to the lower abdomen without too much tension.

W. Tracy Hankins, MD
Las Vegas Plastic Surgeon
4.9 out of 5 stars 293 reviews

Upside down "T"? incision for tummy tuck

It is difficult to suggest one option over another without examining you. I am not sure why your doctor suggested a "T" incision unless you had massive weight loss and you have significant skin laxity. If you are unhappy with the suggestions from the surgeon you meet with, get a second opinion.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

There is probably a better third option.


It's hard to tell exactly without examining you, of course, but most women like you benefit by a full abdominoplasty with a low, horizontal scar only. I doubt very much that you need an upside down T scar, unless you have lost a great deal of weight. I have published about this topic.

On the other hand, most women do not get full correction with "aggressive" liposuction and lower skin removal. And you can get irregularities, and looseness of the upper belly.

It really depends on your anatomy. If you want another opinion, there is a link on my web site to the American Society for Aesthetic Plastic Surgery, where you can get names in your area.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

Tummy tucks options

It seems as though you're caught in the middle of several tummy tuck options. For those that don't have a lot of excess skin and fat, but do have some abdominal wall laxity, a full tummy tuck is an option, but in order to keep the incision low you may have a "t" incision. This is because the incisions around your belly button may remain on your abdomen instead of being removed of you have a lot of excess skin. A new hole is made for your belly button in a full tummy tuck. To prevent this "t" scar liposuction is an option. What about a mini tummy tuck and floating your belly button? Talk to your plastic surgeon about this option, too. Good luck!

Jeffrey E. Schreiber, MD, FACS
Baltimore Plastic Surgeon
5.0 out of 5 stars 201 reviews

Patients generally are dissatsified with vertical abdominoplasty scars

These are two very different options.

Although the upside down T may give you the overall best correction, I have had many patients complain about the vertical scar when performed by other surgeons. Therefore I tend to avoid it with the exception of massive weight loss or previous vertical scars or severe stretch marks

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 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.