Full or Reverse Tummy Tuck for Upper Abdomen Laxity?

If you had a mini tummy tuck usually the belly button base is cut and this takes away the blood supply form below.  When a full tummy tuck is done the belly button is cut all the way around form the skin and surrounding tissue.  The belly button could easily die.  This is the issue in your case.  The surgeon who you like very much can look at the op note and answer this question.  I have never like the reverse tummy tuck results and scar.  Your upper abdomen does not warrant that procedure.

Hello Scrappy,

Thank you for sharing your concerns about addressing laxity in your upper abdomen area. After reviewing your photos, it seems that you would benefit most from a full tummy tuck procedure with muscle plication, possibly combined with liposuction of your superior iliac crest to enhance contouring.

While your surgeon has suggested a reverse tummy tuck, I generally advise against this approach for several reasons. Firstly, reverse tummy tucks typically don't yield as impressive results as traditional full tummy tucks, particularly in addressing laxity above the belly button. Additionally, muscle repair, which is crucial for achieving a tighter and smoother abdominal appearance, cannot be effectively performed during a reverse tummy tuck.

Opting for a full tummy tuck allows for comprehensive correction of both upper and lower abdominal laxity, resulting in a more harmonious and aesthetically pleasing outcome. Although concerns about scarring are understandable, with proper surgical technique and post-operative care, the scar can be well-concealed and minimized over time.

It's essential to have an open and thorough discussion with your surgeon to explore all your options and address any concerns you may have about the procedure. Your surgeon can provide personalized recommendations based on your anatomy, goals, and preferences, helping you make an informed decision that aligns with your desired outcomes.

I hope this information assists you in making the right choice for your tummy tuck procedure. Feel free to reach out if you have any further questions or need additional guidance.

Sincerely, Dr. Katzen

Thank you for your question. Based on your photos you will achieve your body goal with a full tummy tuck combined with intense liposuction including abdomen, waist, laterals and upper and lower back to improve your body contour and get better curves, especially in your waist area.
Kind regards,Dr. Emmanuel Mallol Cotes.-

When
patients have loose saggy upper abdominal skin following mini-abdominoplasty
correction usually always requires conversion to a full abdominoplasty. This procedure involves raising a flap to the
level of the ribcage. The skin is then
advanced in a downward direction and the excess skin is removed at the level of
the lower abdominal incision.An
umbilical transposition is an important part of this procedure.Your picture suggests redundant upper
abdominal wall loose skin.A full
abdominoplasty can remove excess upper abdominal skin and tightens the
abdominal wall muscles.It avoids
additional incisions that potentially compromise the blood supply to the
abdominal wall and decreases the potential for skin necrosis.If you’re considering abdominoplasty
revision, consultation with a board certified plastic surgeon is
appropriate.This surgeon should be able
to formulate a treatment plan that addresses your anatomic findings and
achieves your aesthetic goals.

In my opinion, given the limited information here in your photograph. I believe you would get an improvement with a full tummy tuck. You still may have some residual laxity in the upper most abdomen but I believe that is preferable to the results or risks of a reverse abdominoplasty.

Scrappy,
I would strongly advise against the reverse tummy tuck in your case. You're absolutely right about the scar in the middle - it is very obvious - connecting both breasts. Don't add an extra, visible and long scar if you don't have to.
I think you are a good candidate for a full tummy tuck. I would excise the mini-tummy tuck scar, lower the scar to the pubic hair line and recruit all that extra skin down again. You would need to have your umbilicus (belly button) pulled through a new opening in the upper skin, but this scar heals well and usually looks great.

The reverse abdominoplasty is quite popular in South America but has not gained the same popularity in America. To me, this is reminiscent of vertical(lollipop) breast lifts and reductions as opposed to the inverted "T"(anchor) scars still commonly employed in the United States. As with the vertical breast scar procedure, there is a significant learning curve associated with the reverseabdominoplasty procedure. Sub-optimal quality scars were visible in the lower cleavage and scars migrated from the breast crease caudally(downward). However, these issues have been solved with some important surgical modifications.With the reverse abdominoplasty, the umbilicus(belly button) is elevated into a more youthful position and vertical configuration, the torso is elongated, and the waist is thinned via a full 180 degrees of the lower abdominal skin elevation. The scar can be continued around the back as a back/bra strap excision, smoothing the back rolls from hip to shoulder blades. This procedure will not remove lower abdominal skin excess and muscle tightening of the lower abdomen requires another but small(C-section size) scar. Residual lower abdominal skin excess may be amenable to Ultherapy. Upper abdominal skin removed using conventional abdominoplasty(in my experience) requires not only a periumbillical(belly button) scar but a large amount of lower abdominal skin removal increasing the horizontal scar length to the hips, potentially widening the scar quality due to increased tension and perhaps a traction deformity of the mons, while giving the abdomen a shorter wider appearance. Once the issues of the upper abdominal scar were solved, reverse abdominoplasty has become the procedure of choice for abdominal rejuvenation, when appropriate. The combination of no periumbllical(belly button) scar, elongation of the waist and tapering of the skin from the hips speaks for itself.The cost ranges from $7000 to $8500 including abdominal and anterior hip lipoplasty.

A reverse Upper Tummy Tuck involves removing excess abdominal skin vertically upwards using incisions hidden in the inframammary folds underneath the breasts.  THERE IS NO INCISION MADE BETWEEN THE BREASTS. The photos in my gallery (below) show results and show close ups of the scars undeneath the breasts that are completely hiden unless a wonan actually liifts her breasts up. In general, this operation is best reserved for patients with fairly full or at least slightly droopy breasts, which serve to nicely conceal the inframammary folds. An important part of this procedure is the placement of permanent lifting sutures that elevate the lower skin edge, following removal of excess skin, to the upper skin edge in the inframammary fold. These permanent sutures ensure that the resulting surgical scar remains hidden within the inframammary fold.

A great advantage of this procedure is that the patient's original belly button is preserved, and thus there are absolutely no surgical scars that are visible when wearing a two-piece swimsuit or typical underwear (bra and panties). Additionally, because this procedure generally requires less skin undermining and thus less interruption of the normal blood supply of abdominal skin, more thorough liposuction of the waist and back can be performed at the same time.

Many patients having this surgery, therefore, undergo a reverse upper abdominoplasty combined with a lower 'mini' abdominoplasty, tightening of the entire length of the rectus abdominis muscles, and liposuction of the circumferential trunk - and keep the belly button with which they were born. I usually refer to this operation as 'reverse upper / modified lower abdominoplasty'.

A reverse upper abdominoplasty can be a good option for some patients. be sure to view many before and after photos and look at incision sites and scars which are camoflaged under the breasts and not across the chest between the breasts.

Tummy tucks are a very popular and effective way to contour the abdomen. Like no two patients are the same, in our practice note to tummy tucks are equal. We spent a great deal of time evaluating the patient before the surgery to assess their physical condition and to understand their aesthetic goals. We then create a surgical plan that will help meet these goals. It is possible in your case to perform any revision to me to to correct the laxity in the upper abdomen. I would not consider a reverse tummy tuck for this area as it would add unnecessary scar onto your abdomen and could impair the blood supply to your abdominal skin.

To learn more about tummy tucks, see photos, and help you decide which one is best for you, please visit us at the link below:

Get a full tummy tuck and avoid the reverse. The full tummy tuck will tighten the muscles and pull down the loose extra skin. I think this is better than the reverse.