Best Tummy Tuck Technique for Me

I started consultations with surgeons for mommy makeover. I am 5'6" 150 lbs, 38 yo. Ps states need a horizontal & vertical incision because most of my belly bulge is at the bottom but I will need MR for diastasis from 2 pregnancies. If it is a FTT, why two incisions. And for implants ps wants areola incision but I prefer mammary fold. Also, with thin chest would saline look good or should I go with silicone. Under or over muscle?

Doctor Answers 21

Best Tummy Tuck Technique for Me

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Now these are great posted photos. Sounds like you need MORE in person opinions. Based upon your photos I recommend Full horizontal (only one incision) TT with 3 layered muscle repair and subpectoral inframammary incision augmentation. 

Best tummy tuck option

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Judging by your photographs you've would be an excellent candidate for a Mommy Make Over. The loose skin and stretch marks of your abdomen suggest a full abdominoplasty will be very beneficial. When the abdominoplasty is performed a long incision normally is made low enough on your abdominal wall to allow you to wear a two-piece bathing suit after you are healed. After the incision is made in the skin and fat layer is elevated off of the underlying muscle layer up to the belly button. In order to continue lifting the skin and fat off of the muscle layer it is necessary to cut around the belly button leaving it attached to the underlying muscle layer. The skin and fat layer is elevated off of the muscle layer up to the rib cage. After the muscle is tightened the skin and fat layer is pulled tightly down to the original incision. If the hole that was made to release the belly button can be pulled past the incision it would be removed with the excess tissue. On the other hand if it doesn't reach that far it would leave an opening somewhere between your pubic bone and your belly button requiring closure and resulting in a vertical scar. Judging by your photographs I think you have a good chance of not requiring the vertical incision.
A breast augmentation performed through an inframammary incision is a very good option for you.
Any time you have concerns about a post treatment plan it is a good idea to get a second opinion. Good luck.

John J. Edney, MD
Omaha Plastic Surgeon
4.8 out of 5 stars 133 reviews

Mommy makeover options

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Although the procedures that are best for your depend on your goals and body characteristic you would likely be best served by:

1) a full tummy tuck with one horizontal incision in your lower bikini line (I suspect the plastic surgeon you have seen was recommending a lower tummy tuck and a reverse tummy tuck at the same time)

2) breast augmentation with silicone implants.  the incision is not that important really so choose the one that you want.  It appears that you are a good candidate for either subfascial (on top of the muscle) or subpectoral (under the muscle).  Which one would look best depends on the size of the implant and how much laxity you have.  If you choose saline implants I would definitely recommend under the muscle as saline on top of the muscle does not look very good.

Last but not least ask for and look at the plastic surgeons before and after photos.  These will give you a better idea if the type of work they do is in line with your expectations.

All the best,

Dr Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 reviews

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Mommy makeover techniques

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The angle from which these photos were taken makes it a bit difficult to say for sure, but it does NOT look like you would need a vertical component to your tummy tuck incision.  It looks like you would do fine with a traditional tummy tuck which also allows for muscle plication.  I don't see any reason why you couldn't have an inframammary approach to your breast augmentation.  It is hard to tell how much breast tissue you have, but if your chest wall is thin, I would recommend a submuscular approach.  The choice between saline and silicone is up to you.  Silicone implants tend to feel more natural, but some women fear the history associated with silicone implants.  If the thought of silicone makes you uncomfortable, then go with saline.  That choice is up to you...

B. Aviva Preminger, MD
New York Plastic Surgeon
5.0 out of 5 stars 6 reviews

Mommy makeover incisions

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I would agree with you concerning the tummy tuck and breast augmentation.  I prefer an incision under the breast and believe you would get an excellent result without the need for a lift.  Make sure the implant is compatible with the diameter of your breast.  I prefer under the muscle and either saline or silicone would be available to you.  The nuances of that discussion are beyond the scope of this answer.

The tummy tuck should be able to be achieved without a vertical component to the scar.

All the best,

Talmage J. Raine MD FACS

Talmage J. Raine, MD, FACS
Chicago Plastic Surgeon

Mommy Makeover San Diego

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My opinion:  Regular tummy tuck (or "fitness" tummy tuck), saline or gel OK, inframammary approach preferred (your crease is sharp and well defined), and no vertical incision necessary.  You will look great, provided your child bearing days are behind you, you are a non-smoker, you're generally healthy, you follow instructions, and communicate well with your doctor.  In agreement with other responders, I would be inclined to see several board certified plastic surgeons before committing.

Steve Laverson, MD
San Diego Plastic Surgeon
4.9 out of 5 stars 50 reviews

Mommy makeover

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From your photos, it looks like you would do well with a traditional FTT (horizontal incision only).  You do not need a vertical incision.  For your breasts, I would suggest inframammary crease, subpectoral, silicone or saline implants.  You already have a well-defined crease- perfect for an IMF incision.  Seek a second opinion with a board-certified plastic surgeon.

Elizabeth Kim, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 29 reviews

Options for a mommy makeover

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I would vote that you do not need a vertical scar for the tummy tuck. 

It looks like you have enough implant coverage that either saline or silicone should do fine.  In that case, I generally recommend saline for all of its advantages.  Shorter scar, less expense, no silent ruptures...

I would vote for a IM crease incision.  You have a great place to hide the scar, why put in on the visible part of the breast around the nipple.

York Jay Yates, MD
Salt Lake City Plastic Surgeon
4.9 out of 5 stars 189 reviews

Traditional tummy tuck and inframammary fold breast augmentation

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Based on your photos I would recommend a traditional tummy tuck (no vertical incision) with liposuction of the flanks. The breast implants can certainly be inserted through an inframammary incision (breast fold). A board certified plastic surgeon can easily evaluate you and recommend the best approach for you. There is no need for any vertical incisions to be made on your abdomen based on the photos you have submitted.

Best wishes,


William Bruno, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 410 reviews

Tummy tuck and breast incisions

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I would agree with the other posts that you probably do not need a vertical incision, which is usually reserved for patients who have excessive skin and stretch marks that I don't feel will be improved with a traditional abdominplasty (often massive weight loss patients).  Regarding breast implants, I feel that the decision would be up to you - both incisions offer a very nice result in most patients as long as they do not have a tendency to form hypertrophic or keloid scars.   In the future, if you need revisions on your implants or have a complication, you might need the inframmary or fold scar anyway as it tends to offer slighly easier access to the breast pocket.   Saline versus silicone and pocket placement is an individual decision between you and your physician.  More of my patients choose silicone implants and I place them in the subpectoral position for a variety of reasons, but we talk about the pros and cons of all the options. 

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.