Tummy Tuck Through Incision Under the Breasts?

As you'll notice above, there is general disagreement about the procedure you're considering. If skin is not an issue on your abdomen, you should consider having an abdominal wall tightening (rectus diastasis repair) through an incision placed only in the belly button. You do not need additional scars in the pubic area or underneath the breasts. The procedure takes about 60-90 minutes and can accomplish the same thing from an abdominal wall tightening perspective that a full abdominoplasty can! It can provide the exact same corsette type effect. It can be done with a endoscopic assistance or simply with an adequate lighted retractor.
Your breast implants can be placed throught the same incision (although I personally am not a fan of the transumbilical breast augmentation (TUBA).
Good luck in your research process!
Dr. Kaufman

Hello jmnda,

Thank you for your question regarding getting a reverse tummy tuck with breast augmentation. I generally don't recommend the reverse tummy tuck procedure to many patients, especially when combined with breast augmentation. Performing a reverse tummy tuck simultaneously with breast augmentation can put excessive tension on the breast incisions as well as the reverse abdominoplasty incision. Additionally, we may not be able to achieve full muscle plication through the reverse tummy tuck incision, which could impact the final results. In your case, considering your severe diastasis, I would recommend a traditional tummy tuck combined with breast augmentation. While I understand concerns about the tummy tuck scar, this approach typically yields the best overall results in terms of contouring and muscle repair. Ultimately, the decision is yours, and I respect your preferences and concerns. However, I believe it's important to prioritize safety and optimal outcomes. If you have any further questions or would like to discuss your options in more detail, please don't hesitate to reach out.

Best of luck with your upcoming procedures!

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic and Aesthetic Surgeon

A Mommy Makeover is a combination of procedures to bring a woman’s body back to the way she looked prior to pregnancy. Most commonly some variation of a #TummyTuck and #BreastSurgery are performed. Additional procedures can include liposuction, umbilical hernia repair.  The most common #breastprocedures include #mastopexy or #breastlift, #breastaugmentation, or #breastreduction.  

#Combined operations are often performed with our #Gynecology colleagues. Tubal ligation is a common post pregnancy procedure which is done at the time of many of the surgeries included with a #MommyMakeover. If you require a gynecologic operation or study (laparoscopy) and are considering a plastic surgery procedure, discuss these issues with your physician and board-certified plastic surgeon. Also, combining these #procedures may decrease anesthetics, costs, and recovery time.

Your procedures should be performed by a #PlasticSurgeon who is board-certified and has a great deal of experience specializing in cosmetic #surgery. You will then greatly improve your chances of getting the result you desire, and, without the need for a revision surgery. It is suggested that you look at before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision.

Because you have tight skin rather than using the smaller breast scars to correct the diastasis recti (typically a bit worse below your belly button than above it, I would recommend using the tummy tuck scar as access to insert your breast implants thereby having no scars on your breasts. #Diastasisrepair#BAwithTT

The scars of this type of operation are usually unacceptable.  It is occasionaly done in massive weight loss patients as a secondary procedure to an extended abdominoplasty.  I personally have never used the approach in any other patients.

Some people call this the reverse tummy tuck. It tends to leave a more visible scar then the coventional tummy tuck. The muscle repair cannot always be completed through the upper abdominal scar but it can be accomplished through limited pubic or umbilical scars.

If your major procedure is the breast augmentation you should probably have that done with incisions at the fold beneath the breast or at the areolar border. At the same time if you have a major diastasis of your rectus muscles, but minimal skin excess, a nice procedure is through a short pubic scar (as with a c-section) and a small incision at the belly button through which an endoscope can be introduced to help visualize and repair the stretched out fascial tissue.
Alternatively, if there is minimal loose skin but it is mostly in the upper abdomen area, sometimes a "reverse abdominoplasty" is indicated to pull the skin up at the breast folds rather than through a long incision in the pubic region.

A reverse abdominoplasty is sometimes done in patients undergoing large breast reduction surgery since the incision goes from one side of the chest to the other. However, if you are having breast augmentation, then you should have very small incisions (<3 cm each). The incision to do the reverse abdominoplasty would be closer to 30 to 40 cm. Even if you did not mind the incision, the results from reverse abdominoplasty do not look as nice as traditional abdominoplasty. Please really think this through before letting someone make such a huge incision which would be required for a reverse abdominoplasty. Go luck with your surgery.
David Shafer, MD
Manhattan

Your clinical situation is unusual. Most women who have a severe diastasis don't usually get to keep their abdomens stretch mark free and tight. Any procedure that attempts to tighten only the diastasis of the rectus muscles will cause a midline bunching of skin that will have to be addressed. This can only be done by some type of skin incision. If this bunching is just below the belly button then a mini tummy tuck is possible. If the bunching is above and below the belly button, then a full tummy tuck is appropriate.
Endoscopic, minimal incision procedures are fine if you have minimal diastasis. They are not designed for people who have a severe diastasis as you claim. In the end, just opt for the procedure that delivers the goods and forget about gimmicks. With regards to your question, it is possible to have a reverse abdominoplasty and place breast implants at the same time. Your surgeon will need to be extra careful with closing the base of your implant pocket to keep the implants in the area of the breasts and not have them slip into the belly area. Also, gravity will probably stretch your scar down.
Finally, if you need an incision around your belly button to move all the excess skin up to get it trimmed off, you may be left with a small vertical scar in the middle of your abdominal area. However, if you only get excess skin above your belly button, then when your surgeon pulls the excess skin up, it may distort your belly button shape into something unnatural. Make the best decision you can.
Good luck.
Dr. Shah

Patients who have loose deep fascia may want to get this tightened. This can be done through minimal incisions (endoscopic tummy tuck or hybrid tummy tuck). It is no longer necessary to get a hip to hip incision to tighten the entire deep fascia.
It is possible to remove a small to moderate amount of upper only abdominal skin through a breast lift incision, not through a breast augmentation incision. It can actually be a very satisfying procedure for a fit woman without a lot of loose skin who is undergoing a breast lift and hybrid tummy tuck (short C-section type incision, full abdominal fascial tightening, including above the belly button) to have some skin removed through the breast lift incisions.
This is one of the many newer options in tummy tuck surgery.
For women with a great deal of extra skin, the combination of hybrid tummy tuck plus breast lift / reverse abdominoplasty would not be a good option, since there is too much skin for the procedure to achieve optimal results.