Reverse Tummy Tuck. What are your thoughts on this procedure?

I reserve this operation for a very specific subset of patients with isolated superior abdominal skin laxity and existing inframammary fold breast scars (most commonly prior breast reduction or breast lift scars). There are several downsides to this procedure including a scar spanning between the breasts and the tendency to pull the inframammary fold/IMF scars inferiorly which can distort breast aesthetics. If the skin between the breasts is left alone to avoid the spanning scar, that area tends to pucker and look unnatural. So, the vast majority of the time, I favor a traditional abdominoplasty scar even for isolated superior abdominal skin laxity because the low abdominoplasty scar is more favorable, better hidden in clothing, and does not have a distorting effect on breast appearance.

Thank you for your question about what to do with excess abdominal skin laxity. You did not include pictures, so it’s a little difficult to answer your question. However, based on your description of the problem, I would suggest that, yes, indeed, a reverse tummy tuck would be your best option. I perform this procedure quite frequently. The scar is underneath the breast, so this scar usually is very well hidden. If you have significant excess skin, the spot may need to extend slightly around the side of the breast.
Nonetheless, it’s an excellent and perhaps the best procedure for excess skin of the upper abdomen. Therefore I would highly suggest that if you have upper abdominal skin laxity, your best procedure could be a reverse tummy tuck. Please seek an experienced board-certified plastic surgeon who has performed many reverse tummy tucks.
Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

I would imagine your difficulty finding information on reverse tummy tuck is reflective of the frequency with which this procedure is perfumed. Back in training, I asked my professors about their experiences with reverse abdominoplasty, and most said that had never done it and one said he had: once. So, in some cases this procedure can be more powerful and focused on the specific areas of concern in the upper abdomen, but it's rare that a traditional tummy tuck, which is often combined with rectus muscle plication and judicious liposuction, does not impact the upper abdomen as well. And then your scar is under the belt line instead of under the breast, which is much less noticeable. I would advise talking about these pros and cons with a surgeon that is well-versed in all forms of abdominal rejuvenation so that you get a plan that gets your best result and confidence from an individualized goals-based discussion.