Laser-assisted liposuction can tighten loose skin above the belly button
If you in fact have loose muscles, a hernia, or diastasis (muscle separation) above your belly button, then you will in fact need surgery and a scar to correct it.
If however, you only have loose skin above the belly button, it is possiblke that laser liposuction may help. See before and after photos of Slim Lipo.
Tough problem: lots of good answers below; also consider "Reverse Abdominoplasty".
There are many good answers here. I briefly reviewed these and the one other option I did not see is the "reverse abdominoplasty".
This is not a popular approach and places a long scar in the underwire area. However, what it does allow you to do is correct the upper abdomen without effecting the lower abdomen. You may want to look into this as another potential solution.
Unfortunately, you probably do need a long tummy tuck scar.
Hi! I can visualize exactly what you look like because here in NYC, we see several women like you every year.
What you want is the best possible cosmetic outcome, and this involves several trade offs and compromises. A scar is cosmetically acceptable as long as it is very LOW. Through this approach, your muscles can be fixed, and the loose skin is tightened and slid down.
Your loose skin cannot be removed "where it is". This would give you a horrible result. That is why you need the long low scar even though your lower abdomen is fine. The problem has to be moved downward before it can be corrected.
Loose skin above belly button means you need a full Tummy Tuck
The changes you describe are very typical after pregnancy or significant weight loss.
Some patients have loose skin in the lower abdomen and sometimes it is above the belly button. Most patients also have some degree of rectus diastasis after pregnancy (looseness of fascia over and splaying of rectus abdominus muscles from the stretch of pregnancy). Some patients can even develop a small epigastric hernia in this area after pregnancy if there was extreme stretch on the abdominal wall.
All of these conditions are best corrected with a standard, full abdominoplasty. I prefer a very low incision from hip to hip that conceals the abdominal scar in most undergarments and swimsuit bottoms. This allows access to the entire abdomen for proper tightening of the myofascial (muscular) wall as well are removal and redraping of loose skin. If there was a small hernia discovered, it can easily be repaired prior to the plication or "tighting" stitches in the fascia (covering of the rectus muscles).
Some talk about "Floating the umbilicus" which means "disconnecting" the belly button from its stalk and resetting it in a lower position. In most cases, the appearance of the umbilical depression is changed and made too low, and that is not a technique that I recommend. Sometimes, there is a need to leave a small vertical incision with the closure but I have never had a patient that found this objectionable if it was necessary.
Another technique that some doctors advocate but I DO NOT RECOMMEND is a "reverse abdominoplasty" or reverse tummy tuck -- taking the "loose skin out" from the top and leave a large incision under the breasts. I do not perform this procedure because I think the scarring is more problematic and visible.
I think the best way to manage this problem is a standard, complete, or "full" abdominoplasty (Tummy Tuck).
I hope this helps!
Generally loose skin above the umbilicus requires a full tummy tuck
There are basically three types of tummy tucks. A "mini" only addresses the lower abdomen and has very limited application. A "full" addresses the entire abdomen and corrects problems both above and below the umbilicus. A "floating umbilicus" is a hybrid operation designed to keep the scar low in those with limited excess skin but if overdone can move the umbi too low and create a strange look.
Your problem is not unique but it's also not that common. You need muscle tightening and removal of supraumbilical skin. So let's go through the different surgeries.
A full tummy tuck will require a hip to hip scar but provides access to the entire abdominal wall for muscle tightening. The entire muscle would be tightened. However, because you don't have much excess skin below the belly button I assure you that you will end up with a short vertical scar as well where the belly button had to be incised. It will be someplace between the current belly button and the transverse scar.
A mini tummy tuck removes skin from below the belly button and the access can be used to tighten the muscles. However, it will not address the excess skin above the belly button.
A third option would be an incision around the top of the belly button from 3-9 o'clock, endoscopically tightening the muscle then taking the excess skin out in a crescent. The incision would be a bit "bunchy" for a while but will soften over time.
Like I said a difficult problem but there are options.
Surgery should target areas of concern
This is a great question since it brings up the need to customize surgery to fit the patient's anatomy and concerns. Of course I am speaking in general terms to some extent since I have not examined you and can only take your word at face value. If you are truly only concerned about some loose skin above the belly button and have diastasis of the muscle as well, you can approach both through your C-section scar. Using this incision, a surgeon can usually tighten the muscles directly or endoscopically. You have to be careful of not over-tightening the muscle as this can cause some distortion of the overlying soft tissues since they will tend to bunch up in the midline area. You can then have the belly button moved down a limited degree without cutting around the belly button. This will tighten the skin above the belly button. The limitation is how low your belly button can go before it looks too low. Usually, it can be moved 2-4 cm. If you need further removal of loose skin, you can accept a small scar around the upper portion of the belly button and remove a limited amount of skin. Depending on how moch you move things down, you might end upwith the same C-section scar or something a bit longer but that is something you can customize with your surgeon..
Loose skin above the belly button usually means a longer scar
There are many names for tummy tucks: standard, modified, hybrid, mini, etc. If you have loose skin above your belly button you need to have a standard tummy tuck (which means the long scar you are trying to avoid).
A lesser scar could correct the muscles (Hybrid tummy tuck) or remove skin from below the belly button, but not from above the belly button.
Most patients would gladly give up the separation of their upper muscles and loose skin and trade it for the low, longer scars. Speak to a few patients who are more than one year out from their surgery to get perspective on a scar.
Don't have the wrong operation just to avoid the scar. Your results won't be what you wanted. Consult with a Board-certified plastic surgeon in your area. Best of luck.