Tummy Tuck Surgery and Hip-to-hip Scar my Only Option?

Question

My abdominal muscles are completely flat despite having 5 children. But my skin is a mess. I like the way I look dressed, but hate my tummy naked. Also, is it a less expensive procedure if only skin needs to be removed without muscle repair?

Andrew Smith, MD, FACS · Answer

It sounds like you have kept yourself in good shape, but your abdominal skin has lost it's elasticity after having 5 kids, which is very common. An Abdominoplasty (Tummy Tuck) is the best procedure to remove the excess skin. Typically the scar does goes from hip to hip but upon exam, your surgeon can give you a better idea of how far he/she may have to go and can also determine if you will benefit from muscle wall repair. Every office varies in pricing, but it is best to keep in mind that omitting muscle wall repair for cost is generally not in your best interest as there may be additional costs involved later if you don't do it right the first time. Best of luck!

Edwin C. Pound, III, MD · Answer

With a tummy tuck, you accomplish two goals - tightening up the stomach muscles and removing excess skin. You said that you already have good muscle tone so you may not need that part of the equation. You did not provide a photo so it is difficult to tell you for sure what would be the best option for you. If the amount of skin is VERY minimal, there are some non-invasive skin tightening things that you can do. If you have stretch marks and more loose skin then a tummy tuck is probably the best option. A mini-tummy tuck might be an option of the excess skin is located below the belly button but the longer the incision, the more skin can be removed. Basically, that is the decision you must make. Would you rather have the loose skin or a scar across the lower part of your stomach?

Sacha Obaid, MD · Answer

A tummy tuck can absolutely be performed without muscle repair!  Some patients just don't need it. Unfortunately, it does not create a significant cost savings but you would be surprised at how affordable a tummy tuck can be, especially with the financing options that are available.

	 

	A hip to hip incision is part of a full tummy tuck.  For the luck patient that just has a small amount of extra skin in the lower central par of the abdomen, a mini tummy tuck with a shorter scar is an option.  Good luck.

Richard Baxter, MD · Answer

There are 3 things that a tummy tuck does that you cannot accomplish on your own with diet and exercise alone: tighten skin, repair muscle separation, and remove localized fat if needed. If you do not have a muscle separation(diastasis) then your recovery will be much quicker. There are no short-cuts for skin tightening however, and from what you describe it seems unlikely that anything short of a full tummy tuck will do. You should see a plsatic surgeon for a personal consultation about whether the muscle repair is needed and whether it affects cost.

Steve Laverson, MD, FACS · Answer

In general, the more skin removed, the longer the scar. Quality and placement of scar more important than length. Yes, less expensive without muscle plication, but after five term pregnancies, if you're flat now, plication will supercharge you. Anyone who is opening you up for tummy tuck should want to make you as sexy, youthful, curvaceous, and beautiful as possible, and thus should not want to do tummy tuck without plication.

William T. Stoeckel, MD · Answer

If you have any significant amount of skin that is loose as a result of pregnancies or significant weight fluctuation, there really are no great alternatives to the tummy tuck surgery. The length of the resultant scar is directly proportional to how much skin needs to be removed. I have never seen any significant skin tightening effects with the non-surgical therapies that are seen advertised.

	The rectus muscle plication part of the surgery does take about 10-15 minutes to complete. If you really do not need to have that part of the surgery, it is possible that your surgeon will slightly decrease the cost of your surgery. I have offered a slightly lowered cost for a very few patients who did not need the muscle tightening. (They are almost always men.) Women that have had children almost always can benefit some from the muscle tightening part of the procedure, even if it is not apparent on the pre-op exam.

Jourdan Gottlieb, MD · Answer

Hard to answer without photos.

	Most patients presenting for tummy tucks have some abdominal wall laxity, and tightening the abdominal muscles contributes to the outcome. Not doing that part of the procedure might cut down operating time by 10%, so if there were a fee reduction it would be modest. 

	Removing skin does require a scar, and the improvement doesn't extend beyond the limits of the scar. Cheating on scar length will cheat on outcome. 

	When you are ready for an in person consultation, RealSelf has listings of surgeons in your area. You should consider cross referencing the listings from the The American Society of Plastic Surgeons (plasticsurgery dot org). A listing in the ASPS website assures you that your surgeon is not only board certified,  but also is a member in good standing of the major plastic surgery organization in the U. S. Thank you for your question, best wishes.

Michael Law, MD · Answer

I have been encountering more and more patients who through exercise, good fortune, and quite probably the right genes maintain a flat abdominal wall after pregnancy, but who have some excess skin below the belly button. This situation is actually quite common in patients who are very fit and athletic, and it can often be improved dramatically in an office procedure that involves removal of redundant skin only.

Norman Bakshandeh Day, MD, FACS · Answer

The more skin that needs to be removed the longer the scar will be when a tummy tuck is performed. The muscle repair is part of the procedure.

Peter A. Aldea, MD · Answer

Frankly you have SEVERAL options
	1. Do not have anything done. After all, a Tummy Tuck is NOT a "must have" operation (as in a burst appendix, cancer, gunshot wound) but a cosmetic, "I want to have" operation.You will be saving money and take no risks by choosing this option.

	2. Do a LESSER procedure; either a MINI - tummy Tuck or a heat skin tightening procedure - BOTH are guaranteed to disappoint you.

	3. Have a "full" Tummy Tuck which includes muscle tightening. The BEST option for restoring your figure to its BEFORE babies appearance.

	If you stop and think about it for a second, do you REALLY think that the massive stretching of pregnancy which you had undergone 5 times and which by your own admission messed up your skin somehow managed to spare your muscles (which are closer to the uterus)?  That is extremely unlikely. I have done hundreds of these procedures and am always surprised by the amount of muscle stretching I see even after two pregnancies. the WORST mistake in Tummy tuck surgery (beside scar placement) is a failure to address and correct muscle laxity and separation. This means re-tightening the tummy muscles and thereby achieving flattness and a feminine narrow hourglass waist.

	As to the scar, it can be hidden within the confines of your preferred underwear BUT it needs to go to the sides as far as is dictated by the axtent of YOUR loose skin. Having a flat tummy with remenant bags of skin along the sides of the incision because your surgeon was reluctant to go as far to the sides as was dictated by your skin excess is a mistake.

	Good Luck

	Peter A. Aldea, MD
	Memphis, TN

Tummy Tuck Surgery and Hip-to-hip Scar my Only Option?

Answers (12)

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