Four pregnancies, upper stomach skin is loose. Am I a good candidate for a reverse tummy tuck? (Photos)

If you find a surgeon in your area who has produced results you like for women with an abdomen that appears like yours, then maybe YES, you should consider the procedure. From submitted photos, your body has endured four pregnancies far better than most. You appear to be in rather good physical condition, and not overweight. My own personal recommendation would be a modified abdominoplasty with tightening of the abdominal wall, verticalizing the belly button, and smoothing the loose upper abdominal skin through a bikini-line low short scar (modified abdominoplasty). Reverse abdominoplasty generally places a scar between the breasts which can descend over time, and it's more difficult in my experience to conceal than the C-section type scar.

Yes, a reverse tummy tuck can be performed at the same time as breast augmentation. The incision is usually placed in the breast crease, which allows the upper abdominal skin to be tightened while also placing implants. This combination is fairly common when patients want to address both breast volume loss and loose skin of the upper abdomen in one procedure.
It is important to keep in mind that a reverse tummy tuck only improves the skin above the belly button. It does not tighten the lower abdomen or repair muscle separation. If your main concern is mainly loose skin in the upper stomach, it can be a good option.
I have also shared a detailed video where I explain when reverse tummy tuck is used, and show examples of how it can be combined with breast surgery.
— Güray Yesiladali, MD

Thank you for your inquiry! By your photos, it looks like you would be a great candidate for an reverse abdominoplasty to get rid of excess skin to your upper abdomen. It would require using the same incisions for your breast procedure and both can be done at the same time. I recommend scheduling a consult appointment with a board certified plastic surgeon like myself so we can create a surgical plan that is best for you and your goals!

Having a reverse abdominoplasty isn't the right treatment for you. You can have breast surgery with fewer scars, and you also need an abdominoplasty with muscle reconstruction to correct your diastasis and remove excess skin from your abdomen.

There does seem to be loose skin that can possibly be fixed with a reverse tummy tuck, however, it would be best to also see what the condition of the skin is for your lower abdomen, in a lot of cases when doing a regular tummy tuck when they pull downward the upper skin is also pulled down and it can all be removed with that incision as opposed to a reverse tummy tuck however, if you’re not interested in having a regular tummy tuck with an incision in your lower abdomen then yes it does seem to be that you do have skin for it but the video )additional footage) can help further evaluate, this will help see how much pull the skin has and make sure that they are is enough to actually be able to do the procedure without leaving too much tension.

A reverse tummy tuck can be an excellent option and produce a beautiful correction of upper abdominal skin laxity when performed by a detail-oriented surgeon. If appropriately planned and executed, the resultant scar will fall at the breast fold and with even a modest volume breast can remain largely hidden within the breast fold.
From your photos it appears you have enough tissue laxity to undergo either a reverse or standard tummy tuck. I encourage you to discuss both options with a board-certified plastic surgeon during an in-person consultation to better understand which option is right for you.
Dr. Brandon Lambiris Board-Certified Plastic Surgeon–Sarasota, FL

You seem to have some looseness in the upper part of your stomach, which is really common after multiple pregnancies—especially with four. The good news is that your lower abdominal skin tone sounds excellent, which helps.

A reverse tummy tuck can tighten the upper skin, but it leaves a scar between the breasts that tends to be more noticeable than the looseness itself, so it’s not always the best trade-off.

Since there’s also muscle separation, a better option might be a modified full tummy tuck. This can address both the muscle issue and the upper abdominal skin without putting a scar around the belly button.

The incision is placed low, in the bikini line. The belly button stays attached to the skin—no circular scar—and usually moves down about 3 cm. Sequential tension sutures are often used to help keep the scar low and stable during healing.

It’s worth finding a surgeon who has experience with this kind of approach and is comfortable tailoring the procedure to your specific needs.

-DrB

I do not perform reverse tummy tucks. An in-person assessment will be needed to see how much skin laxity you have and whether you are a standard Abdominoplasty candidate.

Thank you for your query. While reverse tummy tuck for upper abdominal skin looseness, at the same time as getting breast implants makes sense, your upper abdominal skin laxity appears to be mild, based on the photographs you have shared. This can be taken care of non-surgically with J-plasma or Thermitight. Please find an experienced board certified Plastic surgeon who can examine you and help you with all your concerns. All the best!

Unfortunately, you have not provided a photograph of your breasts. You may need a breast lift with possible implants. The breast lift technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. This technique also lifts the upper abdominal skin without crossing the midline. It functions like a reverse tummy tuck.

Best Wishes,

Gary Horndeski, M.D.