What is a reverse abdominoplasty or reverse tummy tuck? A reverse tummy tuck is a very ancient and the usual pattern of skin excision that's performed with standard abdominoplasty. Instead of removing all of the skin in the lower abdomen through a suprapubic incision, in reverse tummy tuck, some lower abdominal skin is removed through the same incision while some upper abdominal skin is removed through incisions placed in the inframammary folds below the breasts. This tightens the upper abdominal skin and lower abdominal skin simultaneously. Through the lower incision, the entire abdominal wall can still be tightened. The belly button or umbilicus is floated with the abdominal skin flap so that through the inferior approach, the muscle layer of the abdominal wall can be tightened from sternum to pubic bone.

A reverse abdominoplasty is a surgery that is primarily performed for patients that have weathered pregnancy very well and do not have a tremendous amount of lower abdominal skin laxity that would be treated with a conventional tummy tuck. There is some important criteria that should be met for this procedure, however. Ideally the patient should have an aesthetically ideal umbilicus or belly button. If the belly button doesn't look good preoperatively, then one might as well perform a conventional tummy tuck and create a new belly button in the process. Secondly patient should have very faint or ideally no stretch marks because with a reverse abdominoplasty, you are pulling the skin both upwards above the belly button and downwards below the belly button. If there are stretch marks around the belly button, the reverse abdominal skin excision will actually pull them higher on the abdominal wall so for patients that have significant stretch marks, I prefer to do a conventional abdominoplasty in most cases. This pulls the stretch marks lower on the abdominal wall and ultimately it makes the patient appear to have fewer stretch marks.

The last consideration is this. The inframammary fold scars need to be hidden within an inframammary fold. This is a surgery for patients that have enough pressure volume to create some lower pole fullness that helps to conceal the inframammary folds and thus the inframammary fold scars. If you feel you meet these criteria, then discuss the surgery with your surgeon and find out if it's something that they offer or have experience with. If you are going to have the surgery performed, you want to make sure that you see lots of before and after photographs of a reverse abdominoplasty so that you can see that the abdominal profile is flat and the scars are well concealed.

Have Your Heard of This Different Take on a Tummy Tuck?

Dr. Michael Law explains a reverse abdominoplasty, which is a variation of the usual pattern of skin excision that is performed with a standard abdominoplasty, or tummy tuck.