Q: Dr. Eppley, I can’t figure out whether I need a full or a mini-tummy tuck. After having two children what bothers me most about my stomach is the little bit of loose skin and the stretch marks between my belly button and my mons. Interestingly, there is no loose skin when I am standing straight but it appears when I am bending over. I am 32 years old and in very good physical shape at 5’ 2” and 106 lbs. My abdominal muscles feel very taut and I don’t think they are separated at all. I also have a hole on the upper part of my belly button from a prior piercing that I would like removed.
A: Your description of your abdominal concerns is a common one and you are what I call a plastic surgery ‘tweener’. This means one is stuck between two procedures and can go either way. Either type of tummy tuck can be done on you.l Understanding which way to go requires an understanding of the trade-offs of making either choice. A full tummy tuck, removing an ellipse of skin from above the belly button down to the pubis, will eliminate all loose skin and will avoid the sag you now see when you bend over. But the final scar will be horizontally long and will end up high, about halfway between the new belly button and the pubic region. A mini-tummy tuck will result in a smaller scar that can be kept down quite low but will result in less skin removed and there will remain some small sag when you bend over. The decision comes down to whether you value the most amount of skin tightening or the best scar location and size.
Dr. Barry Eppley
Q: Dr. Eppley, I need advice as to whether I should have a mini- or full tummy tuck. I have attached some pictures of my stomach so you can see. I have been to two plastic surgeons and have gotten two different opinions. In listening to them, both make sense for what they want to do so I am confused.
A: When considering the type of tummy tuck one may need, it is important to look at the components of the excess tissue problem. The most important consideration in choosing between a mini- vs a full tummy tuck is how much skin is present. While you don’t have a large amount above your belly button, there is enough there that a mini-tummy tuck will not fully get rid of it. The other tissue consideration is the amount of muscle laxity or protrusion. You appear to have a protuberance of your abdomen starts way above your belly button. Like the skin excess, this muscle protrusion indicates that you will get a much better result from a full tummy tuck. One issue to consider in doing a fully tummy tuck is the vertical level of the horizontal scar. If the belly button cut out in the skin needs to stretch down to meet the lower incision, the horizontal scar will likely end up a little high. Therefpre, I would recommend that you end up with a small vertical scar in the lower part of your abdomen. That way the scar can stay low and the belly button hole can be closed vertically. I think this would be better given how jeans and underwear are cut and designed today for women.
Dr. Barry Eppley
Q: I am 28 years old and have had 2 kids. I only gained about 25 to 30 lbs with each pregnancy but I still ended up with stretch marks on my lower stomach and loose skin around my belly button. I know that liposuction alone is not the solution for my stretch marks and loose skin. I am at a fairly good weight for me being 5’ 3” and weighing 130 lbs. Which type of tummy tuck do you think would be best for me?
A: While it is impossible to give an accurate assessment without photos, your description of your abdominal concern do make for a philosphic discussion between the two types of tummy tucks. The conceptual difference between a mini- and full tummy tuck is that the more limited procedure produces less of a result (around the belly button area) but has a smaller and lower placed horizontal scar. The key question is which trade-off can you live with better…a flatter and more complete abdominal result but with a much longer and higher horizontal scar (full) or a less long lower placed horizontal scar but with some stretch marks and loose skin still left around the belly button area. (mini-) There is also a belly button scar difference as the full tummy tuck will have one and the mini-tummy tuck will not. It really comes down to which aesthetic trade-off (scar vs amount of improvement) is more important to you.
Many women will less severe lower abdominal concerns (excess tissue) do opt for a mini-tummy tuck. When combined with liposuction in the upper abdomen and around the sides of the waistline, this more limited tummy tuck approach can provide for good improvement with a very acceptable low-placed scar.
Dr. Barry Eppley