Q: Dr. Eppley, I am interested in a full tummy tuck. I believe I would accept the trade off of the scar for the results of the tummy tuck. My loose skin bothers me so much I do not take my shirt off in front of anyone and I will not wear a bathing suit. I find myself covering my stomach with my arm even when I am alone. It would ultimately depend on how high the incision would be and how inconspicuous it would be over time. I have researched hundreds of before and after photos on real self and women with similar “before” photos like my stomach and was very impressed with the results. With my C-section incision, my appendectomy incisions and all the stretch marks from pregnancy I think the incision would be a fair trade. Again, I would want to know where the incision would be and I know that could only be accomplished through an in-person consultation.
I am slightly concerned about the nipple lift for my breast augmentation. I am not sure what that entails, but it makes me more nervous than the tummy tuck incision. I am most concerned of lost sensation and additional scarring as a result.
A: You have made a key point in understanding the aesthetic trade-offs of many cosmetic procedures, particularly that of a tummy tuck. Each option (keeping your loose abdominal skin vs a tummy tuck) is not perfect and you choose which ‘problem’ you can live with the best. The tummy tuck scar will not end up as low as your c-section scar and will probably end up 1 to 2 inches higher. Also it would be likely that our full tummy tuck scar will end up with a small midline vertical component running just above the horizontal part of the incision. This is sometimes necessary when doing a full tummy tuck to keep the central aspect of the scar low rather than being pulled up in the middle. While many tummy tuck scars do heal well, I don’t think I would ever call them inconspicuous but that is a matter of personal perspective.
The small nipple lift scars are really irrelevant and are not a concern for visibility or nipple sensation. The choice you will have to make is that your nipples may not be centered on your breast mound without them given your existing breast sagging. It is important to understand that implants do not create a lifting effect on the breasts. They merely make breasts bigger and can magnify any existing breast asymmetry or breast sagging.
Dr. Barry Eppley
Q: Dr. Eppley, can I get my nipples lifted higher on my chest? How much nipple lifting is possible? I have attached a picture of my chest so you can see how low my nipples are.
A: Nipples lifts can be done on a male chest but the amount of movement is much more limited than what can be done on a female breast. Men do not have the leeway of allowing or tolerating a vertical scar to raise a nipple very far on their chest that a woman does on a female breast. Thus the procedure for a nipple lift in a male is technically known as a superior crescent nipple lift. This is a simple procedure where a small crescent-shaped segment of skin is removed right above the nipple. This leaves a small fine line scar at the junction of the nipple and skin on the top edge of the nipple which usually heals very well without any significant scar. But the amount of movement upward is limited to usually 8 to 10mm (1/2 inch) at most in a single procedure. This means that even if done in two stages, the best you could hope for is 3/4 of an inch or slightly more.
Dr. Barry Eppley