What is a reverse tummy tuck?

Woman going for a run in Fairfax after recovering from reverse tummy tuck surgery

Pregnancy and weight loss often leave behind excess skin and fat in the midsection that diet and exercise alone may not be able to fully address, and a traditional tummy tuck, or abdominoplasty, has been the standard procedure to achieve a smoother, more youthful midsection and also address abdominal separation (diastasis recti).

A newer tummy tuck technique called a “reverse tummy tuck” removes excess skin from the top portion of the abdomen with an inframammary incision placed discreetly along the natural creases of the breast. This is different from other tummy tuck techniques, which address the midsection through a horizontal incision placed just above the pubic area. Here, Fairfax board-certified plastic surgeon Dr. Christopher L. Hess explains this lesser-known tummy tuck technique and provides insight on how plastic surgeons determine the ideal technique for their tummy tuck patients.

How is a reverse tummy tuck performed?

Reverse tummy tuck is performed under general anesthesia. Your surgeon will make an incision along the breast crease (inframammary fold) that extends across your torso. Liposuction is usually used to remove unwanted fat in this area and to further refine your shape for optimal body contouring results. If upper abdominal muscle separation repair is needed, your surgeon will reposition and tighten these muscles and secure the tissue with permanent nylon sutures.

Your surgeon will then pull the skin on your abdomen up towards your breast, and once a pleasing contour is achieved, excess skin will be trimmed, and the incision line will be carefully sutured. Once surgery is complete, your midsection will be wrapped in surgical gauze and you will wear compression garments to encourage a safe, speedy recovery.

What is reverse tummy tuck recovery like?

Recovery from reverse tummy tuck is similar to that of a traditional tummy tuck and requires 1-2 weeks off from work and most daily activities. You’ll experience soreness, swelling, and bruising for about 2 weeks, and you’ll be asked to wear your compression garments during this period, or until your surgeon advises otherwise.

As with a traditional tummy tuck, strenuous activities like exercise should also be paused for 4-6 weeks. If you have an infant, toddler, or young children, you will also likely need to arrange supplemental childcare as you will not be permitted to lift anything over 5-10lbs for at least a month.

For the right patient, a reverse tummy tuck can achieve natural-looking tummy tuck results with no lower abdominal scar.

How is a reverse tummy tuck different from other tummy tuck techniques?

While there is much overlap between tummy tuck procedure goals, differing techniques have been developed to address each patients’ unique anatomy and aesthetic goals.

Reverse tummy tuck vs traditional tummy tuck

A reverse tummy tuck is performed via a single incision across the natural breast crease and can only address sagging skin and abdominal muscle separation in the upper portion of your abdomen. In contrast, a traditional tummy tuck is performed via an incision just above the pubic area and at the navel. From there, extensive abdominal muscle separation can be repaired from the upper and lower abdomen, and the belly button is repositioned for a natural appearance once excess skin and fat have been removed.

Reverse tummy tuck vs mini tummy tuck

For patients who only require improvement to the lower abdomen to achieve their tummy tuck goals, a mini tummy tuck is performed using a shorter incision to remove excess skin and fat and tighten only the lower abdominal muscles if necessary. This is almost a mirror procedure to a reverse tummy tuck as it addresses only the lower half of the midsection. The belly button is not repositioned during a mini tummy tuck, but the right candidates typically enjoy a shorter recovery time with this less invasive technique.

Reverse tummy tuck vs umbilical float tummy tuck

Unlike a reverse tummy tuck, an umbilical float tummy tuck requires a shorter incision just above the pubic area to detach the umbilicus (belly button) from the abdominal wall and tighten abdominal skin and underlying musculature. The belly button will naturally move down lower on the abdomen or “float” as the skin is pulled taut to create a smooth contour and is then reattached to the abdominal wall. While less commonly performed, an umbilical float tummy tuck may be the ideal technique for patients with minor skin laxity and a belly button that can be lowered 3-4 centimeters while still appearing completely natural.

Who could benefit from a reverse tummy tuck?

Reverse tummy tuck is less commonly performed than other techniques, but it can achieve outstanding results for the right patient.

Previous tummy tuck refinement

Patients who have previously undergone a tummy tuck may experience skin laxity on the upper portion of their abdomen while the bottom portion remains taut and smooth. This could be caused by weight fluctuations or the natural aging process. A reverse tummy tuck can tighten the skin of the upper abdomen without the downtime of a second full or mini tummy tuck.

Improvement is needed in the upper abdomen only

Each patient has unique anatomy and physiology, and a few may hold excess skin and fat above their belly button instead of below. If your symptoms are primarily located on your upper abdomen, and you do not require lower abdominal muscle separation repair, a reverse tummy tuck could be a good option for you.

The treatment plan includes multiple procedures

Mommy makeover patients who wish to combine a tummy tuck with breast surgery such as breast augmentation, breast reduction, breast lift, or breast implant revision may be good candidates for a reverse tummy tuck as multiple procedures could be performed using a shared incision, allowing patients to enjoy an easier recovery.

Chest wall reconstruction is needed after breast cancer

A reverse tummy tuck may be used for reconstructing the chest wall following breast cancer. In the event of recurrent breast cancer, this technique also allows for easier removal of cancerous tissue thru the reverse abdominoplasty flap instead of the pedicled flap—the tissue used to reshape the breast.

Is a reverse tummy tuck safe?

Like any surgery, reverse tummy tuck carries some risks—all of which are shared with its sister techniques and may include:

  • Infection
  • Bruising and swelling
  • Asymmetrical results
  • Poor scar appearance
  • Seromas (fluid collection beneath the skin)
  • Hematomas (blood accumulation beneath the skin)

When performed by a highly-experienced board-certified plastic surgeon, patients can rest assured they will receive optimal care before, during, and after surgery, and their provider will have the expertise to limit surgical risks and quickly identify and treat any issues that may arise.

How do I know if a reverse tummy tuck is right for me?

A personal consultation with an expert tummy tuck surgeon is the best way to determine if a reverse tummy tuck would safely achieve your body contouring goals. To help you get an idea of what your surgeon will consider when determining which tummy tuck technique will best suit you, here are some common indicators used when assessing patients:

  • Full tummy tuck candidates will have skin laxity in the upper and lower abdomen.
  • Mini tummy tuck candidates will have mild skin laxity in the lower abdominal area only and a relatively smooth and firm midsection above the belly button.
  • Reverse tummy tuck candidates will have mild skin laxity in the upper abdominal area only (typically seen after weight loss or a previous tummy tuck), while their lower abdominal area is relatively smooth and firm.

To learn more about your body contouring options, schedule your tummy tuck consultation with Fairfax plastic surgeon Dr. Christopher L. Hess. At Hess Plastic Surgery, patients receive compassionate care and achieve beautiful results from the latest and most advanced surgical techniques. Whether you are looking for transformative surgical procedures, expert Botox and injectable filler results, or proven medical spa and skin care treatments, our highly-experienced team is ready to help you every step of the way. Our practice can be reached at (703) 752-6608 or contact us online.

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