Mini Tummy Tuck VS Full Tummy Tuck?

My practice specializes in body contouring after pregnancy. Being a mom of 4, I can relate to women’s abdominal contour problems after childbearing. It is incredibly frustrating to diet and exercise regularly, and yet be unable to correct the loose skin, fatty deposits, and bulging muscles most women experience after having children or weight fluctuations.

Liposuction alone works great to remove fat, but it does not tighten the skin at all, nor affect underlying muscles. It works well in normal weight patients with great skin and muscle tone, no skin excess, and no stretch marks. Most candidates haven’t had children or significant weight fluctuations. In this subset of patients, results are excellent.

Women who present to my office seeking waistline contouring after childbearing desire a flat abdominal wall, with minimal scarring, and the removal of as many stretch marks as possible. It is not surprising that many normal weight women go into the consult expressing interest in a “mini-tummy tuck” or “mini-abdominoplasty”. Patients have preconceived notions that a full-tummy tuck or full-abdominoplasty is a treatment meant for heavier women. They are turned off by the idea of a long scar on their abdomen, running hip to hip and one around the belly button. I totally understand. The shorter scar associated with mini-abdominoplasty sounds appealing. Many women have C-section scars, and they are comfortable with that particular scar length, as they are relatively inconspicuous and hide well in many bikini brief styles.

The problem is that the candidates for mini-abdominoplasty are far and few between. The fact is, a mini-abdominoplasty does not tighten the skin very much. It only removes 1-2 inches of skin above the pubic hairline. Most patients who are the right candidates for a mini-abdominoplasty already look fabulous in a bikini. They have little to no stretch marks, good tone with minimal looseness, a high belly button position, and are thin with a long-waist. Mini-abdominoplasty equals “mini-results”. Loose skin above or around the belly button is unchanged from mini-abdominoplasty surgery. Bend over to truly assess the amount of skin redundancy you have in this area. If you want that to improve, then a mini-tummy tuck is not the answer. The longer I am in practice, the less mini-abdominoplasties I do, because of patient dissatisfaction with the final results. If you are going to go through the expense of an abdominal contouring operation, the associated recovery and downtime with potential for prolonged swelling, why would you want a 20 percent improvement at best?

Even in patients who are thin and only have loose skin above and around the belly button, a full tummy tuck is really the only way to address the loose skin in this area. There is no way to locally excise skin here and try to hide a scar in the umbilicus. Trust me, it has been done before by many surgeons and it doesn’t really work. Plus, the resulting scar distorts the umbilicus and looks really strange, and much worse than the appearance of a full tummy tuck scar. The next maneuver we all try is pulling the abdominal skin upwards or even the breasts upwards for that matter. Patients show me this in the office all the time. The abdomen looks pretty good when you do this. And no, a breast lift does not affect your abdominal appearance. Well, there is such an operation, called a reverse abdominoplasty. There’s a reason that it is rarely performed. Even in experienced hands, it’s a tricky operation, as the resulting scars going along the inferior breast creases can affect breast contour and often need to go across the midline to avoid skin bunching between the breasts. The final scarring becomes a problem that is hard to hide, and the results on the abdominal wall are not fabulous.

There are no skin-tightening devices such as lasers, ultrasound, or radiofrequency devices that can consistently tighten skin in this area or any area for that matter. Don’t waste your money. As soon as there is some sort of technology that tightens skin safely and effectively without surgery, I am the first one having it done.

The gold standard for abdominal contouring after pregnancy is full abdominoplasty. Even if you have bulges of excess skin around your waistline from genetics, aging, or being overweight, or a chubby adolescent, or dealing with weight fluctuations without having experienced pregnancy, abdominoplasty is the best way to tighten the skin. Lesser treatments will only provide less than satisfactory results. So even though a mini-tummy tuck is appealing and sounds less invasive and cheaper, do the right thing and do what your board certified plastic surgeon recommends.

Dr. Hayley Brown MD, FACS
Plastic Surgeon in Las Vegas
Desert Hills Plastic Surgery Center, Henderson and Las Vegas, Nevada

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