I’m updating the piece I wrote a while back on seven variations of tummy tucks to include mesh reinforcement of diastasis repair, which we have been doing more of lately. The reason for these variations is to allow the tummy tuck (abdominoplasty) procedure to be customized to the patient’s needs. These options include a full (standard) tummy tuck, full tummy tuck with T-closure, extended tummy tuck, reverse tummy tuck, mini tummy tuck, and mini with an umbilical float. This blog will explain the differences and how to determine which one might be best for you.
- Most common is a full tummy tuck. This removes loose skin between the pubic area and the belly button, using the skin of the upper abdomen to expand and cover where the skin was removed. The result is a bikini line scar from hip to hip, and a scar around the belly button. In addition to skin removal and tightening, a muscle separation (called a diastasis) can be repaired and any localized fat can be removed. Liposuction can be added to the sides or adjacent areas if needed.
- The newest addition to our list is the tummy tuck with mesh reinforcement of diastasis repair. I introduced this in an earlier blog as part of the Mothers of Multiples (MoMs) Makeover, because the muscle separation is often much wider after twins/triplets pregnancy. We have two excellent options for the mesh: Galaflex (same material we use for the internal bra) and Durasorb. These are soft, strong, and slowly dissolve allowing the body to build a layer of natural tissue for long-term support. Additionally, the mesh allows the waistline to be pulled in
wide diastasis repair with mesha bit more.
- A tummy tuck with T-closure is a variation of the full tummy tuck that is done when the upper abdominal skin can’t be expanded enough to cover the lower abdomen while still keeping the scar low. The vertical part of the upside-down “T” fades nicely over time and the rest of the scar is in the usual bikini line. In the picture below, the blue line is where a full tummy tuck would normally be done but the skin in the upper abdomen could not be stretched enough to create a low scar.
- For patients with large weight loss, a variation of the T-closure called the Fleur de Lis tummy tuck is sometimes done. This pulls more skin in from the sides as well as top to bottom, with the vertical scar all the way up to the belly button or higher.
- A mini tummy tuck removes skin from the lower abdomen only, and so does not have any effect on the upper abdomen. It can be combined with liposuction of the upper abdomen and adjacent areas when necessary.
- A mini tummy tuck with umbilical float has the same amount of skin removal, but the belly button (or “umbi”) is detached from underneath allowing access to the upper abdomen. This means that a muscle separation (rectus diastasis) can be repaired all the way into the upper abdomen. The umbi is re-attached, sometimes a little bit lower than its original position. This can give a little bit of smoothing of the skin just above it.
- A reverse tummy tuck is really more of an upside-down tummy tuck, because it removes skin from the upper abdomen and pulls the skin upward. Think of it as a sort of upper mini tummy tuck, because it has no effect on the lower abdomen. The scar is under the crease along the bottom of the breasts, so it works especially well when a breast lift or revision surgery is planned with an incision in that location. A mini version of the reverse tummy tuck removes a crescent of skin below the breasts without connecting the scar across the middle.
- An extended tummy tuck is a full but extended to remove more skin on the sides. This is often done when there has been substantial weight loss. The scar is longer but the benefit is more tightening on the sides.