Pregnancy or significant weight gain lead to stretching of both the muscles and the skin. Once the weight is lost, excess skin and stretch marks are usually left behind. Losing more weight and ramping up your exercise program will not correct this condition. Muscles don’t shrink and skin can only be expected to minimally recoil after pregnancy and/or weight loss. If extra belly fat is your concern there are several techniques and procedures that may return the shape you thought was lost forever.

reverse abdominoplasty

During a detailed examination, the abdominal contour will be evaluated relative to the waist, hips and back. This will help determine what procedure is in your best interest. Liposuction, tummy tuck, or a combination of both may be prescribed. Oftentimes patients seen in consultation either ask for or are hoping that liposuction alone will resolve their aesthetic issues; however the degree of laxity of the abdominal musculature is the determining factor. Generally speaking, substituting liposuction for an abdominoplasty (tummy tuck) will not achieve the waistline envisioned. Used in tandem, remarkable results can be yours. In certain circumstances, a “reverse abdominoplasty” takes this procedure and ensuing result to an entirely different level of sophistication and enhancement…

Procedure Snapshot:

What part(s) of body treated by this method: Abdomen
Time for procedure: 2 hours
Adjunct procedures: Breast enhancement
Alternative procedures: Liposuction, conventional tummy tuck
Anesthetic: General
Number of sessions required: One
Downtime: 10 days
Complications/Risks: Poor scarring, DVT
How long results last: Predicated upon weight being stable
Reverse Abdominoplasty Cost: ($/$$/$$$:) $$

One on one with Dr. Andrew Kornstein:

For approximately the last two years I have begun to champion the reverse abdominoplasty. It is a tummy tuck featuring an enhanced technique variation — a procedure coincidentally gaining popularity in Brazil at this time. Many people have no idea such an operation exists. It is a remarkable option for patients who have more skin above their belly button than below—especially in the sitting position. Contrary to conventional abdominoplasty, the reverse abdominoplasty features no scar in the pubic area or around the belly button. The scar is hidden in the crease under the breasts. Depending upon the amount of skin excess the scar can remain in this crease. Should the skin excess be significant, the scar must cross from one crease to another. If this is the case, stem cells can be used to facilitate healing, thereby hiding this larger scar especially in women who have wider separation between their breasts. Alternatively, fat grafting or breast implants can be used to narrow the cleavage distance providing more camouflage for the scar. There are certain factors which inspire me to recommend this particular operation to patients:

  • It dramatically improves the waist contour when compared with conventional abdominoplasty. A standard “tummy tuck will generally deal with the front of the belly whereas the reverse technique deals with the waist and front—roughly 270 degrees around a patient’s torso.
  • Hernias are amenable to repair through this incision, just as they are through the conventional abdominoplasty.
  • Many patients are poor candidates for belly button scars. A lower scar by the pubic region will benefit those who are poor healers.
  • Patients who have skin excess predominantly located in the upper abdominal area are great candidates for this procedure.
  • Accentuation of the waist is of particular benefit to those patients who are short and square waisted.
  • The skin excess typically removed at the incision under the breasts or inframammary fold can be used for an autologous breast augmentation.

The one and only potential downside of this operation is the scar that traverses the upper abdomen between the breasts. In my experience as well as those reported by my Brazilian counterparts, a scar revision done 4-6 months post op can remedy any remorse about the scar. Done under local anesthesia, in our treatment room, there is no recovery time to speak of and it truly makes a difference in the quality of the final scar healing.