Tummy Tuck or Mini Tummy tuck?
I get many patients who come in requesting a Tummy Tuck. They will get a much flatter tummy, and if they get liposuction around the love handle area, a drastic reshaping of the entire midsection. However, the drawback is the scar. It generally goes from hipbone to hipbone. Invariably, I get the question, can we do a Mini Tummy Tuck? The patient is hoping to get most of what she needs with a smaller scar and a less involved surgery. Can that be done?
The first thing for the patient to realize is that although the two procedures, tummy tuck and mini tummy tuck, have a similar name, they treat different conditions. Please view my illustration above to see the difference between the two procedures. My schematic shows the amount of skin removed, the amount of muscle work performed, and the final incisional scar in each procedure.
Mini Tummy Tuck
The Mini Tummy Tuck treats the minor pouching out of the lower belly caused by stretching of the lower abdominal muscles. It is primarily a muscle tightening procedure. Combined with liposuction of the love handles it can truly reshape the midsection. One word of caution:
Invariably I get the question, Can we do a Mini-Tummy Tuck?
I always take out the deep layer of fat in the lower abdomen, because if I don’t, fat will redistribute in that pocket . You cut out enough skin to take out the slack created by tightening the muscle and defatting the skin, and the scar just goes from one side of the pubic mound to the other. It is a very well disguised scar, and very thin because not much tension is used to close the scar. It’s a great procedure provided you are committed to it’s limitations.
These are the conditions and limitations for the Mini Tummy Tuck:
- The procedure is not a good skin tightening procedure.
- It can only tighten a limited area directly above the pubic mound. If you try to tighten more, you end up extending the scar sideways, and you get a longer scar that is no longer well hidden and still not the amount of tightening that will make you happy.
- It really doesn’t take care of stretch marks.
- It does not take care of any muscle wall separation above the belly button.
The Tummy Tuck treats two conditions:
- a muscle separation above and below the belly button
- excessive or loose skin in the belly
It is really two operations, a muscle repair and a skin excision. The skin excision part is called a Dermatolipectomy. All the skin between the belly button and pubic mound is taken out. Thus it can take care of all the stretch marks below the belly button. The skin above the belly button is stretched to reach the top of the pubic mound. Any stretch marks above the belly button will come to lie just above the pubic mound.
The scar from a Tummy Tuck usually goes from hip bone to hip bone, but this is not an absolute. If there is a lot of loose skin, or a fold of abdominal skin, the scar may extend beyond the hipbones. However, keep in mind that I can strategically place the scar below the panty line. Sometimes I can make the scar slightly shorter, but the patient has to be aware she might have darts or little pouches on the side of the wound, which can be taken care of later under local anesthesia. This is important when a patient wants to keep the scar within the limits of certain underwear or bathing suit.
There is a third surgical alternative for patients who have just a muscle separation and very little skin excess, or who want no visible scars. The whole procedure is done through the belly button, and I will make a separate post devoted to this surgical technique.
By Ricardo L Rodriguez, MD
Board Certified Plastic Surgeon
Over 20 Years Experience