Tummy Tuck

River - Forgive the poor drawings below - but hopefully this will give you some insight. Typically "inverted T" pattern incisions for abdominoplasty are used to address excess skin above the umbilicus.

And in my practice the skin excess usually has to be fairly dramatic (typical of massive weight loss patients who have successfully undergone gastric bypass surgery).

The ability to remove excess skin above the umbilicus comes at a cost of additional scar as well increasing the risk of poor healing (as Dr. Di Sai mentions). Typical abdominoplasty excision pattern - note that the skin is pulled downward to improve the abdominal contour.

This is the typical post-op result with a transverse scar low along the abdomen and a scar around the umbilicus. A inverted T abdominoplasty (as pictured below). You can see that this skin excision pattern allows for the skin to be pulled downward and also from side to side.

This additional direction of skin pull can be useful for patients that have a significant amount of extra skin above the umbilicus and where that downward pull alone may not provide enough of an improvement. Here's a picture of the typical end result.

I In my practice the traditional abdominoplasty incision for patients that have not lost significant (more than 100 lbs) amounts of weight is usually all I need to get a great result. Steven Williams, MD.