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Do I need a T-incision tummy tuck?

Typically, "inverted T" pattern incisions for abdominoplasty are used to address excess skin above the umbilicus. In my practice the skin excess has to be fairly dramatic (typical of massive weight loss patients who have successfully undergone gastic bypass surgery). The ability to remove excess skin above the unbilicus comes at the cost of additional scar as well as increasing the risk of poor healing. In a typical abdominoplasty excision pattern you can see that the skin is pulled downward to improve the abdominal contour. The typical post-op result is with a transverse scar low along the abdomen and a scar around the umbilicus. An inverted T abdominoplasty shows a the skin being pulled downward and also side to side. This additional direction of skin pull cna be useful for patients that have a significan amount of extra skin above the unbilicus and where that downward pull alone may not provide enough of an improvement. In my practice, the traditional abdominplasty incision for patients that have not lost significant amounts of weight is usually all I need to get a great result.

Clinical Context

A T-incision (inverted-T) tummy tuck is often confused with a fleur-de-lis procedure, but they're not identical. Fleur-de-lis removes loose skin across the entire trunk, sides included, and is more often used after major weight loss. A T-incision mainly addresses extra skin above the belly button when a standard low horizontal scar won't fully correct it. Scar-revision surgery is different again — it improves an existing scar rather than removing new skin. Knowing which problem you actually have helps set realistic expectations for scarring and results.

Answered by Dr. Steven Williams, President Emeritus of ASPS

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