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Tummy Tuck Through Incision Under the Breasts?
The technique described is called a reverse abdominplasty. The incision changes from hip to hip to being across the entire chest at the level of the intrafamammary fold. This can be an effective technique for patients with significant amounts of excess skin above the unbilicus. Here are the things that are important to consider: 1. Even though the majority of the scar is hidden within the breast fold, the scar typically also continues between the breasts. 2. This technique usually makes it more difficult to deal with excess skin and fat below the umbilicus because it is unusual to continue the dissection below the umbilicus meaning that the area you're improving is really just above the umbilicus. 3. This technique usually does not allow for plication of your abdominal muscles below the umbilicus. Plicating the abdominal muscles helps to improve the contour of your abdomen. 4. This technique is not used as often meaning that your surgeon may not have as much experience with it. In our practice in Dublin, California, I've done hundreds of abdominoplasties but only a handful of reverse abdominoplasties (all with good results!). These limitations are the reason that in people looking for purely cosmetic improvement typically wind up choosing a more traditional technique. There have also been several articles regarding improving excess upper back skin by placing incisions in the inframammary folds as well.
Clinical Context
A reverse abdominoplasty removes excess skin above the belly button by lifting it toward the breast fold instead of pulling downward toward the pubic area, as a traditional tummy tuck does. Because the lift stops at the navel, it does not address loose skin or muscle laxity below it. Patients considering this option should discuss with their surgeon whether their main concerns are above or below the belly button, since that determines which technique will give better results.
