A reverse tummy tuck, formally known as a reverse abdominoplasty, is a specialized body contouring procedure that focuses on the upper torso. This surgery is a distinct variation from the more common abdominoplasty, which typically addresses the lower abdomen. It is designed to tighten the skin and improve the contour of the upper midsection. This technique is used for individuals seeking a smoother, more refined abdominal appearance when traditional methods are not appropriate.
Understanding the Reverse Abdominoplasty
The reverse abdominoplasty targets the region above the belly button, focusing on the upper abdomen. This area can develop loose, inelastic skin due to factors like significant weight loss, aging, or pregnancy. The procedure’s defining characteristic is that the skin is pulled and tightened upward, toward the chest, in contrast to the downward pull of a standard tummy tuck.
The goal is to remove excess skin and sometimes small amounts of underlying fatty tissue from the upper abdominal area. The technique avoids an incision around the navel, which remains in its natural position. This allows for a flatter, more contoured upper abdomen, especially in individuals whose lower abdominal tissues are already relatively firm.
A key difference from a traditional abdominoplasty is the focus area, as the standard procedure addresses skin and muscle laxity primarily below the navel. While a standard tummy tuck often repairs abdominal muscle separation (diastasis recti), the reverse procedure is generally not used for a full muscle repair. The name “reverse” refers to the upward motion of the skin flap, securing the remaining tissue to the rib fascia just beneath the breasts.
Patient Suitability and Indications
Candidates for a reverse abdominoplasty have skin laxity concentrated primarily in the upper abdominal region. They typically present with loose or sagging skin just below the chest that does not respond to diet or exercise. Suitability hinges on having relatively good skin quality and minimal excess skin or fat in the lower abdomen.
This surgery is frequently considered for patients who have undergone massive weight loss, such as following bariatric surgery, where the skin above the navel has become significantly loose. It is also an option for individuals who previously had a standard tummy tuck that successfully addressed the lower abdomen but retained residual skin excess in the upper area.
A good candidate will not have a full diastasis recti, or separation of the abdominal muscles, that extends significantly into the lower abdomen. If the lower abdomen requires extensive skin removal or muscle tightening, a traditional or full abdominoplasty is a more appropriate procedure. The primary indication for the reverse technique remains the targeted correction of skin and tissue excess above the navel.
The Surgical Experience and Recovery
The reverse abdominoplasty is performed under general anesthesia. The technical execution centers on the incision placement, which is strategically made along the inframammary fold, the natural crease beneath the breasts. This allows the resultant scar to be discreetly hidden within the natural body contour.
The surgeon makes a horizontal incision that often extends across the lower sternum to connect the folds beneath both breasts. The full-thickness skin and fat tissue are carefully elevated down the abdomen. The excess skin is then excised, and the remaining skin flap is pulled upward and secured to the fascia of the lower rib cage, achieving the desired tightening and contouring of the upper abdomen.
Recovery generally involves a moderate period of healing, often considered less extensive than a full tummy tuck. Patients should expect mild to moderate discomfort in the initial days, managed with prescribed pain medication. Swelling and bruising in the upper abdomen are common and gradually subside over the first few weeks. A compression garment is worn post-operatively to minimize swelling and support the newly contoured tissues.
Light walking is encouraged soon after surgery to promote circulation, but restrictions on activity are in place for several weeks. Patients with sedentary jobs may return to work within 7 to 14 days. Strenuous activities, heavy lifting, and intense exercise must be avoided for four to six weeks. Full results become progressively evident as the swelling resolves, which can take up to three months.