Question:
Have a question about above belly button and below belly botton tummy tuck

   — sarah C. (posted on June 4, 2004)


June 4, 2004
My surgeon and I were both firm believers that I only needed the vertical incision as that was where all the skin was hanging (below my belly button). I actually had a LBL, so it went all the way around. Anyway, I now sometimes wish I had had the anchor incision because my waist has ended up a 1/2 size larger than my hips which can make buying clothes difficult. It's not something anyone else would notice, but it bugs me trying to get clothes that fit. If it fits my waist confortably, it bags on my hips/butt. If it fits my butt nicely, it's tight around my waist. Thank God for low rise stretch jeans. Don't know what I'll do when they go out of style :) It is nice to be able to show my tummy without a vertical scar (not that I do outside of a bathing suit), but I think I would rather have a thinner waist.
   — mom2jtx3

June 4, 2004
Sarah, Without seeing a picture in your underwear, with all the rolls exposed, it is impossible to guess what you need. I not only needed the anchor incision but I need two surgeries to accomplish what most can get done in 1. I've already had a LBL and so I am cut 360 degrees horizontally and also from pubic bone to just above the bra line. However, this still left me with significant skin above the belly button (BB). We knew this was going to happen going in, so it wasn't a surprise. I had a 2nd panni above the BB that goes around onto the back, so I have large blobs of skin hanging from the bra line to the waist. Normally a surgeon is able to lift the skin up and pull everything down but in my case my waist never stretched about and was very anchored. All 3 plastic surgeons I saw said the same thing - 2 surgeries to accomplish the end result. Even insurance agreed and approved 2 surgeries right away. They did not agree to pay for the lateral thigh lift portion of the LBL of which I paid junt inder $6000. <p>In my case to get rid of all the skin I will need another horizontal cut either at the waist or at the bra line and it will likely go most of the way around if not all the way. He needs to directly excise the skin. I look very weird right now as everything is tight and flat from the BB on down to the thighs. From the BB on up I have small rolls in the front and large ones in the back. So everything hangs over my belt/waist. I also have problems with fitting clothes because right now the waist is about 1/2-1 size bigger than the gut. I am having surgery Monday to remove this skin and he plans to do some lipo in the waist to shape things better and put it more in proportion to the gut. <p>My surgeon said the large roll above the waist isn't very common, at least how mine is. He's only done a few people with it. He said in the past year there has been more talk about this condition and the best way to deal with it in the PS circles. He has some video's from some conferences he wasn't able to attend that address this condition and he plans to be watching them before Monday morning. He'd ideally like to make the incision up high and hide it in the bra coverage. However, he is concerned that over time the skin will start to sag some and I will end up with small rolls, especially in the back. That's why he's thinking that cutting the skin out where the roll is, right above the waist, may give me the best long term result. He's not thrilled about having another horizontal scar right above the LBL scar though. My feeling is no matter what I am going to have lots of scars by the time everythings done that I would prefer he cut wherever I will get the best long term results. Also I am likely to wear 1 piece swimming suits but they tend to scoop down in the back and if the incision was just above the waist it would potentially not show, whereas at the bra line it would. I will live with whatever he decides as I know he has my best interest at heart and wants the best possible results. He a perfectionist, so I know he will think long and hard about it. He's going to revise my belly button and make it smaller and resect an area of skin right above the public bone because he's not happy with how either area is. I agree I would like them worked on some more, but I do not see that he did anything wrong in the first surgery. He had so much skin to remove and things to work out that some things not quite as tight or small as they should be was inevitable. He isn't charging me for the small revision work either. <p>I had 1 surgeon who felt he could do it all from just a horizontal incision. I just did not see how that was possible. I needed the circumference of my skin reduced significantly, especially in the middle. I wasn't normal width with a hanging roll. My surgeon took a large wedge of skin out of the front in order to bring in the sides and provide some contour. Plus then he cut off the roll. I just know I would not have the same tight result I have with just a horizontal incision. But for many that works great. Ask your surgeon to show you before and after pics of patients with similar skin situations as yours. If she doesn't have any with as much skin then I would go for the guy who wants to do the anchor incision. You know you won't end up with excess skin that way. Trust me it would be worth the $4000 if you feel you need skin circumference removed. Many people have just a panni done with good results. It really comes down to your particular anatomy!
   — zoedogcbr

June 4, 2004
I had a full TT a month ago. I interviewed 3 different plastic surgeons and they all recommended the anchor cut. I was told that the key is whether or not you have significant fat or excess skin above the belly button....if you do, it can be drastically reduced with the anchor. Yes, the scar is significant but for me, it was worth it. I get a kick out of looking at a particular freckle that was once on the right side of my back --- now it's just under my breast! haha Think about it - look at your own body, take each surgeon's suggestions into consideration and make the best decision for you. Just from my own experience - I'm glad I went with the anchor. Best of luck to you!
   — Mary W.

June 4, 2004
I also received some conflicting opinions in PS consults. I chose to have the vertical *and* horizontal incisions because I didn't want to be left with a roll in the area over the belly button, and I've seen too many folks report they wound up with exactly that after opting for just the horizontal incision below the belly button.
   — Suzy C.

June 4, 2004
I chose the anchor cut when I had my TT...doc told me that doing it that way would "cinch" my waist...and give me the best results in the area of my hips too. The vertical scar I could live without...but I love the look in clothes...I'm now 35 yrs old and don't dress like Britney Spears, so the scar stays covered anyway. My only problem with it at all is the top of the incision is between my breasts and by its nature looks like I have a 3rd boob there. As soon as I can afford it, I will get a breast lift and scar revision done to take care of it. Good luck and congrats.
   — Mustang

June 4, 2004
Hi. I have never performed the anchor type incision and in my opinion never will. I feel it is not necessary to make that incision to get a nice waistline, and of course it adds excessive scar. I have had many patients with LOTS of excess skin that smoothes out jsut fine with a low "bikini" type incision. There are for sure some advanced techniques needed to accomplish this, but any plastic surgeon with a dedicated interest in body contouring should be able to accomplish this. Please see a few examples of my tummy work at http://www.drlomonaco.com/tummy.htm.
   — DrL

June 4, 2004
Dr. LoMonaco, I have looked at your website before, and now again, and the pictures you have there do not even come close to the amount of skin I had removed in my LBL then add in what I have left to remove in the 2nd stage of my abdominoplasty. I'd kill to have legs that look like those women's. Yes they are larger but no hanging skin. Nothing that just a lift would not cure. In my case it will take a lift and massive skin removal. In other words, an incision from groin to knee. I can see that with the people pictured, that just the low horizontal cut would provide decent results, but add in much larger rolls and multiple ones and all kinds of weird conditions and I believe you would end up agreeing that in some cases an anchor cut and even more is needed. At least for the kind of tightness that I have, which is more extensive than it seems in those pictures. But then again I had the LBL and not just the abdominoplasty or panniculectomy. <p>I do not mean to be disrespectful, so please do not take it that way. But I would bet that not a one of those people were SMO and lost well over 200 lbs. The plastics needed by the former SMO are quite different than what can be done with someone who lost like 100 lbs or less. My surgeon specializes in doing PS on WLS patients and has done many people who were SMO in the past. Even he has said that he'd love to start all over when he is done with me because then he would have all the excess skin gone and he could fine tune and tighten everything how it should be. He had my lateral thigh lift as tight as he could possibly get it, trust me. Yet now 3-1/2 months later he can grab and pull up quite a bit more skin because there is still so much weight in my legs. He's not happy about it because he's a perfectionist, but he realizes he did all he could at the time. Any tighter and I would still be on pain pills to deal with the pain from the tight skin. Even now, if I get the tinyest swelling I feel it and it isn't comfortable. I am realizing that if I want the best long term result that I will likely need to redo a portion of my lower body lift, without abdominal work, to clean everything up once the legs are done. Once that massive weight is gone in the legs then the skin would be able to be pulled tight once and for all and it would stay that way, until mother nature factored in. We will see how everything looks about 6 months after my leg surgery, because maybe just by getting the weight off, the remaining skin might tighten up some. I can hope!
   — zoedogcbr

June 4, 2004
I had a tt last yr. I was a pretty big girl pre op after the weightloss i had ALOT of excess skin above and bellow my bb. When i had my tt i had a I (capital eye) incision. It removed all the excess from above and below my bb. I also had a breast lift at the same time. You can see my ps pics pre and post at picturetrial.com/kbatten278....they are graphic so sit down lol. It has been over a yr now since my ps and you can see the difference in the recovery thru my pics I would say pay the extra money and get done what you want. You only want ot have it done once. Kristi Ky @ goal 302 to 118
   — tinalivesay

June 6, 2004
I saw 2 different plastic surgeons and I opted for the hip to hip incision. I'm THRILLED that I did. I didn't need the anchor cut. My PS was able to do the hip to hip incision and tighten my abdominal muscles without leaving me with scars that I didn't need. He removed 5 pounds of skin also. Ask the doctor who wants to do the hip to hip incision what your belly ABOVE the belly button will look like. With it be flat with no excess skin about it? If so, I would opt for the hip to hip incision. There's no need to do the anchor cut when it's not needed.
   — Patty H.




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