Reverse abdominoplasty or tummy tuck is only suitable for a small subset of patients. For the vast majority of patients though, the standard technique or hip-to-hip incision within the lower abdomen remains the best approach since it can remove the excess skin in both the upper and lower abdomen.
Reverse abdominoplasty primarily targets skin laxity in the upper abdomen, thus it only favors women whose lower abdomen appears relatively tight, according to experts at Inland Empire Plastic Surgery Institute.
The technique typically uses one long incision within the breast fold. While most of the scar aspect is hidden within the natural breast fold, it might become visible in the sternum area (medial chest), especially in small-breasted patients. Nevertheless, most scars fade about 6-12 months that they blend with the skin.
The procedure can be incorporated with “auto” breast augmentation in which the patient’s own [excess] tissue from the upper abdomen is used to add volume in the breast; hence she can avoid implants and the risks that come with them such as leak/rupture, scar capsule hardening (capsular contracture), and possible replacement in the future.
However, it is important to note that “auto” breast augmentation via reverse abdominoplasty is a highly complex procedure. To achieve more natural results, it is often combined with fat transfer in which excess fats are liposuctioned from different parts of the body such as the flanks, thigh, hips, etc., then later used to reshape the breasts.
For the right candidates, reverse abdominoplasty can produce impressive results from the cosmetic point of view. However, proper wound closure is critical to prevent poor scarring or scars migrating inferiorly that they become visible on the upper abdomen.
Once the excess skin the upper abdomen is removed, the remaining tissue is attached to the rib fascia, which is noted for its additional strength and thus preventing scar migration and sagging recurrence.
Aside from women who prefer auto breast augmentation, the technique may also suit previous abdominoplasty patients who develop sagging, which for some reason only affects their upper abdomen and not its lower aspect. Aging, weight fluctuations, and sun exposure are the most common factors that contribute to abdominal laxity.