Full TT usually best
In general a full TT will tighten the entire abdomen while a mini will only improve the lower part, so it there was skin laxity above the belly button then a mini is not usually optimal.
If on the other hand the skin laxity in the upper abdomen is not especially significant, then a T-junction closure is my preference over trying to make a mini work or having the scar too high. (Richard Baxter, MD)
You really do need a full TT with muscle repair. To do things the way you really need to (from a contour standpoint), you may have a small vertical scar between your belly button and your bikini incision.
Unfortunately, you may have to accept this in order to get the best result. That scar typically heals well and you can always get it revised to make it as inconspicuous as possible. I don’t think you will be happy any other way. (J. Garrett Harper, MD, Charlotte Plastic Surgeon)
Revision
I would love to see your preop pictures. you have loose skin when you are sitting, but it sure looks tight when you are standing up. everybod’s skin looks loose when sitting. hard to tell without examining but it sounds like your surgeon is afraid that he wont be able to get the skin low enough to an acceptable scar for you. i would not do what your surgeon is suggesting. get a second opinion (Jonathan Saunders, MD, Newark Plastic Surgeon)
Unhappy with Mini TT
It sounds like a full TT might have been the better option the first time. At this point, I would just extend the incision and do a full TT versus doing a vertical scar which will be harder to hide in clothing. If your belly button was lifted off of the muscle and reattached during your mini-tuck, you may need to wait at least 6 months before considering revision.
There is some risk to the vascularity in cutting around the belly button in someone who has had a previous umbilical float, but I have not had problems with the blood supply doing this if you wait a sufficient amount of time. (Donald Griffin, MD, Nashville Plastic Surgeon)
Tummy tuck
You would definitely benefit from a full TT now with muscle repair from your breastbone down to the pubic area. I would not recommend you proceed with the vertical skin excision as you described above. That would probably leave an unsightly scar which would not allow you to wear a bikini comfortably in public. (Victor Ferrari, MD, FACS, Charlotte Plastic Surgeon)
Mini vs full TT
Not knowing what conversations you had with your surgeon ahead of time certainly may change the opinions I am about to give. If he tried to convince you to have a full rummy tuck but you decided otherwise then you made the wrong decision. You should have had a full TT. Whenever a patient or Dr does a mini on someone who needs a full TT, no one is happy. So what do you do now?
The best treatment is to do the full tummy tuck. There will most likely be a scar that goes up-down, below the belly button but possibly not. I’m not sure from your description what your surgeon is proposing but make sure it fixes what is bothering you and that it makes sense.Seekin a second opinions is almost always a good idea. (John P. Stratis, MD, Harrisburg Plastic Surgeon)
Full TT following mini tummy tuck
Based on the photos you have provided, it appears that you were not a good candidate for a mini tummy tuck and should have had a full TT initially. It appears that you have a weakness of your muscle/fascia layer above your umbilicus which is only addressed with a full abdominoplasty.
In addition, more skin can be resected with a full abdominoplasty procedure. If you were my patient, I would recommend a full abdominoplasty. You may have a vertical scar from your belly button to your pubis depending on how much additional skin can be removed. (Christopher J. Morea, MD, Raleigh-Durham Plastic Surgeon)
I would have recommended a full TT with muscle repair. I would avoid revision surgery for 6 to 12 months due to healing, and changes that will occur. Discuss your concerns with your Plastic Surgeon. (Robert E. Zaworski, MD, Atlanta Plastic Surgeon)