Tummy tucks are a very popular and effective procedure to contour the abdomen. In a small select group of patients, it is possible to perform a vertical tummy tuck where the incision is placed underneath both breasts.
This is best for patient who does not have excess skin or bulge in the lower abdomen. Naturally, patients like this are uncommon so this surgery is performed rarely.
If you have severe diastasis which involves the lower abdomen, the best procedure for you is a regular tummy tuck or a mini tummy tuck.
Your best bet is to work with a board-certified plastic surgeon was great deal of experience in abdominoplasty and body contouring.
They will be able to best assess your bodies physical condition and what procedures will help you meet your goals. (Pat Pazmino, MD)
If your major procedure is the breast augmentation you should probably have that done with incisions at the fold beneath the breast or at the areolar border. At the same time if you have a major diastasis of your rectus muscles, but minimal skin excess, a nice procedure is through a short pubic scar (as with a c-section) and a small incision at the belly button through which an endoscope can be introduced to help visualize and repair the stretched out fascial tissue.
Alternatively, if there is minimal loose skin but it is mostly in the upper abdomen area, sometimes a “reverse abdominoplasty” is indicated to pull the skin up at the breast folds rather than through a long incision in the pubic region. (David J. Levens, MD, Coral Springs Plastic Surgeon)
You can get two small incisions for the implants and a well placed tt incision that can be hidden beneath your favorite underwear or swimsuit. It is a very powerful procedure that can have lipo used as an adjunct. OR You can have a tummy tuck scar that can extend from one side of yor breast to the other, and will likely not be able to give you the same powerful result. (Scott E. Kasden, MD, Dallas Plastic Surgeon)
Reverse tummy tuck
Reverse abdominoplasty may be an effective procedure for loose upper abdominal skin, but not if you only require correction of a diastasis recti. You would do better with an endoscopic or fiberoptic tummy tuck or a full tummy tuck with insertion of your breast implants through the tummy tuck incision. (Kenneth R. Francis, MD, Manhattan Plastic Surgeon)
Most women who have a severe diastasis don’t usually get to keep their abdomens stretch mark free and tight. Any procedure that attempts to tighten only the diastasis of the rectus muscles will cause a midline bunching of skin that will have to be addressed. This can only be done by some type of skin incision. If this bunching is just below the belly button then a mini tummy tuck is possible.
If the bunching is above and below the belly button, then a full tummy tuck is appropriate. Endoscopic, minimal incision procedures are fine if you have minimal diastasis. They are not designed for people who have a severe diastasis as you claim. In the end, just opt for the procedure that delivers the goods and forget about gimmicks.
With regards to your question, it is possible to have a reverse abdominoplasty and place breast implants at the same time. Your surgeon will need to be extra careful with closing the base of your implant pocket to keep the implants in the area of the breasts and not have them slip into the belly area.
Also, gravity will probably stretch your scar down. Finally, if you need an incision around your belly button to move all the excess skin up to get it trimmed off, you may be left with a small vertical scar in the middle of your abdominal area. However, if you only get excess skin above your belly button, then when your surgeon pulls the excess skin up, it may distort your belly button shape into something unnatural. Make the best decision you can. (Manish H. Shah, MD, FACS, Denver Plastic Surgeon)
When the only abdominal problem is the diastasis, this is corrected through a short incision at the level of the pubic hair. Surgery is done with fiberoptic retractors or endoscopically. You need to get around the belly button to correct both the upper and the lower diastasis. Patients accept this scar well.
Trying to do this through incisions under the breasts will only lead to problems. With cosmetic surgery, it is always best to do the safest thing. It sounds good, but it really isn’t. (George J. Beraka, MD (retired), Manhattan Plastic Surgeon)
What you are trying to accomplish will point to the surgical procedure required. If your skin is”normal” and you have little or no excess fat, and if your sole goal is to correct the diastasis of the recti abdominis muscles, you can do this through any incision your surgeon feels comforatable with. Some use endoscopic methods, some use a short “Mini-tuck” incision, and some might be proficient in doing this through an inframammary incision.
You will need to remember that there is usually a medial repositioning of the soft tissues as the muscles are tightened horizontally and this can cause bunching or midline fat bulges that need to be addressed.
A traditional “reverse” abdominoplasty refers to incisions at the upper portion of the abdomen, rather than the lower abdomen, usually along the inframammary crease, and usually indicated removal of lax or excess skin in the epigastrium or upper half of the abdomen.
If you do not have loose skin, you probably don’t need a reverse abdominoplasty. (Robin T.W. Yuan, MD, Beverly Hills Plastic Surgeon)
Reverse abdominoplasty is kinda limited.
I have seen the results and they are not the same as in a regular tummy tuck. It is hard to produce the same tension as in a regular tummy tuck and have the result look good. The incision is also more obvious. Not all things that can be done, should be done. (John P. Di Saia, MD, Orange Plastic Surgeon)
Reverse abdominoplasty with breast augmentation
You are asking about a reverse abdominoplasty to be done at the same time as a breast augmentation. This will only help the upper third of the abdomen. A better alternative is erforming a full tummy tuck and using that approach to insert breast implants without adding an incision on the breasts. This is called a TABA or transabdominal breast augmentation.
It basically saves an incison on the breast. This is something that I have a lot of expereince with, and have presented papers and have given instructional course on this subject. (Steven Wallach, MD, Manhattan Plastic Surgeon)