Mini Tummy Tuck

Skin Below the Navel, With the Navel Left Attached

A mini tummy tuck, or mini abdominoplasty, improves the abdomen by liposuction of abdominal fat and then release and trimming of redundant skin. The trim stops below the belly button. The umbilical stalk stays attached to the skin, so the navel is not detached and skin above the navel cannot be reached. Excess skin above the belly button is a contraindication.

The American Society of Plastic Surgeons describes a tummy tuck as removal of excess abdominal skin, with tightening of the abdominal wall when the muscle has separated. A mini tummy tuck does only the lower skin. The muscle tightening in that description is the full operation, and it is not added here.

Because the undermining is limited, the rest of the fat can still be removed with liposuction. That is the advantage this account states over a full tummy tuck, which forbids liposuction of the raised abdominal flap. The same limited dissection is why a mini tummy tuck can be paired with high definition liposuction, the VASER method, when the goal is muscle outline and natural shadow rather than muscle repair.

The operation takes 1 to 2 hours, depending on size and on whether liposuction is done at the same time. Local anesthesia or general anesthesia may be used. The fuller plan, because skin carries dense sensory nerves, uses general anesthesia, and an epidural is an infrequent addition that numbs the lower abdomen, reduces the general anesthetic, and is described as lowering nausea. An epidural still needs a caretaker. Nothing is eaten or drunk after midnight so food is not aspirated when anesthesia starts. The room is an outpatient suite, a hospital operating room, or an office room only when the office is accredited, such as AAAASF.

Who Is a Candidate, and Who Needs the Full Tuck

Candidates have loose skin and stretch marks limited to the lower abdomen, only moderate weight loss after weight gain, and no protruding abdominal wall that would need muscle tightening. They do not need correction of the upper abdomen. They are usually exercising, with a history limited to 1 or 2 pregnancies, minimal weight gain, and minimal to moderate skin laxity. The consultation is the check that this operation, and not a larger one, matches the exam.

The standing exam marks skin redundancy, fat, and the incision. Skin above the navel, stretch marks above the navel, poor muscle tone, or a hernia means a standard tummy tuck, because only that operation releases the navel and reaches the muscle for repair. Diastasis and plication belong to that full operation. They are the reason a mini tummy tuck is refused, not a step that is added to it. Prior abdominal surgery is not itself a contraindication, because the skin is separated from the muscle only up to the belly button. A scar still has to be examined so it does not jeopardize the skin edge.

Women after 1 or 2 pregnancies who did not gain excessive weight, and who do not have stretch marks above the navel or a muscle that failed to recoil, are the postpartum group this operation is meant for. Women who have not been pregnant can have the same lower-skin problem after weight gain, with fat and girth but without the permanent muscle stretch. The operation addresses that redundant skin and does not tighten the muscle.

How the Mini Tummy Tuck Is Done

Markings are made while the patient stands. After anesthesia, the abdomen is infiltrated with tumescent solution and liposuction is performed. On the high definition plan, that liposuction covers the upper, middle, and lower abdomen before the incision. The incision sits over the pubic area, or below an earlier cesarean incision, and follows the bikini line. Patients are asked to bring the underwear or bikini that should hide the scar. A prior scar can move the line. If redundant skin reaches the flank, the incision has to be longer.

The incision goes down to the muscle. Skin and fat are raised only up to the belly button, then redraped, trimmed, and closed. A single drain takes blood and lymphatic fluid for about one week. A contour garment is fitted so the new abdomen can mold. The pull that recreates the silhouette is medial and oblique, not straight down, and the lateral skin is elevated less so the flank is drawn in. Liposuction of the lateral flank is routine, so the lower waist is narrowed along with the skin pull.

The navel is not released and not remade. Pulling the skin often changes an aged horizontal navel toward a tighter vertical shape. The navel may sit less than a centimeter lower, which is the shift described as a more youthful proportion. Leaving the stalk attached is also why the recovery is shorter than a full tummy tuck.

Scar thickness is limited by keeping tension off the skin. Undermining and the amount of tissue removed are both limited. An internal fascial stitch, a tough layer under the skin, takes the tension, and the skin is closed in layers, including the superficial fascial system. Internal sutures are described as lasting about three months. External glue and tape stay about one month. Intense pulsed laser treatment of the line can start about four weeks after the tape and glue come off.

Recovery, Numbness, and the Risks

Recovery can be as short as one week and is longer when the incision is longer. Work is expected at 1 to 2 weeks. Full physical activity is expected at 2 to 3 weeks. Heavy lifting and strenuous activity wait about one month. The garment is worn about 1 to 2 weeks. Walking starts early to lower the chance of a clot in the leg. After the drain is out, energy usually returns.

Numbness is expected because sensory nerves travel in the muscle and then enter the skin, and raising the skin divides them. Undermining stops at the belly button, so the numb area is the lower abdomen. Sensation is described as returning on average by six months. A hypertrophic scar is a thick skin scar. More excised skin means more tightness and redness that can last 3 to 6 months. Steroid injection, laser therapy, and silicone pressure therapy are the treatments named for that scar. Limited undermining is the reason poor scarring is described as uncommon.

Deep vein thrombosis can follow any of these operations. The clot can travel to the lung as a pulmonary embolus, which is named here as the leading cause of death after surgery even though it is rare. Pneumatic compression boots are used during surgery, and walking starts as soon as possible.

A hematoma is pooled blood and is treated as a medium for bacteria. A seroma is plasma in the space left when skin is raised and lymphatic vessels are divided, tied here to a low blood count and low protein. One drain, left about one week, is the prevention named for both. A seroma is more likely if the drain is removed early, and it may need office aspiration. Infection can open the incision and is treated with a prolonged antibiotic course. Patients who do not smoke, or who have stopped for at least one month, are described as less likely to infect.

Skin-edge death is tied to nicotine, which closes the small vessels the edge needs, and to uncontrolled diabetes. Smoking stops for at least one month before surgery. An open wound needs dressing changes, and a delay in healing is described as compromising the contour. Asymmetry can come from uneven redundancy or from stretch marks that have lost elasticity and stretch again. Stretch marks below the navel are removed when they can be. Stretch marks left unevenly can be revised in the office. Stretch marks above the navel are a reason to choose the full tummy tuck instead.

If weight stays stable and activity continues, the contour is described as lasting. A new pregnancy or a large weight change is a separate event, not a promise the same skin will hold.

The fee is listed on the mini tummy tuck cost page and is not restated here.