Reverse Abdominoplasty Seattle

If you describe a “tummy tuck,” most people picture a traditional abdominoplasty that removes extra skin and fat mainly from the lower abdomen. But for many patients—especially after weight loss, pregnancy, or previous abdominal surgery—the skin laxity and fullness they notice most is higher up, above the belly button. A reverse abdominoplasty targets that specific concern by removing loose skin of the upper abdomen through incisions hidden along the natural breast crease (the inframammary fold), preserving the navel and refining the upper abdominal contour. In carefully selected patients, this approach can be safe, effective, and highly satisfying. (pubmed.ncbi.nlm.nih.gov)

At our Seattle practice, Dr. Javad Sajan offers reverse abdominoplasty options for men and women who want smoother, tighter definition above the umbilicus without a full lower-abdominal tummy tuck. This page explains candidacy, technique, recovery, cost considerations, and how reverse abdominoplasty can be combined with other procedures to create a balanced, natural-looking result.

You may be an excellent candidate if you recognize yourself in one or more of the following:

• You have significant laxity or redundant skin primarily in the upper abdomen (supraumbilical area), often after weight loss or pregnancy.
• You are unhappy with a residual “roll” above the belly button after previous liposuction or standard abdominoplasty.
• You have preexisting inframammary fold scars or you plan breast surgery, and you’d like your abdominal incision concealed along the same fold.
• Your belly button position and the lower abdomen look fine; your main concern is higher up.
• You are at a stable weight, in good general health, and a nonsmoker (or have stopped with adequate lead time before surgery).

Published case series and reviews support these common indications, particularly for post–massive weight loss patients and for those with previous or planned breast incisions where the inframammary fold can hide the scar. (pubmed.ncbi.nlm.nih.gov)

If you have laxity both above and below the belly button, we may recommend one of the following:

• Staged plan: Reverse abdominoplasty for the upper abdomen and a mini- or full lower abdominoplasty (or circumferential contouring) at a separate stage.
• Combined plan: In carefully selected cases, reverse can be performed at the same time as lower abdominal contouring to address the entire trunk more comprehensively.

Peer-reviewed series describe safe, reliable outcomes when upper and lower laxity are corrected either simultaneously or in stages, particularly in post–massive weight loss patients. Your plan is customized to minimize risk and optimize scar placement and shape. (pubmed.ncbi.nlm.nih.gov)

• Anesthesia and setting: Most reverse abdominoplasties are performed under general anesthesia in our accredited, state-licensed surgical facility with a dedicated anesthesia professional monitoring you throughout the procedure.
• Incision and exposure: Incisions are placed within the inframammary fold (the natural crease where the breast meets the chest/upper abdomen). When combined with breast surgery, the incisions can be designed to align for optimal concealment.
• Tissue refinement: Excess upper abdominal skin is elevated and advanced upward; selective fat contouring may be performed to blend the upper abdomen into the midline and rib border smoothly. The umbilicus is not distorted because the tissue is redraped upward rather than downward.
• Inframammary fold integrity: Maintaining or recreating a crisp, symmetric inframammary fold is essential; meticulous technique helps define this fold so the scar rests naturally within it. (journals.lww.com)
• Progressive tension sutures and drainless options: Where appropriate, Dr. Sajan may use progressive tension sutures (PTS) to secure the redraped tissue to the underlying fascia. Robust evidence suggests PTS can reduce fluid collections (seromas) and can allow many patients to avoid drains while maintaining low complication rates. (pubmed.ncbi.nlm.nih.gov)
• Lipoabdominoplasty principles: In select cases, limited liposuction is blended with skin redraping to refine transitions while protecting blood supply—an approach supported by modern body-contouring techniques. (plasticsurgery.org)

One of the advantages of reverse abdominoplasty is the incision’s location: the inframammary fold incision can coincide with breast augmentation, lift (mastopexy), or reduction incisions when both areas are planned. In specific patients, surgeons have even used upper abdominal tissue during reverse abdominoplasty to augment the breast with the patient’s own tissue (a technique described as AMBRA in plastic surgery literature). While not common, this underscores the versatility of the approach in addressing contour harmony between the chest and abdomen. Your plan will be individualized; most patients who want breast enhancement will either place implants or choose a standard mastopexy along with the reverse abdominoplasty. (journals.lww.com)

• Early recovery (days 1–7): Expect swelling, bruising, and a feeling of tightness across the upper abdomen and under the breast crease. You will be up and walking the day of surgery to improve circulation and reduce clot risk. Gentle movement is encouraged; avoid lifting, straining, and reaching overhead. Many patients wear a supportive compression garment or soft supportive bra, depending on the plan. (plasticsurgery.org)
• Return to work: Most patients feel ready to return to desk work within about 10–14 days, depending on the extent of surgery and whether additional procedures were performed. If your job is physically demanding, plan for more time. (plasticsurgery.org)
• Activity and exercise: Light walking is recommended early. More vigorous exercise, heavy lifting, and high-impact workouts are typically restricted for 4–6 weeks, then increased gradually as cleared by Dr. Sajan. If a breast procedure was performed at the same time, your activity timeline may be adjusted accordingly. (my.clevelandclinic.org)
• Pain control and modern ERAS-style care: Many patients benefit from multimodal pain strategies and, where appropriate, regional blocks such as transversus abdominis plane (TAP) blocks, which can reduce early postoperative pain and opioid needs in abdominal surgery and cosmetic abdominoplasty settings. Your anesthetic plan will be tailored to you. (pubmed.ncbi.nlm.nih.gov)
• Scar care: Scars initially appear pink and firm, then fade over several months. Because the incision sits in the inframammary fold, it is typically well concealed by bras or swimwear. Scar optimization includes sun protection, topical care, and time.

• Immediately after surgery, you will notice a flatter, smoother upper abdominal contour. Swelling evolves over a few weeks, and refinement continues over several months. Maintaining a steady weight and healthy lifestyle helps preserve your outcome long term.
• For the right candidate, treating upper abdominal laxity can make the entire torso look more balanced—especially when the lower abdomen is already in good shape or has been treated in a separate stage. Published series report high satisfaction in appropriately selected patients. (pubmed.ncbi.nlm.nih.gov)

All surgeries carry risk. With reverse abdominoplasty, potential risks include bleeding, infection, seroma (fluid collection), delayed wound healing, unfavorable scarring, asymmetry, changes in sensation, and blood clots (DVT/PE). Risk is influenced by individual health factors, whether procedures are combined, and adherence to postoperative instructions. Choosing a board-certified plastic surgeon operating in an accredited facility and following a tailored recovery protocol help keep risks low. If drains are not used, progressive tension sutures and careful surgical technique help limit seroma risk in many cases. We will discuss your personalized risk profile and prevention plan in detail during your consultation. (plasticsurgery.org)

Because every reverse abdominoplasty is customized, pricing varies depending on:

• Whether you combine it with liposuction or breast procedures
• Operating time and complexity
• Anesthesia and facility fees
• Pre- and postoperative care, garments, and follow-up

During your one-on-one visit with Dr. Sajan, we will:

• Review your medical history, previous surgeries, medications, allergies, and lifestyle factors
• Examine skin tone, tissue quality, and the distribution of laxity above and below the belly button
• Discuss whether a reverse abdominoplasty alone, a reverse upper/modified lower approach, or a staged plan best fits your anatomy and goals
• Consider the synergy of pairing reverse abdominoplasty with breast procedures, if desired
• Outline incision placement options, expected scars, recovery timeline, and what to do before and after surgery to support great healing

During your one-on-one visit with Dr. Sajan, we will:

• Progressive tension sutures for drainless recovery: Strong evidence shows PTS can significantly reduce seroma rates and may allow many patients to avoid drains altogether, even when liposuction is added. That means fewer dressing changes and greater comfort during early healing. (pubmed.ncbi.nlm.nih.gov)
• Meticulous inframammary fold design: The incision’s concealment depends on a well-defined fold. Surgical techniques that re-establish or enhance the inframammary fold help keep scars discreet and maintain natural breast–chest junction aesthetics. (link.springer.com)
• Multimodal analgesia: From local anesthetics and non-opioid medications to regional blocks, we plan pain control strategies that improve early mobility and comfort. Evidence from abdominal and cosmetic surgery literature supports TAP blocks as part of a multimodal plan to reduce early pain and, in some studies, opioid requirements. (pubmed.ncbi.nlm.nih.gov)

When reviewing reverse abdominoplasty before and after examples, evaluate:

• The smooth transition between the upper abdomen and the costal margin (rib area)
• Preservation of natural midline definition without exaggerated hollows
• Symmetry of the inframammary fold and how well the incision hides in different poses
• Harmony with the breasts and lower abdomen (especially if only the upper abdomen was treated)
• Consistency across lighting and posture

Explore our reverse abdominoplasty before and after photos and reverse abdominoplasty photos to see real patient outcomes.

When reviewing reverse abdominoplasty before and after examples, evaluate:

• You’re planning a significant weight change or future pregnancy
• You smoke and cannot pause nicotine use for the recommended period before and after surgery
• You have uncontrolled medical conditions that increase surgical risk (for example, poorly controlled diabetes, active heart or lung disease)
• You cannot commit to the recovery plan and activity restrictions

If full-thickness laxity exists both above and below the navel, you might be better served by a different abdominoplasty style or a combined plan. During your consultation, we’ll help you compare options to meet your goals safely.

Is reverse abdominoplasty only for women?

No. Men with upper abdominal laxity after weight loss can be excellent candidates. The incision can be designed to rest in the natural chest fold, and chest hair patterns often further camouflage the scar.

Will my belly button change?

Unlike a traditional tummy tuck, reverse abdominoplasty does not typically require cutting around or repositioning the navel because skin is redraped upward. The goal is to maintain a natural umbilical shape and position while smoothing the tissue above it. (journals.lww.com)

Can I combine reverse abdominoplasty with a breast augmentation or lift?

Yes. The inframammary fold incision can be shared, and combining procedures can improve overall proportion in a single operation for qualified patients. Your plan will balance goals with safety and recovery. (journals.lww.com)

What about a “reverse upper abdominoplasty” with a “modified lower” at the same time?

For selected patients, combining upper (reverse) and lower (mini or standard) abdominoplasty can comprehensively treat both zones. Others do best with a staged approach. Published experiences with combined or staged strategies after major weight loss show effective, reliable results when tailored to the patient. (pubmed.ncbi.nlm.nih.gov)

How visible is the scar?

Early on, scars are pink and firm. Over months, they typically fade and flatten. Positioning within the inframammary fold makes the scar easy to conceal. Scar care, sun protection, and time are key.

• Reverse abdominoplasty overview, indications, IMF scar placement, and outcomes: Agha-Mohammadi S, Hurwitz DJ; Halbesma GJ, van der Lei B; PRS Global Open case report. (pubmed.ncbi.nlm.nih.gov)
• Inframammary fold design and concealment concepts: Aesthetic Plastic Surgery IMF-defining techniques. (link.springer.com)
• Combining with breast procedures; AMBRA concept: Plastic and Reconstructive Surgery 2009 (Zienowicz & Karacaoglu). (journals.lww.com)
• Progressive tension sutures, drainless abdominoplasty evidence: Aesthetic Surgery Journal and PubMed meta-analyses and series. (pubmed.ncbi.nlm.nih.gov)
• Recovery timelines and activity guidance (general abdominoplasty/ASPS/Cleveland Clinic): ASPS and Cleveland Clinic resources. (plasticsurgery.org)
• Costs context (national average surgeon’s fee for tummy tuck): American Society of Plastic Surgeons current statistics. (plasticsurgery.org)