A reverse tummy tuck is a cosmetic surgery that removes loose skin from the upper abdomen, between the belly button and the breast crease. Unlike a standard tummy tuck, which pulls skin downward and places the incision along the bikini line, a reverse tummy tuck pulls skin upward and hides the incision in the fold beneath the breasts. It’s a less common procedure, typically performed when the upper stomach has excess skin that a traditional approach can’t effectively address.
How It Differs From a Standard Tummy Tuck
A standard tummy tuck is the most common type of abdominoplasty. It targets both the upper and lower abdomen, tightening muscles and removing sagging skin through a long horizontal incision just above the pubic area. The skin is pulled downward, and the belly button is usually repositioned. A mini tummy tuck is even more limited, improving only the area below the belly button.
A reverse tummy tuck works in the opposite direction. The surgeon makes an incision along the inframammary fold (the natural crease where the underside of the breast meets the chest wall), then lifts and removes excess skin from the upper abdomen by pulling it upward toward the chest. The belly button stays untouched. If the upper abdominal muscles have separated, the surgeon can tighten them during the same operation.
Think of it this way: a standard tummy tuck is best when the problem is below or around the belly button. A reverse tummy tuck addresses the area above it.
Who Is a Good Candidate
This procedure is most often performed on people who have loose, sagging skin concentrated in the upper abdomen. That’s a relatively specific situation, which is why the surgery is far less common than its standard counterpart. The most typical candidates fall into a few categories:
- People who already had a standard tummy tuck or liposuction. These procedures work well for the lower abdomen, but they can sometimes leave behind excess tissue above the belly button. This happens when the skin doesn’t shrink enough after liposuction, or when muscle tightening during a prior tummy tuck actually pushes extra fullness upward. The bulging tends to be most visible when sitting and often looks worse under clothing.
- People who’ve had breast surgery. If you already have a scar along the breast crease from a previous breast augmentation, lift, or reduction, a reverse tummy tuck can use that same incision line. Larger breast bases also help conceal the scar more effectively.
- People who want to avoid a scar around the belly button. Since the incision is placed beneath the breasts, the navel is left completely alone.
The procedure works best when the upper abdominal skin laxity is moderate and doesn’t extend far past the midline of the body. People with a history of keloid scarring (where scars grow thick and raised) are generally not considered good candidates because of the scar placement in a visible area.
Where the Scars End Up
The primary incision sits along the inframammary fold, the crease directly beneath each breast. In many cases, the scar is well hidden by the breast itself, especially in patients with a larger breast base that naturally drapes over the fold. If you already have a scar there from a prior breast procedure, the surgeon can often incorporate it into the new incision rather than creating additional scarring.
Some patients also end up with a vertical midline scar running down from the breast crease if a larger amount of skin needs to be removed. When the excess skin is moderate and mostly off to the sides, the surgeon may be able to avoid this midline scar entirely. Scar complications like keloids or hypertrophic scarring occur in roughly 1% to 4% of abdominoplasty patients overall.
Combining It With Breast Surgery
Because the incision sits right at the breast fold, a reverse tummy tuck pairs naturally with breast procedures. Surgeons sometimes perform it alongside a breast lift, reduction, or augmentation, using a shared incision to address both the upper abdominal contour and the breasts in one operation. This combined approach reduces total recovery time compared to staging the procedures separately and avoids an additional scar.
Recovery Timeline
Recovery follows a similar arc to other abdominal surgeries, though the specifics depend on whether additional procedures are performed at the same time. The first few weeks involve limited movement, swelling, and soreness in the upper abdomen and chest area. Most patients return to normal daily activities by weeks five to six. By weeks seven to eight, you can generally resume all prior activities, including exercise.
Fluid accumulation beneath the skin (called seroma) is the most common complication after any type of abdominoplasty, occurring in roughly 15% of cases. Most seromas resolve with drainage in the office and don’t require further surgery.
Cost
The American Society of Plastic Surgeons lists the average cost of abdominoplasty at $8,174, though this figure covers all types of tummy tucks and reflects only the surgeon’s fee. Anesthesia, operating room fees, and any combined procedures add to the total. A reverse tummy tuck may cost more or less than the average depending on the complexity of the case and your geographic area. Because it’s a cosmetic procedure, insurance typically does not cover it.