A reverse abdominoplasty removes loose skin from the upper abdomen, pulling it upward and hiding the scar in the fold beneath the breasts rather than at the bikini line. It is an uncommon operation, and it exists for a specific problem that a standard abdominoplasty cannot reach.
A conventional tummy tuck pulls skin downward. Where the looseness sits above the umbilicus — and particularly where a previous abdominoplasty has already used up the skin below it — pulling down achieves nothing.
When it is the right operation
- Loose skin confined to the upper abdomen, with the lower abdomen already flat
- Residual upper abdominal looseness after a previous abdominoplasty
- Significant weight loss where the upper abdomen is the remaining problem
- Patients already having breast surgery, where the incision under the breast fold can be shared
That last point is the common one in practice. Where a woman is having a breast reduction or lift at the same time, the scar in the inframammary fold is being made anyway, and the upper abdominal skin can be addressed through it.
The trade
| Standard abdominoplasty | Reverse abdominoplasty | |
|---|---|---|
| Skin removed from | Lower and mid abdomen | Upper abdomen |
| Direction of pull | Downward | Upward |
| Scar | Low, hip to hip, hidden by underwear | Beneath the breast folds, across the midline |
| Umbilicus | Repositioned | Usually untouched |
| Medicare | Items 30166, 30175, 30177 where criteria are met | Generally no specific item; assessed case by case |
The scar is the reason this operation is uncommon. It sits where a bra band rests, it crosses the midline between the breasts, and it is harder to conceal in a low-cut top than a bikini-line scar is in underwear. Patients who accept it are usually those for whom the alternative is no correction at all.
Where it sits in a weight-loss plan
For most patients after major weight loss, the dominant problem is below the umbilicus, and the answer is a standard abdominoplasty or, where there is horizontal excess as well, a fleur-de-lis abdominoplasty — which uses a vertical midline scar to take in the width and addresses the upper abdomen at the same time. Where a fleur-de-lis is suitable, it is usually preferred over a reverse abdominoplasty.
Dr Kumar will tell you which of these he thinks fits, rather than offering the list. There is background on timing and weight stability at My Weight Loss Journey.
Recovery
Similar to an abdominoplasty but usually easier, because the abdominal wall itself is not tightened: around two weeks off work and a gradual return over the following four. Prineo and Micropore stay on the wound for six weeks and a compression garment is worn for the same period. Dr Kumar reviews his surgical patients for twelve months. The week-by-week timeline.
Common questions
Can it be combined with a breast operation? Yes, and that is when it makes most sense.
Will it help my lower abdomen? No. If both are loose, a standard or fleur-de-lis abdominoplasty is the operation.
Is the scar under the breast noticeable? It is in a fold, which helps, but it crosses the midline where there is no fold to hide it. That segment is the visible part.
Can it be done after a previous tummy tuck? That is one of its main uses, where upper abdominal skin remains.
Does Medicare cover it? There is no item written for this operation specifically. Whether any item applies depends on your findings and is set out in your quote. More about costs.
Next step
This is a judgement best made with you standing in front of a mirror. Bring a GP referral — it is required to see Dr Kumar — and you can send photos first if you are travelling. He consults at Westmead, Penrith and Orange. Call 1300 267 726.
The initial consultation with Dr Kumar is $400, with a Medicare rebate of approximately $88 where you have a GP referral. Surgical fees are quoted individually after your consultation, in a written itemised quote.
All surgery carries risks, and individual results will vary. Read more about the risks of surgery here. A GP referral is required to see Dr Kumar.
Dr Rohit Kumar (MED0001630444) Registered medical practitioner, specialist plastic surgeon (specialist registration in surgery – plastic surgery).
