Most abdominal skin excess sits below the navel and hangs downward. A smaller group of people have the opposite: the laxity is above the navel, across the upper abdomen and towards the ribs, while the lower abdomen is relatively tight.
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It is uncommon enough that people usually have not read about it, and distinct enough to be worth recognising.
How to tell
Stand and look at where the slack actually is.
- Lower-predominant, the usual pattern: the fold hangs below the navel, the upper abdomen is flat, and lifting the lower fold upward improves the shape.
- Upper-predominant: the skin above the navel is loose and can be gathered between the fingers, while the area below the navel is comparatively tight. Lifting the lower abdomen changes little, because the problem is not there.
Another sign of the upper pattern: skin that gathers under the bust or across the lower ribs rather than at the waistband.
Why it behaves differently
The lower abdomen is more mobile and has more capacity to be redraped downward. The upper abdomen sits over the ribs, is less mobile, and does not respond the same way to approaches designed for the lower abdomen.
The practical consequence is that the standard approach for the common pattern does not address the uncommon one, and can leave the upper abdomen unchanged while flattening an area that was already acceptable.
Who tends to have it
People whose weight was carried higher on the torso, and some people who have already had abdominal surgery that tightened the lower abdomen. If you have had abdominal skin surgery before and remain unhappy with the upper abdomen, this is a distinction worth raising.
What to do with this
Nothing, immediately — other than knowing which pattern you have before any assessment, so that you can describe it accurately and recognise whether what is being proposed addresses the area that actually bothers you.
The fat or loose skin tests apply. The readiness assessment covers timing.
What this involves surgically →
For the operations themselves, Dr Kumar’s procedure guides cover each one in detail, including staging, Medicare and recovery.