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Tummy Tuck Scar Too High, and Belly Button Protruding? (photo)

I'm almost 5 weeks post op and was promised a "super low scar that even the most revealing clothes would cover" but the scar is pretty high, and has pulled my pubic mound up appx 2.5 inches! Also my belly button is protruding.... I'm not sure what to do, my doctor seems unconcerned and irritated when I voice these concerns...

Doctor Answers (10)

Anchoring sutures

+1
Thank you for your post. It is not common for surgeons to anchor the lower incision to the fascia or covering of the abdominal muscles to keep the scar low, however, I do use this technique and agree with it. All the tension on the incision is from above, not below, and thus the scar tends to move toward the area of maximal tension (towards the ribs/bellybutton). This moves the scar higher than desired. I like to keep my scars very low, and feel that anchoring the scar helps accomplish this. The following photo is an example of this.


Phoenix Plastic Surgeon
5.0 out of 5 stars 26 reviews

Tummy Tuck Revision - need to wait several months

+1
Wait at least 6 months after healing and seek a second opinion from a board certified plastic surgeon. Depending on how much residual laxity, it may be possible to lower the abdominal scar to a more satisfactory position.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 40 reviews

Where are Tummy Tuck scars placed?

+1
The placement of the Tummy Tuck scar does make a big difference as to whether you can comfortably wear a bikini after surgery. There are two types of incisions that need to be made :
1-Horizontal Scar to remove excess skin
2-Belly Button Scar to reposition the belly button

The best advice to patients is to discuss the location of both scars at your consultation, and on the morning of surgery.  The best possible scenerio is for your surgeon to make the markings with you while you are awake on the morning of surgery. In this capacity , you would both agree on where the scar will go.

I hope that your recovery has gone well.

Ricardo L Rodriguez MD
Baltimore, Maryland

Ricardo L. Rodriguez, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 39 reviews

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Scar too high after aTT

+1

Problem scars around the umbilicus and positioning of the low transverse scar after an abdominoplasty.  The umbilical scar is really he cherry on the ice cream sundae when it comes to abdominoplasty surgery.  It is the most visible scar and most plastic surgeons are very careful to create a nice, aesthetically pleasing scar.  Everything can be done correctly and a small percentage of patients will make a bad scar.  Your scar may lower over time.  I always have my patients pull up as hard as they can in the pre op room and I mark the incision to be 6 cm above the top of the superior labial area.  This keeps the scar in low position. 

Jeffrey Zwiren, MD
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Tummy tuck scar too high

+1

Hard to improve on what Dr Tholen has explained. I would imagine that you saw pictures of your doctors previous work before surgery I am sorry if it mislead you. I would like to remind every patient that it is important to look at your doctors pre and post photos and not be "sold" a procedure by a smooth talker.

Gregory Lynam, MD
Richmond Plastic Surgeon
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The incision position

+1

The issue of how high and how low the incision line is after surgery has everything to do with how much loose skin you had before surgery and how high or low the belly button is located on the abdomen and where the incision was initially made for your surgery.

 

Typically, when the belly button area is cut, that incision is brought down to the level of lower horizontal abdominal scar of the tummy tuck.  If the belly button is located high on the abdomen, sometimes it is difficult to remove all of the skin below the belly button level because there is simply not enough skin to remove.  So, the alternative is to make the abdominal incision higher so that your belly button incision is able to be pulled down enough to meet the horizontal scar or make the abdominal horizontal incision really low and close the belly button incision vertically in the lower part of your abdomen.  (This would leave you with a floating vertical scar in the lower abdomen.)

 

I would talk to your plastic surgeon about your concerns.  There are different techniques that can be done to lower the scar, but you have to heal adequately from this surgery first.  

Richard H. Lee, MD
Newport Beach Plastic Surgeon
5.0 out of 5 stars 12 reviews

Too-high tummy tuck scar and protruding belly button--here's what happened.

+1

Your question indicated that your surgeon "promised" a "super low scar that even the most revealing clothes would cover; your follow-up comment stated that indeed this is what was said. Unfortunately, what this tells me is that your surgeon either did not make an achievable plan based on your physical examination, or simply "sold you" with comments that could not be lived up to in the operating room. Belly button position and the amount and location of skin possible to be excised while still allowing an appropriate closure are the essence of the pre-op exam and assessment. 

Here's my assessment, based on your photo: your belly button is exactly where God and your mother placed them at your birth, and it appears fairly high compared to the lower tip of your breastbone (xiphoid)--pubis distance. In other words, you had more distance from your belly button to your pubis than from your belly button to the xiphoid.

What we plastic surgeons excise is the skin between the belly button and the pubis, and then we must lift up and stretch the remaining skin from the belly button to the xiphoid to cover the excision (a new operning is made for the belly button, which "stays" right where it has always been). When you've got less skin to stretch than the skin you removed, "We have a problem, Houston!"

This leaves the surgeon with one of two choices: 1) make the lower incision somewhat higher, removing less skin so the top has "enough" to get the closure completed without excessive tension, but raising the final scar position, or 2) keep the lower incision low, and do not remove all the skin to the belly button, leaving a vertical scar above the pubis where the belly button used to be. Either way, you have a scar that is above the skimpiest bikini bottom. Your surgeon chose #1. . .

 . . .which means that s/he mis-estimated what could be accomplished at the time of your consultation, OR simply told you what you wanted to hear (even though what was "promised" was not anatomically possible), and did what had to be done.

Unfortunately, your hopes and expectations were based on what your surgeon said, but your anatomy made this an impossibility from the get-go. Even more unfortunately, you have the scars you have, and they are permanent. After everything heals and softens maximally, you might develop enough additional laxity to perhaps lower the scar a centimeter or two (this is the truth, unless you have lots of residual laxity), but this would necessitate re-doing the entire incision and lower dissection, a costly and uncomfortable re-do for such little real improvement. Usually, when this happens, patients just say "forget it."

Sorry, but yours is not a bad result, and a "super low scar, etc." is a common hope (and misperception)! Paying "more" doesn't always equate with "guaranteed result." For comparison with examples of my own incision placement, you can click on the web reference link below. Although these scars are in various phases of maturity and fading, you will see that the majority of my patients could wear a fairly small bikini bottom if they so desired, but I would never promise that any of these is "super low" or capable of being concealed by a tiny bathing suit bottom or thong. Pre-op anatomy is the key to what is possible. Best wishes! Dr. Tholen

 

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 116 reviews

Tummy Tuck Scar Too High, and Belly Button Protruding? (photo)

+1

Sorry for your issues. But after the operation is a little late. In your pre operative discussions this should have been fully understood by you. Again sorry. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 61 reviews

The too high tummy tuck scar

+1

The low, easily concealed tummy tuck scar is our goal, even if we risk a short vertical scar if the 'old' belly button opening will not reach all  the way down. Photos would help us determine how you have done, as what you describe, is concerning.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 26 reviews

Tummy Tuck Scar Too High, and Belly Button Protruding

+1

 It is hard to comment on this situation without looking at photos, so think about attaching some to the query, and include if possible pre-op pictures. Elevating the pubic mound and hairline that much would certainly be a concern.

Thanks for your question, and best wishes. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.