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What Influences the Height of a Tummy Tuck Scar? (photo)

I'm interested in getting a tummy tuck this winter (have some consultations booked already.) I also need hernia and muscle repair. I'm curious what factors into the height of the scar? I'd like to wear low-rising bikinis/jeans after the surgery. Is it mostly dependent on how much excess skin there is, doctor's preference, or what? What are the reasons for choosing a higher or lower scar?

Doctor Answers (13)

ALL tummy tuck scars are higher than the lowest mark in the pre-op ellipse drawn on your tummy.

+2

Every surgeon answering your question here wants to reassure you that the scar will (probably) be low enough to wear your skimpiest bikini bottom and hide the scar. Some even have a "special" name for their procedure as if to imply that he or she has the "secret to the perfect and lowest scar position!" Some even talk about secrets to hiding the belly button scar to make it "invisible." While most of my colleagues' answers are accurate and scholarly, you could imagine some wearing plaid pants and white shoes as they extoll the virtues of their capabilities like some bad used car salesman ad. None of them are lying, but you know what I mean!

Since the loose abdominal skin is freed up from the pubic area to the lower breastbone (sternum's lowest point, or xiphoid), the upper edge of the incision (after the loose "extra" skin from the lower pubic incision to the belly button area has been excised and removed) is stretched over the belly button (requiring a new opening through this tightened skin) and sutured to the still-attached pubic and groin tissues. The idea is that these tissues remain anchored, and the scar will remain at that position. However, tissues stretch, and once secured by sutures, there is ALWAYS some migration of the scar upward. Sometimes a lot, most times a little. There are techniques for securing the closure sutures to the lower abdominal fascia to help minimize the upward migration, and most surgeons use some form of this. These techniques usually allow the scar to be low and appropriate for bikini bottoms to conceal them.

As others have stated, styles and requests for incision and scar placement have varied over the years--from the high lateral scar for the Rio or tanga bikini bottoms, to the present Brazilian hiphugger low lateral scar. Careful closure in layers by an experienced, ABPS-certified plastic surgeon will give you a great result, but bring in your desired swimsuit bottom and discuss the incision placement with your surgeon as he or she does your markings pre-operatively!

Your anatomy (umbilicus to xiphoid distance compared to umbilicus to pubis distance) and the degree of skin laxity are the most important determinants of how low the incision can be made. Another way of saying this is that it depends on how much skin needs to be removed to get the top elliptical incision just above your umbilicus(to avoid the inverted-T scar above your pubis) and how low the remaining above-the-umbilicus skin can be stretched to keep the bottom elliptical incision as low as possible (just above the pubic hair). And then, how to keep the scar from stretching upwards, pulling the pubic area and hair towards the umbilicus. Look at lots of after-abdominoplasty scars to get an idea how your chosen surgeon operates. Best wishes! Dr. Tholen


Minneapolis Plastic Surgeon
5.0 out of 5 stars 109 reviews

You would great result with floating belly button

+2

You have high belly button and umbilical hernia. I would suggest low incision with floating and lower belly button with no incision around it . You may check my web site for similar case.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
5.0 out of 5 stars 52 reviews

Tummy tuck scar position

+2

Thank you for the questions and photos.  In my practice, I ask the patient where they want their scar.  Patients bring in a swimsuit the day of surgery and I mark it pre-operatively.  Then, the incisions can be carefully designed in such a way as to make sure the scar will be hidden at the poolside or beach.  The degree of skin laxity will determine the length of the scar, but not the position.  Hope it goes well!

Victor Ferrari, MD, FACS
Charlotte Plastic Surgeon
5.0 out of 5 stars 17 reviews

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You can choose to have a low incision

+2

Hello,

Thank you for the photos.  You can always have a final horizontal incision that is very low near your pubic bone.  Placing the final incision higher is sometimes done to allow removal of the previous belly button location, but I do not see much benefit in doing so.  If the previous belly button location cannot be included in the tummy tuck resection with a very low incision that location can simply just be close in a small vertical incision.  The benefit of doing so is that the tummy tuck incision is very low and hidden in the bikini incision and the small vertical belly button location closure simply looks like a small laprascopic incision scar.  The link below is from one of my patients who exhibits this.

All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 82 reviews

Abdominoplasty with Mesh reinforces hernia repair

+1

Your incision can be placed where you desire.  Most patients request the incision at about the pubic level so it can be hidden by underwear.  You also need a hernia and muscle repair, which can be done simultaneously.  A hernia is a defect in the fascia and often occurs after pregnancies.  I recommend Abdominoplasty with Mesh Reinforcement for hernias or fascia injury from pregnancies.  There have been several articles published in Plastic and Reconstructive Journal  describing this technique.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
5.0 out of 5 stars 120 reviews

Abdominoplasty scar

+1

The height of an abdominoplasty scar can be varied to suit your preference for a higher or lower scar.  Low rise bikinis are much more popular now than in the past.  The key is to place the corners of the incisions at the right level.  I often have the patient wear a bikini bottom the day of surgery so I can customize the location of the scar.  Ask your surgeon if they agree with this approach.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 7 reviews

Tummy tuck scar placement

+1

Placement of the scar during a tummy tuck is always a big question for patients.  Generally, most surgeons will place the scar as low as possible based on patient preference.  During the preoperative marking, most surgeons will ask the patient to wear clothes that they would like the scar hidden in.  This helps in placement of the scar.  The ease with placing the scar low depends on the patient's anatomy and how loose the skin remaining behind is.  Repairing your hernia and your muscle diastasis will not affect the location of the transverse scar.

Naveen Setty, MD, FACS
Dallas Plastic Surgeon
5.0 out of 5 stars 18 reviews

Tummy Tuck Scar

+1

Your scar can be placed at just about any level you would like.  There are trade-offs, however.  A low scar is generally preferable, in my opinion, as it is easier to hide in certain clothing.  A low scar does increase the possibility of a small vertical scar that is the location where your navel was released from its surrounding skin.  Raising the scar will lessen the likelihood that you will have the vertical scar but will make the horizontal scar more visible.  Furthermore, a high scar will elevate the pubic hair more which can also be a problem.  I do not think your hernia or need for muscle repair is related to the location of the scar.  

Richard Kofkoff, MD, FACS
Saint Louis Plastic Surgeon
5.0 out of 5 stars 29 reviews

Tummy tuck can be individualized for each patient

+1

Yours is a common question and is influenced by many factors that can be assessed and discussed during a consultation. As many have stated, when the skin above the umbilicus will stretch adequately to a low and desireable transverse scar location there will be much less scar visibility. When this is not the case, I discuss options that each have trade-offs. Once you know your options you can decide if your are ready to get a flat and firm tummy back. The specifics of your "hernia" and muscle examination will also influence the recommendations. You have laxity and a shape that will allow for a lot of improvement with surgery. From your photos and your stated goals, a modified approach to your abdominoplasty will be likely be recommended. 

 

Dr. Mosher

Mathew C. Mosher, MD
Vancouver Plastic Surgeon
4.5 out of 5 stars 6 reviews

Tummy Tuck Scar? (photo)

+1

Great question!   There are multiple factors influencing scar position and configuration, but in summary:  A greater than 3:2 ratio of vertical midline supraumbilical to infraumbilical distance without confounding factors (previous surgical scar) and with good skin and post partum abdominal wall compliance allows transverse abdominoplasty scar placement across the upper marginal escutcheon.  If the ratio is less, scar can still be placed low, but must add short vertical suprapubic component or perhaps an alternative technical sacrifice to do so (personal observation and experience).

Steve Laverson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 38 reviews

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.