I would like to know if anyone ever had abdominal skin reduction with and up and down incision using () from 1 side of the abdomen to the other side of the abdomen with the skin removed between them and the abdominal muscle repaired? I want to have the procedure done but I do not like the long scar across the lower abdomen.
Vertical Incision Abdominoplasty
Doctor Answers 12
Vertical scar tummy tuck
If you have a long narrow abdomen, you might actually get more skin off with a vertical scar rather than a horizontal one. Most wouldn't want this though because vertical scars never heal as well as horizontal ones and they are impossible to hide.
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Vertical or horizontal Tummy Tuck Scar?
About your tummy tuck plans...
No one likes the idea of having a scar. But everything we do is a trade. Most people are very happy to have a scar they can hide beneath their panty or bikini line with a tight flat belly, instead of excess skin hanging out above your bikini.
As far as the vertical scar. I always reserve this for patients with a Lot of horizontal laxity of their skin at the mid abdominal level. Most commonly I use this for patients who have lost a lot of weight, usually more than one hundred pounds. The reason for this is that it is a visible scar when wearing anything that shows your midriff.
Vertical incision abdominoplasty will result in lousy flattening and pooch
To best understand what you are asking IMAGINE the excess tummy skin was cloth but that you were working simultaneously on 2 DIFFERENT layers of cloth and that the ultimate outside appearance depended on how alterations to these layers affected the OVERALL appearance.
A Tummy Tuck (Abdominoplasty) is first and foremost a tightening of loose abdominal muscles. As the tightening is done and the muscles are moved to the center - so is the skin that is attached to them. BUT -- the skin does NOT move to the same degree despite the same tightening. The waist skin moves in a lot with great narrowing of the waist but the hip skin does not move in as much because of the "resistance" of the hip bones. This results in a different, non uniform skin excess along the midline.
Now let's consider where the most tummy skin laxity is located. In MOST people (especially post-pregnancy tummies), it is located centrally and in the lower tummy. The area where the muscle tightening does NOT move as much skin in as it does at the waist.
As a result, a VERTICAL SCAR ONLY abdominoplasty would nicely remove central loose skin but result in a lousy skin flattening and a pooch at the lower aspect of the scar. THIS is why a transverse scar is needed in most cases.
One more consideration. As Plastic surgeons we live and die based on our scars and their visibility. We are LOATHE to leave scars anywhere if we do not have to. A vertical scar is visible with most Spring and Summer women's clothes. While a transverse scar is hidden by ALL clothes and most underwear and bathing suits. Therefore, in terms of visibility a transverse scar abdominoplasty would give you the stomach flattening you need with the least visible scar.
But if you insist and you understand the trade offs of a vertical scar - than I am sure your Plastic surgeon would do what you ask for.
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Removal of abdominal skin using a midline incision is not unheard of at all. It had been proposed over 30 years ago. And it does make more sense from a blood supply/anatomic standpoint. It's a straight shot to repairing the muscles and the skin is easily removed. The only downside is recreating of an esthetically appealing belly button is difficult.
Vertical scars in abdominoplasty
The vertical scar is not a substitute for the horizontal scar that goes across the lower abdomen. But it is sometimes added to the horizontal scar in patients who have a large amount of excess skin. This is rare, but does sometimes occur in patients after gastric bypass surgery or in those who lose over 100lbs. It used to be more common when "open" gastric bypasses were common, and patients already had a vertical scar present.
Tummy tuck can be done with vertical incisions
Tummy tuck can absolutely be done with an up and down incision. In fact, this is often done for massive weight loss patients. A more typical horizontal incision is more easily hidden under clothes, but there are some indications for doing a vertical incision.
You should see a plastic surgeon who is certified by the American Board of Plastic Surgery. During the consultation, you should express your concerns about the lower abdominal transverse incision. The surgeon should be able to help you understand the pros and cons of each so that you proceed in the safest way possible. But a tummy tuck through a vertical incision can be done, in the correct circumstances.
Uually the vertical component is just that- a component of the operation, and usually, there is a horizontal component.
Most ps's don't really like the vertical part because it ususlly doesn't form a scar as nice as the horizontal one, and you can't hid it beneath underpants, etc.
In and of its own, a vertical alone is not done because that is not where the majority of patients have issues with as far as skin redundancy and excess goes. Fleur-de-lis abdominoplasty is an option in patients with a lot of loose and excess skin as in patients after massive weight loss. This involves removal of skin in a horizontal and vertical vector.
What I believe you are referring to is just using a vertical incision which in the mind of many is not acceptable when compared to the lower horizontal incision which can be hidden very well, as the vertical cant be.
Hope that answers your question.
Vertical incision abdominoplasty
Though rarely requested, the vertical abdominoplasty, occurs in 5% of all Tummy Tuck surgeries. Make sure you use an experience board certified Plastic surgeon to perform this.
Best of Luck!
Vertical tummy tuck incsions
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Yes this has been done and is typically combined with a horizontal incision and carries the lovely eupehemistic title the "fleur-de-lis" abdominoplasty mieaning the french lily symbol skin pattern excision.
Most of my patients are terrified of the vertical scar and will do anything to avoid it. Therefore I do not use it commonly. About the only time I use this approach is in a patient with a pre-existing vertical scar which most commonly is from a traditional open gastric bypass procedure.
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