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.
If your surgeon felt that the skin is not too stretchy it is going to be difficult, the vertical scar might help though.
It is difficult to tell what the best plan for you would be without seeing pictures or through an in-person consultation.
This is a well known way to get a lower scar. How that scar heals is variable but often times there is a dent under the scar too
do involve short vertical scars if your skin does not allow for the belly button skin to be pinched to the mons. A lower scar is always better as you can cover it with your undergarments and swimsuits. There are many ways to do a tummy tuck and if someone guarantees you won't have a vertical scar and that your scar will be low when you don't have much skin excess, I suggest you get it in writing and know what happens if what was promised isn't delivered. And if you really don't like you belly button, consider giving it up and having a reconstruction later. When muscles are plicated, the belly button can get really deep.
The small vertical scar is rarely necessary, but the scar should always be placed low.
Kenneth Hughes, MD
Los Angeles, CA
Thank you for asking. This is a good question to ask your Board Certified Plastic Surgeon. It is true that a scar can be lower if a small vertical component is placed where the belly button was. A lower scar may be longer, so make sure you have a good understanding of what is likely to occur for your particular circumstances. Your anatomy guides what can be done for you. There maybe a limit to where your scar can be placed based on your skin elasticity and other issues. Find a well trained surgeon you can place your trust in and listen to their recommendations for you. Best of luck to you.
It would not be possible to comment on your situation specifically without a photo, but in general, if you don't mind a lower midline scar from the old bellybutton site, you can make the TT scar as low as you like. But it is rarely necessary to have a that happen if the closure is done with progressive advancement sutures after doing the upper dissection up over the lower ribs.
Ideal abdominoplasty scars are located very low and easily covered with undergarments and bikinis. If there is not enough skin laxity to fully remove the previous hole of the belly button, it is better to close this with a short vertical scar as opposed to positioning the entire abdominoplasty scar higher. These vertical belly button closures are usually only a few centimeters in length.
You can have a lower scar but the trade off is a small vertical scar (possible separate scar higher on the abdomen) from the peri umbilical incision. This scar does settle well in most patients. I would discuss your concerns with your treating PS.
I tend to keep my tummy tuck scars low as well. I always inform patients that I may need to have a small vertical scar from the prior belly button site. Most of the times I can avoid this scar. In the times the vertical closure is needed it will typically heal well and patients usually are very satisfied. Good luck.