Vertical TT scar?
I agree with your surgeon. I think you should have another detailed discussion with your surgeon about this, because although you say that you are not OK with a vertical scar, sometimes the alternative is worse. If you refuse a possible small vertical scar in the midline, your surgeon will likely then start your horizontal incision higher than he normally would, thus alleviating the need for a vertical scar but placing your horizontal scar higher. But the downside to that is that you may have a horizontal scar that would show in hip hugging jeans or a bikini, etc. Discuss with your surgeon where you would ideally want your horizontal scar to be, so he can then advise you if you would have the possibility of the small vertical scar or not. Good luck!
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Vertical scar is sometimes not avoidable
I have been referred more patients unhappy about a higher scar than a vertical scar. A higher scar seems to bother patients more than the vertical scar and to me, does not looks as aesthetically pleasing. I am glad your surgeon warned you of this as it should be discussed in any tummy tuck consultation. There are times when the original umbilical scar is not able to be removed or the abdominal contour can be improved by removing some excess tissue utilizing the vertical scar - sometimes all the way to the belly button! It most cases, however, the vertical component of the scar is only a few centimeters from the horizontal scar. Good luck!
Vertical TT scar?
Based on your photos, it is unlikely that you will need the vertical scar. Prior to surgery, seek a second opinion to make sure you are comfortable with your choice.
Thank you for the picture.
In my opinion, I don't believe that a vertical scar would be necessary to correct the protruded abdomen. I believe that an extended tummy tuck would be ideal for your case.
Vertical Tummy Tuck Scar
A few patients have severe post-pregnancy skin and soft tissue excess that cannot be adequately corrected by means of a horizontal, suprapubic incision alone. In select patients, a vertical midline incision can be added to allow removal of skin excess in a horizontal as well as vertical direction. A great advantage of adding this incision is the ability to draw the waist inward as the tummy tuck is closed. This procedure is sometimes referred to as an 'anchor' or 'inverted-T abdominoplasty', as the resulting scar has that configuration. The technique is performed for patients in whom the resulting improvement in the overall abdominal profile outweighs the 'downside' of a midline surgical scar. The surgeon with whom you had a consultation was honest with you about that possibility.
The vertical tummy tuck scar will often fade to a fine white line. I have attached a gallery of more than 40 patients who have had tummy tucks with me. A few had a minot vertical incision. Take a look. The scar is not bad, The scar that IS BAD is the scar around the belly button. This scar, or a distorted, face looking belly button is a telltale sign of a tummy tuck. Look carefully to be sure you select a plastic surgeon who created beautiful, natural looking belly buttons with no visible scars.
Vertical tummy tuck scar
Judging from your photos, I agree that it would be unlikely that you would need a vertical incision as part of your tummy tuck. Your surgeon is being wise to warn you about potential risks even if the chances are low. Good luck.
Need for vertical scar in Abdominoplasty
It is often difficult to discern whether or not a short vertical scar may be necessary in those patients with limited skin above the umbilicus. While unusual, sometimes it is necessary and your surgeon has done correct thing in warning you of this possibility.
The choices in these situations are somewhat limited. I believe that the "short vertical" scar is the best of the limited options. The option of raising the entire incision appears less acceptable (and more visible) and can also place your umbilicus very close to the the scar--not a good look. Other options such as allowing the umbilicus to "float" or simply resecting some infra-umbical skin can be considered, but seldom give acceptable results. I would encourage you to meet again with your surgeon and ask to see some pictures of patients with these short vertical scars. The photographs may help to allay your fears. The overall improvement to your abdomen is typically worth the small scar. Best of luck!
Vertical TT scar?
You have evidentally seeen a good and honest surgeon. His job is to warn you of possibilities. I frequently mention that same thing to appropriate patients, but find it almost never is necessary when the dissection goes up over the lower ribs and the tissues are closed with progressive advancement sutures.
Sounds like you have a good doc! We need to see your upper torso length but from what I see he or she gave you great advice. A vertical scar better then a high tummy tuck scar which you will not like!
Vertical scar with tummy tuck better than a high scar without
With a full tummy tuck, typically the skin is removed from the level of the belly button to just above the pubic area, where the scar will be. This requires that the skin from above the belly button can be expanded and stretched all the way down to the desired location of the scar. If the belly button is a little bit high, as in the pictures you posted, this may not be possible unless the scar is high. The alternative is to remove a little less skin and close the opening where the belly button was as an upside-down "T". This usually fades very well and is much less noticeable than a horizontal scar that is placed high.