If I Dont Have Alot of Loose Skin Can my Tummy Tuck Be Extremely Low and Horizontal ?

It appears that you have a fair amount of abdominal wall laxity without an extremely large amount of upper skin laxity. When performing a standard tummy tuck in this setting it can be difficult to remove all the skin below the belly button without excessive tension on the closure. A decision is made in the operating room after the flap is elevated as to whether or not all this skin can be remove. If not, the excision is lowered which will ultimately result in a small vertical scar in the midline in addition to the low horizontal scar. Although the horizontal scar can be predictably low, the vertical scar could be visible in certain bathing suits.

In patients with very little excess skin, and muscle bulging limited to the lower abdomen, a mini-tummy tuck is ideal.In this procedure, the scar is kept low (just at or below the hairline), the muscle can be tightened, and skin can be removed without adding a visible scar to the belly button. A similar case is shown at the link below, where I performed a mini-tummy tuck and breast augmentation.I'm a plastic surgeon in a beach community and I am very conscious about incisions. Bikinis are not the most forgiving!

I looked at your pictures carefully. I don't see as much laxity above the belly bottom as my other colleagues,  therefore I think you are a candidate for a mini abdominoplasty. If your plastic surgeon agrees with my assessment, then he can put the scar as low as you desire. If a standard Tummy tuck is needed then it might be difficult to make the scar very low. in these cases a vertical scar is left in the mid line abode the pubis to close the belly bottom hole and allow the surgeon to keep the scar low. You need to see a plastic surgeon  with a lot of experience to give you a good result. You have to understand that the mini tumy tuck that i am talking about is a more difficult operation that a standard procedure. It deals with the upper muscle maxity where the repair is done using an endoscope through the scar above the pubis.

You do not appear to be a candidate for a 'mini tummy tuck' because of your degree of skin laxity.  You might be a candidate for a tummy tuck but your surgeon should discuss the details of the scar with you in detail prior to surgery.  The length of your scar depends on the amount of skin that needs to be removed.  The scar can be low but your surgeon should follow your natural crease lines to some some degree for the best scar.

Placement of a tummy tuck scar is very important.  There are several different techniques for its placement and this becomes useful for each patient.  I ask my patients to bring in a bathing suit bottom or one piece they typically wear.  This helps me plan the placement of the scar.  Although one can plan this, tissues stretch and give and scars can "migrate",  So there are no guarantees given that the scar will end up exactly where a patient wants it.  Operating is not like measuring and cutting a piece of wood.  Thats what makes it unpredictable.  Fashions also may change and certain styles of bathing suits that are popular now, may not be years from now.  If you want a tummy tuck, you have to be accepting and willing to have a scar that may be visible in your bathing suit despite best attempts to place it where you want.  Otherwise don't have the operation.

The scar placement and length is related to what needs to be corrected.  I place my tummy tuck scars at the top edge of the pubic hair. If you place the scar IN the pubic hair, then when you pull down the loose skin from above and trim it, you bring hairless skin down to the incision, so the incision is once again at the top of the current pubic hair line.  I do like to keep my scars low, whereas some surgeons make them too high, in my opinion. I mark patients in a bathing suit, so that we can hide the scar under their suit, but a scar does better in my opinion if it angles or curves up from the pubic hair towards the hip. When we try to keep the scar straight without curving up a bit, as if to keep it under very low hip huggers, I think the scar gathers more at the ends and we chase it farther out and it doesn't look as good.  You have a fair amount of what appears to be bulging fascia/muscles, and when that is corrected and tightened to restore a flat tummy for you, you may have more loose skin than you think, as now it is being filled out by the bulging. Sometimes you just have to make a choice as to what "price" you are willing to pay...tight, flat tummy with some scars that you need to adjust your swimwear to hide, or a looser more bulgy tummy that you may need to adjust your swimwear to hide.