How do you decide where to place a tummy tuck scar?

Question

1st the doctors on here are so nice to respond to all our questions!! Q. I have noticed that tummy tuck scars are mostly placed 2 different ways..1 straight across the abdomen and the other run over the pubic bone and up just above the thigh crease more or less.. is there a reason for this or just different techniques. I am looking to get TT this year.

Larry S. Nichter, MD, MS, FACS · Answer

Best Scar Management is important to minimize or completely hide from view, the telltale signs of your surgery—namely, scars. Both you and your surgeon want you to have the most minimal scarring possible. There are many possible causes for scars that are enlarged or not healing well. Unsightly scars are most commonly due to genetics, underlying medical conditions, or improper scar/wound care. The last part is very important and patients can make a noticeable difference in their scars’ appearance by following best scar management practices. Here are some simple tips.
Scar Management tips:Minimize tension on the scar. Steri-Strips and/or surgical tape are often placed in non-hair bearing areas at the time of surgery to minimize tension and keep pressure over the scar.  This minimizes the  stress that  can pull the scar apart (dehiscence) creating a wound and  delaying healing time, and can make the scar wider, or more “ropy”. In the first few weeks after surgery, I recommend the use of Embrace Scar Therapy which is an adherent silicone sheeting pre-stretched when applied so as to offload tension on the scar.Keep your incision site/scar clean to prevent infection. Follow your surgeon’s wound care instructions to the letter with out modification. Never apply different products then recommended without first discussing them with your surgeon. This is especially important during the first few weeks. If there are any signs of infection, contact your surgeon’s office right away and/or see your doctor or his nurse immediately. Typical signs of infection may include redness outside the immediate incision site, asymmetric swelling, and drainage, of pus, fever, chills, and “feeling sick”.Protect your scars from the sun. Staying out of the sun is the best advice. Minimal exposure to sunlight is prevents hyperpigmentation (permanently turning brown) and other problems that can make the scar more noticeable. Sunscreen, at least 30 SPF and an overlying make camouflage make up additionally protects the scar from the suns harmful rays. This advice is especially important the first year following your surgery.Use specific scar maturation products recommended by your surgeon. Patients seem to have their own opinions on this touting everything from Pure Vit E, Coco butter, to Aloe Vera, etc but most have minimal benefit other than keeping the scar hydrated. Although hydration is important there are better, scientifically studied products with greater efficacy. Most of the scientific articles written about this subject indicate that topical silicone gel or silicone sheets work the best. The best product available in my opinion is the Embrace Scar Therapy System by Neodyne BioSciences, Inc. available in many surgeons’ offices. Essentially this is an adherent silicone sheeting pre-stretched when applied so as to offload tension on the scar. For areas that are not applicable for this product (e.g. smaller areas or on the face), I prefer BioCorneum or Kelo-Cote products There are a lot of products to choose from, but silicone should be one of the key ingredients. Although Mederma, an onion extract derivative active ingredient rather than mainly silicone based may help, primarily silicone based products are better and many also contain other ingredients that may be synergistic (hydrocortisone or other steroid, Vitamin E, Sunscreen, etc).. If the reader has problems obtaining these they can call my office. Patient compliance is also critical – use often and according to directions or it will not work optimally. NEVER apply products without first discussing them with your surgeon.Monitor to make sure your scar is progressing optimally. Keep your scheduled follow-up appointments with your surgeon to verify that your scars are maturing as expected.  Occasionally if indicated you may need a topical steroid preparation or even a series of  injections (5-FU and/or Steroids) or laser treatments  to treat or  prevent scar hypertrophy or keloid formation (red raised scars), or other topical medicines to treat post inflammatory hyperpigmentation (brown scars) with prescription creams and possible laser treatments.

Damien Grinsell MBBS, FRACS (Plast) · Answer

HiThe short answer is that the scar is placed as low as physically possible  on the abdomen taking into regard the laxity of your skin.  This will then be hidden in underwear. It goes from right across from one side of the abdomen to the other in a standard abdominoplasty and is longer and extends around toward the back in an extended abdominoplasty.RegardsDamien

Jake Lim, MBBS, FRACS · Answer

HiThe placement of the scar really depends on how much and where skin laxity is so that the scar can be well hidden within your garment. However, minor adjustments may be made to alter the shape of the scar to suit your preference.

Terrence Scamp, MBBS, FRACS · Answer

Hi there The placement of the scar is determined by the degree of laxity [excess skin ] and the natural curves of your lower torso .Generally we try to place the scars as low as possible so they are easily concealed by minimal clothing , and we take measures to try to optimize scar quality .This should mean in the long-run that you can enjoy your new shape without too much inhibition from the scars .CheersTerrence

Jerome Edelstein, MD · Answer

Hello,Thank you for your question. The incision is usually made across the lower abdomen, a little above the pubic area and beneath the bathing suit line. An incision is also made around the belly button to free it from the surrounding skin. I ask my patients to bring in a favorite pair of underwear so that we can use this as a guide for planning. Factors such as the amount of excess skin available and the patient's personal preference are used to place Abdominal incisions.I recommend that you discuss these specifics with your Plastic Surgeon.All the best

Dean Trotter, MBBS, FRACS · Answer

The decision regarding tummy tuck scar placement involves considering factors such as the patient's body shape, any previous scars and patient clothing preference, particularly type of bikini.  It therefore varies from patient to patient and is even influenced by fashion trends.As a general rule, a low scar at the front and then a higher position across the hips will be hidden in most underwear/bikini types and will give good long term results.Kind regards,Dean

Naveen Somia, MBBS, PhD, FRACS · Answer

Dear GabiThanks for posting your questionTo some extent, Surgeons preference and patients expectations decide the placement of the scar. TT scars can be cleverly concealed to stay within a bikini. You need to mention this to your PS at your consultation.Best wishes

Tom J. Pousti, MD · Answer

Thank you for the question. The main determinant of the tummy tuck incision and resulting scar line is the patient's body type.  Ideally the incision and resulting skyline is kept as little as possible,  planned to be hidden beneath undergarments and swimming suit.If the patient has a significant amount of redundant skin (especially about the umbilicus)  then the incision and resulting scar line  of the tummy tuck may be kept  very low. On the other hand, if the patient has a short torso and/or very little skin above the umbilicus then the  incision and scar line may need to be placed higher.  Sometimes a short vertical scar is also necessary (previous umbilical opening).Also, the longer the incision used, the more skin/tissue that can be removed from the patient's sides;  often this allows for improved  contouring of the patient's “flanks” (or "love handles" or "muffin top" areas. Also, the placement of the tummy tuck incision may also influence the ability of the plastic surgeon to  improve the appearance of the pubic area as well. Therefore, careful communication between patient and plastic surgeon is important when planning the tummy tuck procedure. Patient's priorities should be considered   heavily during the planning process. In my practice, I find it very helpful to mark the patients as much as possible the day before surgery with the patient's  undergarment/swimming suit as a guide. Patients can then consider the markings overnight and adjustments can be made the morning of surgery as necessary. I hope this, and the attached link, helps.

Robert T. Buchanan, MD (retired) · Answer

Tummy tuck scars can be placed where they will be invisible in certain clothes. I once did a mother and daughter and did different scar placement on each. The daughter wanted to wear a bikini and hide the scar so we did a low scar which was completely hidden under her bikini. The mother, however, wanted to wear a french cut one piece bathing suit and never wore bikini panties. Her scar was placed higher laterally so it, too, was completely hidden in what she wore. Discuss your desires with your board certified plastic surgeon.

Elliot Duboys, MD, FACS (retired) · Answer

Depends on how much skin has to be removed.  If you have a large, overhanging abdomen, the scar has to be longer.  If the redundancy is central, a small incision can be used.

How do you decide where to place a tummy tuck scar?

Answers (10)

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