When is there a need for a vertical incision during a Tummy Tuck?

My doctor was explaining the need for a possible additional incision vertically for a tummy tuck. I thought he was suggesting this may be needed because of my petite frame-but was confused.

Doctor Answers 14

When is a vertical incision needed in tummy tuck

A vertical incision is needed in two situations:  First, if  a patient has an extreme excess of abdominal tissue generally following massive weight loss.  In this situation, it is sometimes best to do both a vertical and horizontal incision in an effort to redistribute the excessive amount of excess skin.   The second situation is if your have minimal laxity of the skin between your belly button and pubic area.   In this instance you may end up with a small vertical incision which represents the closure of your belly button.   Most patients can avoid this incision by pulling the tissue tighter, but on occasion the tissue will not reach down to the pubic area thus requiring the small vertical closure.   If you have questions about your procedure, always meet with your surgeon a second time so that your are fully informed.   

New York Plastic Surgeon
5.0 out of 5 stars 21 reviews

Vertical incision

Thanks for the question.

I RARELY ever use a vertical incision with an abdominoplasty.  Your surgeon may have been referring to a residual vertical scar where your old belly button hole ends up down by your pubis if you are too tight to advance your skin down.

You should speak to your Plastic Surgeon again to clarify the scar and maybe consult with another board certified surgeon or two for other opinions.

Dr T

Douglas Taranow, DO, FACOS
New York Plastic Surgeon
4.8 out of 5 stars 52 reviews

Vertical Incision with Tummy Tuck

Without a photo or seeing you in person, hard to say. A vertical incision is sometimes necessary with patients who have lost a considerable amount of weight and have a significant amount of excess skin. The best person to ask is your surgeon who has assessed you in person. Hope this helps.


Kouros Azar

Kouros Azar, MD
Thousand Oaks Plastic Surgeon
4.8 out of 5 stars 21 reviews

Vertical Incision during tummy tuck

Thank you for your question.

There are several situations in which a vertical incision may be needed during tummy tuck.  The first is typically in small patient with minimal excess skin.  The vertical incision exists because when the belly button is incised roughly as a circle and the abdominal skin pulled down the circle (from the belly button) cannot be pulled low enough to meet the low transverse incision.  This circle is typically closed in a vertical fashion and is in the lower abdomen.

The other situation is when a patient that has extra skin and fat in the transverse or horizontal direction typically following bariatric surgery or massive weight loss desires abdominoplasty.  A fleur di lis abdominoplasty can be performed that removes excess skin from the horizontal and vertical directions and allows proper contouring for these patients.

A third situation would be if a patient already has a vertical midline incision such as from previous abdominal surgery.  I am sure there are other special situations that exist but these are what comes to mind.

Best Dr. L

Andre Levesque, MD
Austin Plastic Surgeon
5.0 out of 5 stars 1 review

Vertical addition to Tummytuck Incision

Hard to answer without exam or photos, but usually necessary in patients with limited redundant skin who need full Tummytuck to address weak abdominal wall, or patients with significant redundant skin. Sounds confusing, but easy to explain in person. Be sure to consult with a board certified plastic surgeon. Good luck!

Robert M. Tornambe, MD
New York Plastic Surgeon
5.0 out of 5 stars 24 reviews

Vertical incision and tummy tuck

I will often reserve this for massive weight loss patients and/or patients with a previous midline vertical scar extending to their upper abdomen.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

When is there a need for a vertical incision during a Tummy Tuck?

These problems can be seen in any part of body but especially in abdominal area. Tummy tuck (abdominoplasty) is a surgical procedure to make the abdomen thinner and more firm. It consists of removing excess skin and fat tissue and muscle repairing if required. In some patients it can be combined with liposuction. There are several variations of tummy tuck surgery like regular tummy tuck, mini tummy tuck, extended tummy tuck each designed to target certain areas of the abdomen. During the procedure the incision will be made low at about the same level as your pubic hair for the scar to be hidden under bikini level. For improved tightening of the upper abdomen a small incision around belly button might be necessary. Placement of the belly button is very important for a beautiful belly. Tummy tuck operation is also a surgical choice for patients whom want to get rid of love handles. Our experienced plastic surgeons will explain these options and help you find out best treatment plan to reach satisfactory results.

Bulent Cihantimur, MD
Turkey Plastic Surgeon
4.9 out of 5 stars 80 reviews

Vertical incision for Tummy Tuck

Thanks for reaching out.  Sometimes when your excess skin requires a tummy tuck but there is not so much excess that the skin from above your belly button will reach the low tummy tuck incision, a small vertical scar will be seen where you belly button used to be attached to your abdominal skin.  Your belly button is cut away from your abdominal skin so the entire skin flap can be pulled down and the excess is cut away.  The vertical scar only comes into play if the hole on your abdominal skin where your belly button used be attached doesn't move enough to be included in what is cut away.  I know this may be difficult to visualize.  Feel free to come in person to talk in more detail.

I hope this helps :)

John Paul Tutela, MD
Livingston Plastic Surgeon
5.0 out of 5 stars 29 reviews

Verticle Scar

There are times that the excess skin that needs to be removed as part of a tummy tuck cannot be removed completely by a traditional horizontal tummy tuck incision.  When that skin excess is more horizontally located, the addition of a vertical scar allows for there to be better tapering.  It can also lead to the horizontal scar being shorter since some of the excess skin can be removed through the vertical incision.  If you don't completely understand your surgeon's explanation it would make sense to ask him again and I am sure that he will help clarify it for you.

Isaac Starker, MD
Morristown Plastic Surgeon
5.0 out of 5 stars 5 reviews

Dr Kayser

Thank you for your question. The need for having a vertical extension in a tummy tuck will depend on whether or not there is excess skin around the abdomen in a circumferential or horizontal plane. What this means is that patients who gain weight, or through pregnancy expand the abdomen, do so not unlike a balloon being blown up...this occurs in 360 degrees and in all vectors or directions. When a traditional tummy tuck is performed, excess skin is removed below the belly button in an elliptical fashion that goes from hip to hip. The upper skin is then pulled down which takes care of the vertical skin access. This does nothing to take care of the skin that goes around the trunk or abdomen in the horizontal plane. The only way to remove this would be to take out a vertical ellipse in the middle of the abdomen which would necessarily leave you with a vertical scar. Most patients are willing to accept the extra skin from side to side because they do not want this added scar. These type of procedures also increase the risk of wound break down so it may be prudent for you to have your regular tummy tuck first and then come back and have the second skin excision at a second procedure if it is necessary. I would look for photos and talk to your plastic surgeon about this. I hope this helps and have a wonderful day. Dr. Kayser -  Detroit

Melek Kayser, MD
Detroit Plastic Surgeon
4.9 out of 5 stars 31 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.