Vertical incisions in abdominoplasty
The quick answer to your question is yes. This procedure is commonly known as a vertical abdominoplasty of a fleur de lis abdominoplasty. It is a very powerful addition to a standard abdominoplasty to aid in waist definition and to rid the laxity that can be present in the vertical dimension as a result of significant weight loss.
Most tt incisions are horizontal, but occasionally a vertical component is utilized in the lower abdomen. The vertical component in my opinion should only be rarely used in cases of excessive skin, as most times a great result can be obtained with only the horizontal incision.
I have linked to a tt of a massive weight loss patient for an example.
All the best.
The standard tummy tuck incision is a low horizontal incision just above the pubic hairline and extending to the sides. In cases of skin excess in the horizontal and vertical orientations - most commonly seen after significant weight loss, it might be better to remove skin vertically as well. In this case, one will have BOTH a vertical and horizontal scar. Good luck- J. Vicente Poblete, MD, FACS, Avon, Ohio.
In cases in where there has been substantial weight loss, it is sometimes necessary to remove skin both horizontally and vertically. This ends up being a T-shaped scar going from the rib cage to the pubis vertically and extending from hip bone to hip bone horizontally. I will use this method not infrequently in patients who already have a vertical scar. Try to find a plastic surgeon in your area with experience in post bariatric surgical patients. Good luck.
Fleur De Lis Abdominoplasty
Yes this combination can be performed. The right question is in whom and why? In patients who have had a prior vertical incision (open weight loss surgery or other) where the scar goes above the belly button, it makes sense to use that scar to further tighten the abdomen.
Fleur de Lis (Horizontal and Vertical Scar) Abdominiplasty
In the largest skin excess cases which are often in people who lose large amounts of weight we have to remove this excess skin by using both s vertical and s transverse scar in what is called a Lilly Flower ( Fleur de Lis ) Abdominoplasty. I performed one yesterday.
Peter Aldea MD